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Vagal nerve stimulator

Alessandro S Zagami
PURPOSE OF REVIEW: To review recent studies outlining the management of refractory primary headache patients, including emerging therapies such as neuromodulation. This includes both noninvasive and invasive neuromodulation techniques. Recent studies on the management of medication overuse headache were also reviewed. RECENT FINDINGS: There is no consensus as yet on the definitions of refractory chronic migraine and chronic cluster headache although there is broad agreement on some aspects of these terms...
March 19, 2018: Current Pain and Headache Reports
Erin D'Agostino, Vyacheslav Makler, David F Bauer
BACKGROUND: Vagal nerve stimulation (VNS) is a safe and well-tolerated treatment for drug resistant epilepsy. Complications and failure of the device can result from lead fracture, device malfunction, disconnection, or battery displacement and can result in a variety of symptoms. We present an interesting case of stimulator malfunction with increased impedance change seen only with a change in head position. CASE DESCRIPTION: Patient is a 25-year-old male with a vagal nerve stimulator (VNs) placed for medically refractory epilepsy who presented with neck pain and an electrical pulling sensation in his neck whenever he turned his head to the right...
March 16, 2018: World Neurosurgery
Meyrick Kidwell, Bart A Ellenbroek
There is a bidirectional relationship between affective disorders and cardiovascular abnormalities, often described as a downward spiral, whereas major depressive disorders (MDD, and anxiety disorders) significantly increase the risk of developing cardiovascular diseases (CVD); CVD are also associated with increased risk of developing MDD (and anxiety disorders). Moreover, the prognosis and progression of CVD is significantly worsened in the presence of MDD. Heart rate variability (HRV) has often been suggested as a potential mediator in this comorbidity...
April 2018: Behavioural Pharmacology
Marion Griton, Jan Pieter Konsman
Although the immune and nervous systems have long been considered independent biological systems, they turn out to mingle and interact extensively. The present review summarizes recent insights into the neural pathways activated by and involved in infection-induced inflammation and discusses potential clinical applications. The simplest activation concerns a reflex action within C-fibers leading to neurogenic inflammation. Low concentrations of pro-inflammatory cytokines or bacterial fragments may also act on these afferent nerve fibers to signal the central nervous system and bring about early fever, hyperalgesia and sickness behavior...
March 14, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Maria M Buckley, Dervla O'Malley
Background and Objectives: Bidirectional signaling between the gastrointestinal tract and the brain is vital for maintaining whole-body homeostasis. Moreover, emerging evidence implicates vagal afferent signaling in the modulation of host physiology by microbes, which are most abundant in the colon. This study aims to optimize and advance dissection and recording techniques to facilitate real-time recordings of afferent neural signals originating in the distal colon. New Protocol: This paper describes a dissection technique, which facilitates extracellular electrophysiological recordings from visceral pelvic, spinal and vagal afferent neurons in response to stimulation of the distal colon...
2018: Frontiers in Neuroscience
Naoko Yamaguchi, Kentaro Yamakawa, Pradeep S Rajendran, Tatsuo Takamiya, Marmar Vaseghi
BACKGROUND: Neuraxial modulation with cardiac sympathetic denervation (CSD) can potentially reduce burden of ventricular tachy-arryhthmias (VT). Despite catheter ablation and CSD, however, VT can recur in patients with cardiomyopathy and the role of vagal nerve stimulation (VNS) in this setting is unclear. OBJECTIVE: The purpose of this study was to evaluate electrophysiological effects of VNS after CSD in normal and infarcted hearts. METHODS: In 10 normal and 6 infarcted pigs, electrophysiological and hemodynamic parameters were evaluated before and during intermittent VNS pre-CSD (bilateral stellectomy and T2-T4 thoracic ganglia removal) as well as post-CSD...
March 9, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Zeljka Petelin Gadze, Andreja Bujan Kovac, Ivan Adamec, Nina Milekic, Vlatko Sulentic
No abstract text is available yet for this article.
