Epilepsy, Electroacupuncture and the Nucleus of the Solitary Tract

2006 ◽  
Vol 24 (4) ◽  
pp. 164-168 ◽  
Author(s):  
Yusuf Ozgur Cakmak
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagal Afferents ◽  
Auricular Acupuncture ◽  
Acupuncture Points ◽  
Solitary Tract ◽  
Laboratory Findings ◽  
Afferent Pathways ◽  
The Brain ◽  
Stimulation Of

Vagal nerve stimulation and electroacupuncture have some promise as neuroprotective therapies for patients with poorly controlled epilepsy. It has been demonstrated that stimulation of acupuncture points on the extremities results in stimulation of the vagus nerve. It is possible that the antiepileptic effects of these two applications might be targeting the same centre in the brain. The nucleus of the solitary tract, which is a primary site at which vagal afferents terminate, is also the site for afferent pathways of facial, scalp and auricular acupuncture via trigeminal, cervical spinal and glossopharyngeal nerves. Taken together with laboratory findings, the neuroprotective pathways of electroacupuncture in epileptic models may stem from the collaboration of its anti-inflammatory and neurotrophic actions through the nucleus of the solitary tract via vagus nerve stimulation.

Somatosensory Evoked Potentials in the Investigation of Auricular Acupuncture Points

2000 ◽  
Vol 18 (1) ◽  
pp. 2-9 ◽  
Author(s):  
Nadia Volf
Keyword(s):  
Gall Bladder ◽  
Nerve Stimulation ◽  
Brain Area ◽  
Intercostal Nerve ◽  
Auricular Acupuncture ◽  
Acupuncture Points ◽  
Somatosensory Area ◽  
Auricular Point ◽  
Median Nerve Stimulation ◽  
Stimulation Of

A preliminary study correlating the wrist and gall bladder body areas with their auricular acupuncture points, through recording the somatosensory evoked potentials (SEP) at the corresponding brain localisation, showed that stimulation of the “Wrist” auricular point activates the primary cortical somatosensory area of the upper extremity on the contralateral hemisphere in a similar way to direct median nerve stimulation. A “placebo” point 5 to 8mm from the “Wrist” auricular point was used as a control: no activation in the brain area was observed. In patients with post-stroke hemiplegia, SEP traces obtained both by direct median nerve stimulation at the wrist, and by stimulation of the “wrist” auricular point, were altered in a similar manner and only on the damaged side. Similarly, “gall bladder” auricular point stimulation activates the corresponding cortical somatosensory area in the same way as direct stimulation of the T7 intercostal nerve. Again, a “placebo” point, 5 to 8mm away from the “Gall bladder” auricular point, was used as a control, and activation in the brain area was not observed. Also, in patients with cholelithiasis, both the SEP traces evoked by T7 direct intercostal nerve stimulation and those evoked by “Gall bladder” auricular point stimulation were altered in the same manner. These results demonstrate that there is correlation between the activation of specific areas of brain cortex and stimulation of their corresponding auricular acupuncture points, and indicate a convergence into the same cortical somatosensory area of nerve impulses coming from the body organ itself and from the auricular point corresponding to that organ. This might be taken as suggesting neurological support for a functional somatic relationship of auricular points.

scholarly journals Vagus nerve stimulation for primary headache disorders: An anatomical review to explain a clinical phenomenon

Cephalalgia ◽  
2019 ◽  
Vol 39 (9) ◽  
pp. 1180-1194 ◽  
Author(s):  
Dylan Jozef Hendrik Augustinus Henssen ◽  
Berend Derks ◽  
Mats van Doorn ◽  
Niels Verhoogt ◽  
Anne-Marie Van Cappellen van Walsum ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Trigeminal Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Primary Headache ◽  
Solitary Tract ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Non Invasive ◽  
Stimulation Of

