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https://www.readbyqxmd.com/read/29144720/cost-effectiveness-of-gammacore-non-invasive-vagus-nerve-stimulation-for-acute-treatment-of-episodic-cluster-headache
#1
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
Cluster headache is a debilitating disease characterized by excruciatingly painful attacks that affects 0.15% to 0.4% of the US population. Episodic cluster headache manifests as circadian and circannual seasonal bouts of attacks, each lasting 15 to 180 minutes, with periods of remission. In chronic cluster headache, the attacks occur throughout the year with no periods of remission. While existing treatments are effective for some patients, many patients continue to suffer. There are only 2 FDA-approved medications for episodic cluster headache in the United States, while others, such as high-flow oxygen, are used off-label...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144718/the-emerging-role-of-gammacore%C3%A2-in-the-management-of-cluster-headache-expert-panel-recommendations
#2
Stephen D Silberstein, Anne H Calhoun, Christina Treppendahl, David W Dodick, Alan M Rapoport, Avinash Mamidi, Peter Vargas, Thomas H Ebert, Stewart J Tepper
A panel of 9 experts, including neurologists, other headache specialists, and medical and pharmacy directors, from 4 health plans (1 integrated delivery network and 3 plans with commercial, Medicare, and Medicaid lines of business), convened to discuss cluster headache (CH). Topics covered included the current treatment landscape, treatment challenges, economic impact of disease, and gaps in care for patients with CH. One major challenge in the management of CH is that it is underrecognized and frequently misdiagnosed, leading to delays in and suboptimal treatment for patients who suffer from this painful and disabling condition...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144717/review-of-non-invasive-vagus-nerve-stimulation-gammacore-efficacy-safety-potential-impact-on-comorbidities-and-economic-burden-for-episodic-and-chronic-cluster-headache
#3
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
The FDA has cleared gammaCore (non-invasive vagus nerve stimulator [nVNS]) for the treatment of episodic cluster headache (eCH). With the exception of subcutaneous sumatriptan, all other treatments are used off label and have many limitations. The FDA approval process for devices differs from that of drugs. We performed a review of the literature to evaluate new evidence on various aspects of gammaCore treatment and impact. The ACute Treatment of Cluster Headache Studies (ACT1 and ACT2), both double-blind sham-controlled randomized trials, did not meet the primary endpoints of the trials but each demonstrated significant superiority of gammaCore among patients with eCH...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144716/mechanism-of-action-of-non-invasive-cervical-vagus-nerve-stimulation-for-the-treatment-of-primary-headaches
#4
Bruce Simon, Justyna Blake
Stimulation of the cervical vagus nerve with implanted vagus nerve stimulation (iVNS) has been used clinically for more than 20 years to treat patients with epilepsy. More recently, a non-invasive cervical vagus nerve stimulation (nVNS), gammaCore, was developed, which has been purported to also stimulate the vagus nerve without the cost and morbidity associated with an iVNS system. gammaCore has been used to acutely treat various types of primary headaches, including migraine and cluster headaches (CH), and for the prevention of episodic, chronic, and menstrual migraines and CH...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29137067/harlequin-syndrome-and-horner-syndrome-after-neck-schwannoma-excision-in-a-pediatric-patient-a-case-report
#5
Dong Hoon Lee, Jong Yuap Seong, Tae Mi Yoon, Joon Kyoo Lee, Sang Chul Lim
RATIONALE: Harlequin syndrome is an extremely rare benign condition characterized by unilateral facial flushing and sweating. PATIENT CONCERN: An 11-year-old boy presented with complaint of a right neck mass of 1-month duration. DIAGNOSIS: The preoperative diagnosis was neurogenic tumor of vagus nerve or sympathetic nerve. INTERVENTIONS: We performed right neck mass removal under general anesthesia. OUTCOMES: We report a case of harlequin syndrome associated with Horner syndrome in an 11-year boy who underwent excision of right neck schwannoma...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29134359/anxiety-depression-and-the-microbiome-a-role-for-gut-peptides
#6
REVIEW
Gilliard Lach, Harriet Schellekens, Timothy G Dinan, John F Cryan
The complex bidirectional communication between the gut and the brain is finely orchestrated by different systems, including the endocrine, immune, autonomic, and enteric nervous systems. Moreover, increasing evidence supports the role of the microbiome and microbiota-derived molecules in regulating such interactions; however, the mechanisms underpinning such effects are only beginning to be resolved. Microbiota-gut peptide interactions are poised to be of great significance in the regulation of gut-brain signaling...