March 6, 2018: Seizure: the Journal of the British Epilepsy Association
Emad Kandil, Khuzema Mohsin, Mohammad A Murcy, Gregory W Randolph
OBJECTIVES/HYPOTHESIS: Continuous intraoperative neuromonitoring (CIONM) of the vagus nerve was proposed to obtained frequent repetitive electromyography (EMG) data to recognize early change in intraoperative function of the recurrent laryngeal nerve. We examine our initial experience using this technology. STUDY DESIGN: Retrospective review. METHODS: Data for all patients who underwent neck surgery by a single surgeon at a North American institution over a 5-year period were reviewed...
February 26, 2018: Laryngoscope
Robin M McAllen, Anthony D Shafton, Bradford O Bratton, David Trevaks, John B Furness
Vagal nerve stimulation is widely used therapeutically but the fiber groups activated are often unknown. Aim: To establish a simple protocol to define stimulus thresholds for vagal A, B and C fibers. Methods: The intact left or right cervical vagus was stimulated with 0.1 ms pulses in spontaneously breathing anesthetized rats. Heart and respiratory rate responses to vagal stimulation were recorded. The vagus was subsequently cut distally, and mass action potentials to the same stimuli were recorded...
January 2018: Bioelectron Med (Lond)
K Murray, C Reardon
Inflammatory bowel disease negatively affects the quality of life of millions of patients around the world. Although the precise etiology of the disease remains elusive, aberrant immune system activation is an underlying cause. As such, therapies that selectively inhibit immune cell activation without broad immunosuppression are desired. Inhibition of immune cell activation preventing pro-inflammatory cytokine production through neural stimulation has emerged as one such treatment. These therapeutics are based on the discovery of the cholinergic anti-inflammatory pathway, a reflex arc that induces efferent vagal nerve signaling to reduce immune cell activation and consequently mortality during septic shock...
March 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Bruno Bonaz, Thomas Bazin, Sonia Pellissier
The microbiota, the gut, and the brain communicate through the microbiota-gut-brain axis in a bidirectional way that involves the autonomic nervous system. The vagus nerve (VN), the principal component of the parasympathetic nervous system, is a mixed nerve composed of 80% afferent and 20% efferent fibers. The VN, because of its role in interoceptive awareness, is able to sense the microbiota metabolites through its afferents, to transfer this gut information to the central nervous system where it is integrated in the central autonomic network, and then to generate an adapted or inappropriate response...
2018: Frontiers in Neuroscience
Reid Hoshide, Rahul Jandial
No abstract text is available yet for this article.
March 1, 2018: Neurosurgery
Sanjeet S Grewal, Krzysztof R Gorny, Christopher P Favazza, Robert E Watson, Timothy J Kaufmann, Jamie J Van Gompel
BACKGROUND AND IMPORTANCE: Laser interstitial thermal therapy (LiTT) has increasingly been used as a treatment option for medically refractory epilepsy, tumors, and radiation necrosis. The use of LiTT requires intraoperative magnetic resonance (MR) thermography. This can become an issue in patients with other implanted therapeutic devices such as pacemakers and vagal nerve stimulators due to concerns regarding increases in the specific absorption rate (SAR). This is a technical case report demonstrating a successfully and safely performed LiTT in a 1...
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Farahnaz Jazaeri, Razieh Afsharmoghaddam, Alireza Abdollahi, Giti Ghamami, Ahmad Reza Dehpour
Cirrhosis is associated with cardiac chronotropic and inotropic dysfunction which is known as cirrhotic cardiomyopathy. Cardiac responsiveness to adrenergic stimulation is impaired in cirrhosis. Moreover, there is vagal nerve dysfunction which is related to neuromodulatory dysfunction of the angiotensin II in the cirrhosis. This study was aimed to explore the hypothesis that administration of Losartan-angiotensin II receptor antagonist increases cardiac chronotropic response to isoproterenol in cirrhotic rats; and if so, whether this is associated with altered cardiac TGF-β receptor expression...