Background Non-invasive stimulation of the vagus nerve has been proposed as a new neuromodulation therapy to treat primary headache disorders, as the vagus nerve is hypothesized to modulate the headache pain pathways in the brain. Vagus nerve stimulation can be performed by placing an electrode on the ear to stimulate the tragus nerve, which contains about 1% of the vagus fibers. Non-invasive vagus nerve stimulation (nVNS) conventionally refers to stimulation of the cervical branch of the vagus nerve, which is made up entirely of vagal nerve fibers. While used interchangeably, most of the research to date has been performed with nVNS or an implanted vagus nerve stimulation device. However, the exact mechanism of action of nVNS remains hypothetical and no clear overview of the effectiveness of nVNS in primary headache disorders is available. Methods In the present study, the clinical trials that investigated the effectiveness, tolerability and safety of nVNS in primary headache disorders were systematically reviewed. The second part of this study reviewed the central connections of the vagus nerve. Papers on the clinical use of nVNS and the anatomical investigations were included based on predefined criteria, evaluated, and results were reported in a narrative way. Results The first part of this review shows that nVNS in primary headache disorders is moderately effective, safe and well-tolerated. Regarding the anatomical review, it was reported that fibers from the vagus nerve intertwine with fibers from the trigeminal, facial, glossopharyngeal and hypoglossal nerves, mostly in the trigeminal spinal tract. Second, the four nuclei of the vagus nerve (nuclei of the solitary tract, nucleus ambiguus, spinal nucleus of the trigeminal nerve and dorsal motor nucleus (DMX)) show extensive interconnections. Third, the efferents from the vagal nuclei that receive sensory and visceral input (i.e. nuclei of the solitary tract and spinal nucleus of the trigeminal nerve) mainly course towards the main parts of the neural pain matrix directly or indirectly via other vagal nuclei. Conclusion The moderate effectiveness of nVNS in treating primary headache disorders can possibly be linked to the connections between the trigeminal and vagal systems as described in animals.

scholarly journals Vagus nerve stimulation increases stomach-brain coupling via a vagal afferent pathway

2021 ◽  
Author(s):  
Sophie J Mueller ◽  
Vanessa Teckentrup ◽  
Ignacio Rebollo ◽  
Manfred Hallschmid ◽  
Nils B Kroemer
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Energy Homeostasis ◽  
Solitary Tract ◽  
Afferent Pathway ◽  
Preclinical Research ◽  
Novel Treatments ◽  
Induced Changes ◽  
The Brain

Maintaining energy homeostasis is vital and supported by vagal signaling between digestive organs and the brain. Previous research has established a gastric network in the brain that is phase synchronized with the rhythm of the stomach, but tools to perturb its function were lacking. Here, we investigated the effect of acute right-sided transcutaneous auricular vagus nerve stimulation (taVNS) versus sham stimulation (randomized crossover-design) on stomach-brain coupling. In line with preclinical research, taVNS increased stomach-brain coupling in the nucleus of the solitary tract (NTS) and the midbrain while boosting coupling across the brain. Crucially, in the cortex, taVNS-induced changes in coupling occurred primarily in transmodal regions and were associated with changes in hunger ratings as indicators of the subjective metabolic state. Hence, taVNS alters stomach-brain coupling via an NTS-midbrain pathway that signals gut-induced reward, potentially paving the way for novel treatments in disorders such as Parkinson's disease or depression.

scholarly journals Cervical vagus nerve stimulation augments spontaneous discharge in second- and higher-order sensory neurons in the rat nucleus of the solitary tract

2017 ◽  
Vol 313 (2) ◽  
pp. H354-H367 ◽  
Author(s):  
Eric Beaumont ◽  
Regenia P. Campbell ◽  
Michael C. Andresen ◽  
Stephanie Scofield ◽  
Krishna Singh ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Higher Order ◽  
Second Order ◽  
Vagal Afferents ◽  
Visceral Afferents ◽  
Solitary Tract ◽  
C Fiber ◽  
Vagal Afferent