November 13, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/29129819/nicotinic-acetylcholine-receptor-%C3%AE-7-subunit-improves-energy-homeostasis-and-inhibits-inflammation-in-nonalcoholic-fatty-liver-disease
#7
Dong-Jie Li, Jian Liu, Xia Hua, Hui Fu, Fang Huang, Yi-Bo Fei, Wen-Jie Lu, Fu-Ming Shen, Pei Wang
OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is one of the most common liver diseases worldwide; yet, the pathogenesis of the disorder is not completely understood. The nicotinic acetylcholine receptor α7 subunit (α7nAChR) plays an indispensable role in the vagus nerve-regulated cholinergic anti-inflammatory pathway. METHODS: In the present study, we investigated the key role of α7nAChR in NAFLD development. Male wild-type (WT) and α7nAChR knockout (α7nAChR(-/-)) mice were fed a normal chow or a high-fat diet (HFD) for 16 weeks to induce NAFLD...
November 9, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29129793/the-interval-between-vns-tone-pairings-determines-the-extent-of-cortical-map-plasticity
#8
Michael S Borland, Crystal T Engineer, William A Vrana, Nicole A Moreno, Navzer D Engineer, Sven Vanneste, Pryanka Sharma, Meghan C Pantalia, Mark C Lane, Robert L Rennaker, Michael P Kilgard
Repeatedly pairing vagus nerve stimulation (VNS) with a tone or movement drives highly-specific and long-lasting plasticity in auditory or motor cortex, respectively. Based on this robust enhancement of plasticity, VNS paired with rehabilitative training has emerged as a potential therapy to improve recovery, even when delivered long after the neurological insult. Development of VNS delivery paradigms that reduce therapy duration and maximize efficacy would facilitate clinical translation. The goal of the current study was to determine whether primary auditory cortex (A1) plasticity can be generated more quickly by shortening the interval between VNS-tone pairing events or by delivering fewer VNS-tone pairing events...
November 9, 2017: Neuroscience
https://www.readbyqxmd.com/read/29128975/transcutaneous-vagus-nerve-stimulation-tvns-modulates-flow-experience
#9
Lorenza S Colzato, Gina Wolters, Corinna Peifer
Flow has been defined as a pleasant psychological state that people experience when completely absorbed in an activity. Previous correlative evidence showed that the vagal tone (as indexed by heart rate variability) is a reliable marker of flow. So far, it has not yet been demonstrated that the vagus nerve plays a causal role in flow. To explore this we used transcutaneous vagus nerve stimulation (tVNS), a novel non-invasive brain stimulation technique that increases activation of the locus coeruleus (LC) and norepinephrine release...
November 11, 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/29124439/lennox-gastaut-syndrome-a-comprehensive-review
#10
Ali A Asadi-Pooya
Lennox-Gastaut syndrome (LGS) is considered an epileptic encephalopathy and is defined by a triad of multiple drug-resistant seizure types, a specific EEG pattern showing bursts of slow spike-wave complexes or generalized paroxysmal fast activity, and intellectual disability. The prevalence of LGS is estimated between 1 and 2% of all patients with epilepsy. The etiology of LGS is often divided into two groups: identifiable (genetic-structural-metabolic) in 65 to 75% of the patients and LGS of unknown cause in others...
