scholarly journals Alternative Paradigm of Selective Vagus Nerve Stimulation Tested on an Isolated Porcine Vagus Nerve

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Polona Pečlin ◽  
Janez Rozman
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Fibre Type ◽  
Vagus Nerve Stimulation ◽  
Experimental Testing ◽  
Present Stage ◽  
Stage Of Development ◽  
Isolated Segment ◽  
Left Vagus ◽  
Stimulation Of

Alternative paradigm for spatial and fibre-type selective vagus nerve stimulation (VNS) was developed using realistic structural topography and tested in an isolated segment of a porcine cervical left vagus nerve (LVN). A spiral cuff (cuff) containing a matrix of ninety-nine electrodes was developed for selective VNS. A quasitrapezoidal stimulating pulse (stimulus) was applied to the LVN via an appointed group of three electrodes (triplet). The triplet and stimulus were configured to predominantly stimulate the B-fibres, minimizing stimulation of the A-fibres and by-passing the stimulation of the C-fibres. To assess which fibres made the most probable contribution to the neural response (NR) during selective VNS, the distribution of conduction velocity (CV) within the LVN was considered. Experimental testing of the paradigm showed the existence of certain parameters and waveforms of the stimulus, for which the contribution of the A-fibres to the NR was slightly reduced and that of the B-fibres was slightly enlarged. The cuff provided satisfactory fascicle discrimination in selective VNS as well as satisfactory fascicle discrimination during NR recording. However, in the present stage of development, fibre-type VNS remained rather limited.

scholarly journals Complete section of the left vagus nerve does not preclude the efficacy of vagus nerve stimulation: illustrative case

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Alice Noris ◽  
Paolo Roncon ◽  
Simone Peraio ◽  
Anna Zicca ◽  
Matteo Lenge ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Vocal Cord ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Neurological Deficits ◽  
Vocal Cord Dysfunction ◽  
Illustrative Case ◽  
Nerve Section ◽  
Complete Section ◽  
Left Vagus

BACKGROUND Vagus nerve stimulation (VNS) represents a valid therapeutic option for patients with medically intractable seizures who are not candidates for epilepsy surgery. Even when complete section of the nerve occurs, stimulation applied cranially to the involved nerve segment does not preclude the efficacy of VNS. Complete vagus nerve section with neuroma causing definitive left vocal cord palsy has never been previously reported in the literature. OBSERVATIONS Eight years after VNS implant, the patient experienced worsening of seizures; the interrogation of the generator revealed high impedance requiring surgical revision. On surgical exploration, complete left vagus nerve section and a neuroma were found. Vocal cord atrophy was found at immediate postoperative laryngeal inspection as a confirmation of a longstanding lesion. Both of these events might have been caused by direct nerve injury during VNS surgery, and they presented in a delayed fashion. LESSONS VNS surgery may be complicated by direct damage to the left vagus nerve, resulting in permanent neurological deficits. A complete section of the nerve also enables an efficacious stimulation if applied cranially to the involved segment. Laryngeal examination should be routinely performed before each VNS surgery to rule out preexisting vocal cord dysfunction.

Complete Atrioventricular Nodal Block in Patient Undergoing Left Vagus Nerve Stimulation: A case report

2005 ◽  
Vol 49 (4) ◽  
pp. 578
Author(s):  
Young Kug Kim ◽  
Gyu Sam Hwang ◽  
In Young Huh ◽  
Hyung Seok Seo ◽  
Su Jin Kang ◽  
...  
Keyword(s):  
Case Report ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Complete Atrioventricular ◽  
Left Vagus

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.

scholarly journals REFRACTORY EPILEPSY AND VAGUS NERVE STIMULATION: THE WAY FORWARD

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Bhupendra Chaudhary ◽  
Ansh Chaudhary
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Pulse Generator ◽  
Refractory Epilepsy ◽  
Cardiac Innervation ◽  
On Demand ◽  
The Poor ◽  
Us Fda ◽  
Left Vagus

Vagus Nerve Stimulation (VNS) an efficacious neurophysiological modality of treatment for both medically & surgically refractory epilepsy was first implanted in 1988 & later approved by US FDA in 1997. In clinical practice, trains of current are applied intermittently to the left vagus using a pacemaker or AICD like device 'the VNS device'. The device has four components pulse generator, lead, spiral electrodes & a magnet. The pulse generator is implanted beneath left clavicle by a simple surgical method & attached to left vagus nerve via lead & spiral electrodes.[1] The magnet provides an extra edge to control the aura or impending seizure by providing 'On Demand' stimulations. The poor cardiac innervation by left vagus helps to minimize the unwanted or at time dangerous side effects like severe bradycardia, brady arrythmia, or even cardiac asystole.[2]  

Left vagus nerve stimulation suppresses experimentally induced pain

Neurology ◽  
2001 ◽  
Vol 56 (7) ◽  
pp. 985-986 ◽  
Author(s):  
T. J. Ness ◽  
A. Randich ◽  
R. Fillingim ◽  
R. E. Faught ◽  
E. M. Backensto ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Left Vagus ◽  
Experimentally Induced

Vagus nerve stimulation: quality control in thyroid and parathyroid surgery

2000 ◽  
Vol 114 (2) ◽  
pp. 125-127 ◽  
Author(s):  
A. W. Lambert ◽  
C. Cosgrove ◽  
J. Barwell ◽  
S. Oxenham ◽  
D. C. Wilkins
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Vocal Fold ◽  
Contralateral Side ◽  
Equipment Failure ◽  
Parathyroid Surgery ◽  
Initial Identification ◽  
Vocal Fold Palsy ◽  
Stimulation Of

This paper describes the use of the Neurosign 100 Nerve Monitor and vagus nerve stimulation in the identification and assessment of the integrity of the recurrent laryngeal nerve (RLN) during thyroid and parathyroid surgery.Vocal fold function was assessed pre- and post-operatively in all patients undergoing thyroid and parathyroid surgery. The nerve monitor, used in association with endotracheal electrodes, was used to confirm correct RLN identification and demonstrate its integrity at the completion of surgery.There were 21 unilateral and 19 bilateral neck explorations. In these 40 patients, 57 of 59 RLNs were identified. The nerve monitor demonstrated RLN continuity in all but one case (equipment failure: electrode misplacement) after initial identification. Vagus nerve stimulation was performed in 21 patients without adverse sequelae. Damage to the RLN was identified in one of these patients, in whom direct RLN stimulation close to the larynx had failed to indicate discontinuity. Post-operatively this patient had a transient unilateral vocal fold palsy.The use of the Neurosign 100 Nerve Monitor is no substitute for meticulous surgery. Stimulation of the vagus nerve may be a more sensitive means of assessing RLN integrity during thyroid and parathyroid surgery than stimulation of the RLN itself. Confirmation of RLN integrity allows the surgeon to proceed with confidence to the contralateral side of the neck during hazardous bilateral explorations.

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.

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