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Spatially selective stimulation of the pig vagus nerve to modulate target effect versus side effect.
Blanz, Stephan L; Musselman, Eric D; Settell, Megan L; Knudsen, Bruce E; Nicolai, Evan N; Trevathan, James K; Verner, Ryan S; Begnaud, Jason; Skubal, Aaron C; Suminski, Aaron J; Williams, Justin C; Shoffstall, Andrew J; Grill, Warren M; Pelot, Nicole A; Ludwig, Kip A.
Affiliation
  • Blanz SL; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America.
  • Musselman ED; Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America.
  • Settell ML; University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America.
  • Knudsen BE; Department of Biomedical Engineering, Duke University, Durham, NC, United States of America.
  • Nicolai EN; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America.
  • Trevathan JK; Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America.
  • Verner RS; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America.
  • Begnaud J; Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America.
  • Skubal AC; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America.
  • Suminski AJ; Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America.
  • Williams JC; Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United States of America.
  • Shoffstall AJ; Mayo Clinic, Rochester, MN, United States of America.
  • Grill WM; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America.
  • Pelot NA; Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America.
  • Ludwig KA; LivaNova USA Inc., Houston, TX, United States of America.
J Neural Eng ; 20(1)2023 02 22.
Article in En | MEDLINE | ID: mdl-36649655
Electrical stimulation of the cervical vagus nerve using implanted electrodes (VNS) is FDA-approved for the treatment of drug-resistant epilepsy, treatment-resistant depression, and most recently, chronic ischemic stroke rehabilitation. However, VNS is critically limited by the unwanted stimulation of nearby neck muscles-a result of non-specific stimulation activating motor nerve fibers within the vagus. Prior studies suggested that precise placement of small epineural electrodes can modify VNS therapeutic effects, such as cardiac responses. However, it remains unclear if placement can alter the balance between intended effect and limiting side effect. We used an FDA investigational device exemption approved six-contact epineural cuff to deliver VNS in pigs and quantified how epineural electrode location impacts on- and off-target VNS activation. Detailed post-mortem histology was conducted to understand how the underlying neuroanatomy impacts observed functional responses. Here we report the discovery and characterization of clear neuroanatomy-dependent differences in threshold and saturation for responses related to both effect (change in heart rate) and side effect (neck muscle contractions). The histological and electrophysiological data were used to develop and validate subject-specific computation models of VNS, creating a well-grounded quantitative framework to optimize electrode location-specific activation of nerve fibers governing intended effect versus unwanted side effect.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Vagus Nerve Stimulation Limits: Animals Language: En Journal: J Neural Eng Journal subject: NEUROLOGIA Year: 2023 Document type: Article Affiliation country: United States Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Vagus Nerve Stimulation Limits: Animals Language: En Journal: J Neural Eng Journal subject: NEUROLOGIA Year: 2023 Document type: Article Affiliation country: United States Country of publication: United kingdom