November 9, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/29122764/mr-imaging-of-the-superior-cervical-ganglion-and-inferior-ganglion-of-the-vagus-nerve-structures-that-can-mimic-pathologic-retropharyngeal-lymph-nodes
#11
H Yokota, H Mukai, S Hattori, K Yamada, Y Anzai, T Uno
BACKGROUND AND PURPOSE: The superior cervical ganglion and inferior ganglion of the vagus nerve can mimic pathologic retropharyngeal lymph nodes. We studied the cross-sectional anatomy of the superior cervical ganglion and inferior ganglion of the vagus nerve to evaluate how they can be differentiated from the retropharyngeal lymph nodes. MATERIALS AND METHODS: This retrospective study consists of 2 parts. Cohort 1 concerned the signal intensity of routine neck MR imaging with 2D sequences, apparent diffusion coefficient, and contrast enhancement of the superior cervical ganglion compared with lymph nodes with or without metastasis in 30 patients...
November 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29122559/constant-hepatic-atp-concentrations-during-prolonged-fasting-and-absence-of-effects-of-cerbomed-nemos-%C3%A2-on-parasympathetic-tone-and-hepatic-energy-metabolism
#12
Sofiya Gancheva, Alessandra Bierwagen, Daniel F Markgraf, Gidon J Bönhof, Kevin G Murphy, Erifili Hatziagelaki, Jesper Lundbom, Dan Ziegler, Michael Roden
OBJECTIVE: Brain insulin-induced improvement in glucose homeostasis has been proposed to be mediated by the parasympathetic nervous system. Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) activating afferent branches of the vagus nerve may prevent hyperglycemia in diabetes models. We examined the effects of 14-min taVNS vs sham stimulation by Cerbomed Nemos(®) on glucose metabolism, lipids, and hepatic energy homeostasis in fasted healthy humans (n = 10, age 51 ± 6 yrs, BMI 25...
October 25, 2017: Molecular Metabolism
https://www.readbyqxmd.com/read/29113812/differential-associations-of-lower-cardiac-vagal-tone-with-insulin-resistance-and-insulin-secretion-in-recently-diagnosed-type-1-and-type-2-diabetes
#13
Dan Ziegler, Alexander Strom, Gidon Bönhof, Sonja Püttgen, Kálmán Bódis, Volker Burkart, Karsten Müssig, Julia Szendroedi, Daniel F Markgraf, Michael Roden
OBJECTIVE: It is unclear to which extent altered insulin sensitivity/secretion contribute to the development of diabetic cardiovascular autonomic neuropathy (CAN) characterized by diminished heart rate variability (HRV). We hypothesised that lower HRV is differentially associated with measures of insulin resistance and insulin secretion in recent-onset type 1 and type 2 diabetes. MATERIALS/METHODS: This cross-sectional study included participants from the German Diabetes Study with type 1 (n=275) or type 2 diabetes (n=450) with known diabetes duration ≤1 year and glucose-tolerant controls (n=81)...
November 4, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29101567/vagus-nerve-preserving-versus-conventional-laparoscopic-splenectomy-and-azygoportal-disconnection
#14
Dou-Sheng Bai, Ping Chen, Sheng-Jie Jin, Jian-Jun Qian, Guo-Qing Jiang
BACKGROUND: Conventional open and conventional laparoscopic splenectomy and azygoportal disconnection (CLSD) result in poor quality of life because of damage to the vagal nerve. We have developed vagus nerve-preserving laparoscopic splenectomy and azygoportal disconnection (VLSD). This study aimed to evaluate whether VLSD is effective and safe, and to determine whether a reduction in the incidence of postoperative complications improves postoperative quality of life compared with CLSD...
