title: Electrical pharyngeal stimulation increases substance P level in saliva.
abstract: Substance P (SP) is a neuropeptide known to enhance the swallow response. It likely acts as a neurotransmitter in the pharyngeal mucosa in response to local stimuli. It has been proposed that dysphagia after stroke may be related to reduced levels of SP, which therefore constitutes a therapeutic target. In the present pilot study, we evaluated whether electrical pharyngeal stimulation (EPS), a neuromodulation device to enhance cortical reorganization for the restoration of swallowing function after brain injury, is able to increase SP in saliva or serum.
  
  
  
  In a randomized crossover study design, 20 healthy volunteers were treated with 10 min of real (0.2-ms pulses, 5 Hz, 280 V, stimulation intensity (mA) individually adjusted to tolerance level) or sham EPS on two separate sessions. Stimulation was delivered via a pair of bipolar ring electrodes mounted on an intraluminal catheter positioned in the pharynx. Blood and saliva samples were taken prior to, during, and up to 1 h after EPS and analyzed for their SP concentration by ELISA.
  
  
  
  Following real EPS but not sham stimulation, SP levels in saliva increased immediately and significantly about 28% (p < 0.01) compared to baseline. Serum levels remained unchanged.
  
  
  
  Electrical pharyngeal stimulation is able to induce pharyngeal SP release in healthy subjects.
authors.affiliation: Department of Neurology, University Hospital Münster, Münster, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Suntrup-Krueger
authors.affiliation: Department of Neurology, University Hospital Münster, Münster, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Bittner
authors.affiliation: Department of Neurology, University Hospital Münster, Münster, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Recker
authors.affiliation: Department of Neurology, University Hospital Münster, Münster, Germany.
authors.forename: S G
authors.initials: SG
authors.lastname: Meuth
authors.affiliation: Department of Neurology, University Hospital Münster, Münster, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Warnecke
authors.affiliation: Department of Neurology, University Hospital Münster, Münster, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Suttrup
authors.affiliation: Department of Neurology, University Hospital Münster, Münster, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Marian
authors.affiliation: Department of Neurology, University Hospital Münster, Münster, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Dziewas
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D004558:Electric Stimulation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010614:Pharynx / Q000378:metabolism*; D010865:Pilot Projects; D012463:Saliva / Q000378:metabolism*; D013373:Substance P / Q000097:blood / Q000378:metabolism*; D055815:Young Adult
chemical_list: D013373:Substance P
keywords: electrical pharyngeal stimulation; neurogastroenterology; neurogenic dysphagia; substance P; swallowing