January 2018: Acta Medica Iranica
Simona Svajdova, Lenka Mazurova, Mariana Brozmanova
Sphingosine-1-phosphate (S1P) is an inflammatory mediator increased in the tissue in the number of inflammatory conditions. Preliminary data indicate that the vagal afferent neurons express several S1P receptors including S1PR2-3. We therefore evaluated the hypothesis that S1P induces cough and/or enhances the cough evoked by other tussive stimuli (TRPA1 and TRPV1 activators) in naïve guinea pigs. Inhalation of S1P in the concentrations of 0.1 mM and 1 mM did not evoke cough. Preinhalation and continuing inhalation of S1P (1 mM) during citric acid (0...
February 8, 2018: Respiratory Physiology & Neurobiology
Nicole A Pelot, Warren M Grill
Implanted vagus nerve stimulation (VNS) for obesity was recently approved by the FDA. However, its efficacy and mechanisms of action remain unclear. Herein, we synthesize clinical and preclinical effects of VNS on feeding behavior and energy balance and discuss engineering considerations for understanding and improving the therapy. Clinical cervical VNS (≤30 Hz) to treat epilepsy or depression has produced mixed effects on weight loss as a side effect, albeit in uncontrolled, retrospective studies. Conversely, preclinical studies (cervical and subdiaphragmatic VNS) mostly report decreased food intake and either decreased weight gain or weight loss...
February 6, 2018: Brain Research
Khalil Hajiasgharzadeh, Behzad Baradaran
The hepatic vagus branches innervate the liver and serve an important role in liver-brain connection. It appears that brain modulates inflammatory responses by activation of vagal efferent fibers. This activation and subsequent acetylcholine releases from vagus nerve terminals leads to inhibition of inflammatory cytokines through α7 nicotinic acetylcholine receptors (α7nAChRs) which located on the surface of different cell types such as liver Kupffer cells. This protective role of vagus-α7nAChR axis in liver diseases has been shown in several experimental studies...
December 2017: Advanced Pharmaceutical Bulletin
S Veedfald, A Plamboeck, B Hartmann, T Vilsbøll, F K Knop, C F Deacon, L B Svendsen, J J Holst
BACKGROUND: Ghrelin, an orexigenic peptide, is secreted from endocrine cells in the gastric mucosa. Circulating levels rise in the preprandial phase, suggesting an anticipatory or cephalic phase of release, and decline in the postprandial phase, suggesting either the loss of a stimulatory factor or inhibition by factors released when nutrients enter the intestine. We hypothesized that vagal signals are not required for the (i) preprandial increase or (ii) postprandial suppression of ghrelin levels...
February 2, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Konstanze Plaschke, Thuc Quyen Monica Do, Florian Uhle, Thorsten Brenner, Markus A Weigand, Jürgen Kopitz
Acetylcholine is the main transmitter of the parasympathetic vagus nerve. According to the cholinergic anti-inflammatory pathway (CAP) concept, acetylcholine has been shown to be important for signal transmission within the immune system and also for a variety of other functions throughout the organism. The spleen is thought to play an important role in regulating the CAP. In contrast, the existence of a "non-neuronal cardiac cholinergic system" that influences cardiac innervation during inflammation has been hypothesized, with recent publications introducing the heart instead of the spleen as a possible interface between the immune and nervous systems...
February 1, 2018: International Journal of Molecular Sciences
Constantine Tarabanis, Nicholas B Abt, Heather A Osborn
BACKGROUND: The etiologies of intraoperative cardiac arrest within otolaryngology are not well understood as they are rare events. METHODS: A comprehensive review of the etiologies and corresponding pathophysiologic neural mechanisms of intraoperative cardiac arrest in otolaryngologic surgery are examined. RESULTS: The occurrence of this rare complication has been described in a range of head and neck procedures, including but not limited to suspension laryngoscopy and oncologic resections in the neck, maxilla and thyroid...
January 31, 2018: Head & Neck
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