Vagus nerve stimulation (VNS) currently treats patients with drug-resistant epilepsy, depression, and heart failure. The mild intensities used in chronic VNS suggest that primary visceral afferents and central nervous system activation are involved. Here, we measured the activity of neurons in the nucleus of the solitary tract (NTS) in anesthetized rats using clinically styled VNS. Our chief findings indicate that VNS at threshold bradycardic intensity activated NTS neuron discharge in one-third of NTS neurons. This VNS directly activated only myelinated vagal afferents projecting to second-order NTS neurons. Most VNS-induced activity in NTS, however, was unsynchronized to vagal stimuli. Thus, VNS activated unsynchronized activity in NTS neurons that were second order to vagal afferent C-fibers as well as higher-order NTS neurons only polysynaptically activated by the vagus. Overall, cardiovascular-sensitive and -insensitive NTS neurons were similarly activated by VNS: 3/4 neurons with monosynaptic vagal A-fiber afferents, 6/42 neurons with monosynaptic vagal C-fiber afferents, and 16/21 polysynaptic NTS neurons. Provocatively, vagal A-fibers indirectly activated C-fiber neurons during VNS. Elevated spontaneous spiking was quantitatively much higher than synchronized activity and extended well into the periods of nonstimulation. Surprisingly, many polysynaptic NTS neurons responded to half the bradycardic intensity used in clinical studies, indicating that a subset of myelinated vagal afferents is sufficient to evoke VNS indirect activation. Our study uncovered a myelinated vagal afferent drive that indirectly activates NTS neurons and thus central pathways beyond NTS and support reconsideration of brain contributions of vagal afferents underpinning of therapeutic impacts. NEW & NOTEWORTHY Acute vagus nerve stimulation elevated activity in neurons located in the medial nucleus of the solitary tract. Such stimuli directly activated only myelinated vagal afferents but indirectly activated a subpopulation of second- and higher-order neurons, suggesting that afferent mechanisms and central neuron activation may be responsible for vagus nerve stimulation efficacy.

scholarly journals Evidence of activation of vagal afferents by non-invasive vagus nerve stimulation: An electrophysiological study in healthy volunteers

Cephalalgia ◽  
2017 ◽  
Vol 37 (13) ◽  
pp. 1285-1293 ◽  
Author(s):  
Romain Nonis ◽  
Kevin D’Ostilio ◽  
Jean Schoenen ◽  
Delphine Magis
Keyword(s):  
Vagus Nerve ◽  
Healthy Volunteers ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Electrophysiological Study ◽  
Vagal Afferents ◽  
Response Analysis ◽  
Bipolar Electrode ◽  
Non Invasive ◽  
Vagal Afferent

Background Benefits of cervical non-invasive vagus nerve stimulation (nVNS) devices have been shown in episodic cluster headache and preliminarily suggested in migraine, but direct evidence of vagus nerve activation using such devices is lacking. Vagal somatosensory evoked potentials (vSEPs) associated with vagal afferent activation have been reported for invasive vagus nerve stimulation (iVNS) and non-invasive auricular vagal stimulation. Here, we aimed to show and characterise vSEPs for cervical nVNS. Methods vSEPs were recorded for 12 healthy volunteers who received nVNS over the cervical vagus nerve, bipolar electrode/DS7A stimulation over the inner tragus, and nVNS over the sternocleidomastoid (SCM) muscle. We measured peak-to-peak amplitudes (P1-N1), wave latencies, and N1 area under the curve. Results P1-N1 vSEPs were observed for cervical nVNS (11/12) and auricular stimulation (9/12), with latencies similar to those described previously, whereas SCM stimulation revealed only a muscle artefact with a much longer latency. A dose-response analysis showed that cervical nVNS elicited a clear vSEP response in more than 80% of the participants using an intensity of 15 V. Conclusion Cervical nVNS can activate vagal afferent fibres, as evidenced by the recording of far-field vSEPs similar to those seen with iVNS and non-invasive auricular stimulation.

scholarly journals Non-invasive stimulation of vagal afferents reduces gastric frequency

2019 ◽  
Author(s):  
Vanessa Teckentrup ◽  
Sandra Neubert ◽  
João C. P. Santiago ◽  
Manfred Hallschmid ◽  
Martin Walter ◽  
...  
Keyword(s):  
Energy Expenditure ◽  
Vagus Nerve ◽  
Energy Homeostasis ◽  
Resting Energy Expenditure ◽  
Vagal Afferents ◽  
Metabolic Effects ◽  
Net Energy ◽  
Non Invasive ◽  
Induced Changes ◽  
Stimulation Of

AbstractMetabolic feedback between the gut and the brain relayed via the vagus nerve contributes to energy homeostasis. We investigated in healthy adults whether non-invasive stimulation of vagal afferents impacts energy homeostasis via efferent effects on metabolism or digestion. In a randomized crossover design, we applied transcutaneous auricular vagus nerve stimulation (taVNS) while recording efferent metabolic effects using simultaneous electrogastrography (EGG) and indirect calorimetry. We found that taVNS reduced gastric myoelectric frequency (p =.008), but did not alter resting energy expenditure. We conclude that stimulating vagal afferents induces gastric slowing via vagal efferents without acutely affecting net energy expenditure at rest. Collectively, this highlights the potential of taVNS to modulate digestion by activating the dorsal vagal complex. Thus, taVNS-induced changes in gastric frequency are an important peripheral marker of brain stimulation effects.