November 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29093707/add-on-pyridostigmine-enhances-cd4-t-cell-recovery-in-hiv-1-infected-immunological-non-responders-a-proof-of-concept-study
#15
Sergio I Valdés-Ferrer, José C Crispín, Pablo F Belaunzarán-Zamudio, Carlos A Rodríguez-Osorio, Bernardo Cacho-Díaz, Jorge Alcocer-Varela, Carlos Cantú-Brito, Juan Sierra-Madero
Background: In human immunodeficiency virus (HIV)-infection, persistent T-cell activation leads to rapid turnover and increased cell death, leading to immune exhaustion and increased susceptibility to opportunistic infections. Stimulation of the vagus nerve increases acetylcholine (ACh) release and modulates inflammation in chronic inflammatory conditions, a neural mechanism known as the cholinergic anti-inflammatory pathway (CAP). Pyridostigmine (PDG), an ACh-esterase inhibitor, increases the half-life of endogenous ACh, therefore mimicking the CAP...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29089157/a-rare-case-of-bilateral-vagus-nerve-schwanomatosis
#16
Makoto Hosoya, Nobuko Yamamoto, Takeshi Wakabayashi, Keitaro Toshikuni, Haruna Yabe, Shujiro B Minami
Schwanomatosis is the third most common form of neurofibromatosis. Schwanomatosis affecting the vagus nerve is particularly rare. In this report, we describe an extremely rare case bilateral vagus nerve schwanomatosis in a 45-year-old male patient. The patient initially presented with bilateral neck tumors and hoarseness arising after thoracic surgery. We performed left neck surgery in order to diagnose and resect the remaining tumors followed by laryngeal framework surgery to improve vocal cord closure and symptoms of hoarseness...
October 28, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29080623/relationship-between-abnormal-vagus-nerve-tension-and-basal-ganglia-cerebral-infarction-induced-paroxysmal-atrial-fibrillation
#17
Wen-Bo Cheng, Dong Li, Qin Yang, Yue-Mei Hou
OBJECTIVE: To investigate the relationship between basal ganglia cerebral infarction and paroxysmal atrial fibrillation (PAF) caused by abnormal vagus nerve tension. METHODS: A total of 1483 cases of elder patients with cerebral infarction who received head CT or MRI examination during the period were enrolled, including 830 male and 613 female, with the average age as 78 years. These cases were divided into basal infarction ganglia group (n = 1045) and non-basal ganglia infarction group (n = 438) according to the anatomic site of cerebral infarction...
September 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/29079124/laryngocardiac-reflex-a-case-report-and-review-of-the-literature
#18
REVIEW
Christian S Pingree, Jacob S Majors, Nelson S Howard, Robert L Eller
INTRODUCTION: The vagus nerve has sensory and motor function in the larynx, as well as parasympathetic function in the thorax and abdomen. Stimulation of the superior laryngeal nerve can cause reflexive bradycardia. CASE: We describe a case of a 45-year-old man with pre-syncopal symptoms while exercising, and bradycardia found during cardiology workup. Radiography and flexible laryngoscopy showed evidence of a right-sided, vascular laryngeal mass. Exercise testing before and after superior laryngeal nerve block showed reversal of the symptoms with the block...
October 24, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/29078771/a-spatial-agent-based-model-of-anopheles-vagus-for-malaria-epidemiology-examining-the-impact-of-vector-control-interventions
#19
Md Zahangir Alam, S M Niaz Arifin, Hasan Mohammad Al-Amin, Mohammad Shafiul Alam, M Sohel Rahman
BACKGROUND: Malaria, being a mosquito-borne infectious disease, is still one of the most devastating global health issues. The malaria vector Anopheles vagus is widely distributed in Asia and a dominant vector in Bandarban, Bangladesh. However, despite its wide distribution, no agent based model (ABM) of An. vagus has yet been developed. Additionally, its response to combined vector control interventions has not been examined. METHODS: A spatial ABM, denoted as ABM[Formula: see text], was designed and implemented based on the biological attributes of An...
October 27, 2017: Malaria Journal
https://www.readbyqxmd.com/read/29078572/continuous-intraoperative-vagus-nerve-stimulation-for-monitoring-of-recurrent-laryngeal-nerve-during-minimally-invasive-esophagectomy
#20
REVIEW
Ian Wong, Daniel K H Tong, Raymond K Y Tsang, Claudia L Y Wong, Desmond K K Chan, Fion S Y Chan, Simon Law
For squamous cell carcinoma of the esophagus, extended mediastinal lymphadenectomy especially around the bilateral recurrent laryngeal nerves (RLN) is associated with high risk of nerve injury. This does not only result in hoarseness of voice, increase the chance of pulmonary complications, but would also affect the quality of life of patients in the long term. Methods to improve safety of lymphadenectomy are desirable. Continuous intraoperative nerve monitoring (CIONM) based on a system using vagus nerve stimulation was tested...
2017: J Vis Surg
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