Responses and Afferent Pathways of Superficial and Deeper C1–C2 Spinal Cells to Intrapericardial Algogenic Chemicals in Rats

2001 ◽  
Vol 85 (4) ◽  
pp. 1522-1532 ◽  
Author(s):  
Chao Qin ◽  
Margaret J. Chandler ◽  
Kenneth E. Miller ◽  
Robert D. Foreman
Keyword(s):  
Afferent Input ◽  
Vagal Afferents ◽  
Male Rats ◽  
Prostaglandin E ◽  
Joint Movement ◽  
Spinal Neurons ◽  
Afferent Pathways ◽  
Bilateral Vagotomy ◽  
Cardiac Afferents ◽  
Stimulation Of

Electrical stimulation of vagal afferents or cardiopulmonary sympathetic afferent fibers excites C1–C2spinal neurons. The purposes of this study were to compare the responses of superficial (depth <0.35 mm) and deeper C1–C2 spinal neurons to noxious chemical stimulation of cardiac afferents and determine the relative contribution of vagal and sympathetic afferent pathways for transmission of noxious cardiac afferent input to C1–C2 neurons. Extracellular potentials of single C1–C2 neurons were recorded in pentobarbital anesthetized and paralyzed male rats. A catheter was placed in the pericardial sac to administer a mixture of algogenic chemicals (0.2 ml) that contained adenosine (10− 3 M), bradykinin, histamine, serotonin, and prostaglandin E2(10− 5 M each). Intrapericardial chemicals changed the activity of 20/106 (19%) C1–C2 spinal neurons in the superficial laminae, whereas 76/147 (52%) deeper neurons responded to cardiac noxious input ( P < 0.01). Of 96 neurons responsive to cardiac inputs, 48 (50%) were excited (E), 41 (43%) were inhibited (I), and 7 were excited/inhibited (E-I) by intrapericardial chemicals. E or I neurons responsive to intrapericardial chemicals were subdivided into two groups: short-lasting (SL) and long-lasting (LL) response patterns. In superficial gray matter, excitatory responses to cardiac inputs were more likely to be LL-E than SL-E neurons. Mechanical stimulation of the somatic field from the head, neck, and shoulder areas excited 85 of 95 (89%) C1–C2 spinal neurons that responded to intrapericardial chemicals; 31 neurons were classified as wide dynamic range, 49 were high threshold, 5 responded only to joint movement, and no neuron was classified as low threshold. For superficial neurons, 53% had small somatic fields and 21% had bilateral fields. In contrast, 31% of the deeper neurons had small somatic fields and 46% had bilateral fields. Ipsilateral cervical vagotomy interrupted cardiac noxious input to 8/30 (6 E, 2 I) neurons; sequential transection of the contralateral cervical vagus nerve (bilateral vagotomy) eliminated the responses to intrapericardial chemicals in 4/22 (3 E, 1 I) neurons. Spinal transection at C6–C7 segments to interrupt effects of sympathetic afferent input abolished responses to cardiac input in 10/10 (7 E, 3 I) neurons that still responded after bilateral vagotomy. Results of this study support the concept that C1–C2 superficial and deeper spinal neurons play a role in integrating cardiac noxious inputs that travel in both the cervical vagal and/or thoracic sympathetic afferent nerves.

scholarly journals Central-peripheral neural network interactions evoked by vagus nerve stimulation: functional consequences on control of cardiac function

2015 ◽  
Vol 309 (10) ◽  
pp. H1740-H1752 ◽  
Author(s):  
Jeffrey L. Ardell ◽  
Pradeep S. Rajendran ◽  
Heath A. Nier ◽  
Bruce H. KenKnight ◽  
J. Andrew Armour
Keyword(s):  
Cardiac Function ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Vagal Afferents ◽  
Intact State ◽  
Mediated Effects ◽  
Functional Consequences ◽  
Anesthetized Dogs ◽  
The Right

Using vagus nerve stimulation (VNS), we sought to determine the contribution of vagal afferents to efferent control of cardiac function. In anesthetized dogs, the right and left cervical vagosympathetic trunks were stimulated in the intact state, following ipsilateral or contralateral vagus nerve transection (VNTx), and then following bilateral VNTx. Stimulations were performed at currents from 0.25 to 4.0 mA, frequencies from 2 to 30 Hz, and a 500-μs pulse width. Right or left VNS evoked significantly greater current- and frequency-dependent suppression of chronotropic, inotropic, and lusitropic function subsequent to sequential VNTx. Bradycardia threshold was defined as the current first required for a 5% decrease in heart rate. The threshold for the right vs. left vagus-induced bradycardia in the intact state (2.91 ± 0.18 and 3.47 ± 0.20 mA, respectively) decreased significantly with right VNTx (1.69 ± 0.17 mA for right and 3.04 ± 0.27 mA for left) and decreased further following bilateral VNTx (1.29 ± 0.16 mA for right and 1.74 ± 0.19 mA for left). Similar effects were observed following left VNTx. The thresholds for afferent-mediated effects on cardiac parameters were 0.62 ± 0.04 and 0.65 ± 0.06 mA with right and left VNS, respectively, and were reflected primarily as augmentation. Afferent-mediated tachycardias were maintained following β-blockade but were eliminated by VNTx. The increased effectiveness and decrease in bradycardia threshold with sequential VNTx suggest that 1) vagal afferents inhibit centrally mediated parasympathetic efferent outflow and 2) the ipsilateral and contralateral vagi exert a substantial buffering capacity. The intact threshold reflects the interaction between multiple levels of the cardiac neural hierarchy.

Aortic nerve-activated cardioinhibitory neurons and interneurons

1975 ◽  
Vol 229 (3) ◽  
pp. 783-789 ◽  
Author(s):  
J Schwaber ◽  
N Schneiderman
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Baroreceptor Reflex ◽  
Motor Nucleus ◽  
Vagus Nerves ◽  
Antidromic Activation ◽  
Medial Nucleus ◽  
Aortic Nerve ◽  
Dorsal Motor Nucleus ◽  
Stimulation Of

Unit activity evoked by electrical stimulation of the aortic and vagus nerves was recorded in the dorsal motor nucleus and nucleus solitarius of unanesthetized rabbits. Cardioinhibitory cells which showed antidromic activation to stimulation of the vagus nerve and synaptic activation to stimulation of the aortic nerve were localized in lateral dorsal motor nucleus 0.5-0.8 mm anterior of the obex. Additionally, units were found that appeared to be interneurons in the medullary pathway subserving baroreceptor reflex effects on cardioinhibitory neurons. These cells were activated by aortic, and usually vagus, nerve stimulation, appeared to be polysynaptically activated, and were located in medial nucleus solitarius rostral to the obex. Neurons reflecting a cardiac rhythm but not activated by aortic nerve stimulation were also observed.

A literature review on the neurophysiological underpinnings and cognitive effects of transcutaneous vagus nerve stimulation: challenges and future directions

2020 ◽  
Vol 123 (5) ◽  
pp. 1739-1755
Author(s):  
Lorenza Colzato ◽  
Christian Beste
Keyword(s):  
Literature Review ◽  
Vagus Nerve ◽  
Brain Stimulation ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Cognitive Effects ◽  
Future Directions ◽  
Transcutaneous Vagus Nerve Stimulation ◽  
Stimulation Technique ◽  
Stimulation Of

Brain stimulation approaches are important to gain causal mechanistic insights into the relevance of functional brain regions and/or neurophysiological systems for human cognitive functions. In recent years, transcutaneous vagus nerve stimulation (tVNS) has attracted considerable popularity. It is a noninvasive brain stimulation technique based on the stimulation of the vagus nerve. The stimulation of this nerve activates subcortical nuclei, such as the locus coeruleus and the nucleus of the solitary tract, and from there, the activation propagates to the cortex. Since tVNS is a novel stimulation technique, this literature review outlines a brief historical background of tVNS, before detailing underlying neurophysiological mechanisms of action, stimulation parameters, cognitive effects of tVNS on healthy humans, and, lastly, current challenges and future directions of tVNS research in cognitive functions. Although more research is needed, we conclude that tVNS, by increasing norepineprine (NE) and gamma-aminobutyric acid (GABA) levels, affects NE- and GABA-related cognitive performance. The review provides detailed background information how to use tVNS as a neuromodulatory tool in cognitive neuroscience and outlines important future leads of research on tVNS.

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