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术中人体迷走神经复合动作电位

Intraoperative human vagus nerve compound action potentials.

作者信息

Evans M S, Verma-Ahuja S, Naritoku D K, Espinosa J A

机构信息

Department of Neurology, Southern Illinois University School of Medicine, Springfield, IL 62794, USA.

出版信息

Acta Neurol Scand. 2004 Oct;110(4):232-8. doi: 10.1111/j.1600-0404.2004.00309.x.

Abstract

OBJECTIVE

Although electrical stimulation of vagus nerve is used widely for treatment of epilepsy the electrophysiological properties of human vagus nerve are not well characterized. Our objective was to measure compound action potentials of human vagus nerve fiber groups intraoperatively by stimulation using a commercially available generator and electrode system (Neurocybernetic Prosthesis System, NCP).

MATERIAL AND METHODS

During NCP implantation we recorded compound action potentials evoked by stimulating the left vagus nerve through the NCP bipolar lead. Current intensities were varied from 0.25 to 3.0 mA.

RESULTS

Vagus nerve compound action potential components conducting in the A, Adelta, and C velocity ranges could be elicited using either the NCP pulse generator or by a standard evoked potential instrument. A fiber potentials were recordable in all nerves, and were activated by very low stimulus currents. Adelta and C fibers were less reliably elicited, with C fibers requiring the highest currents.

CONCLUSIONS

Three clearly identified fiber populations can be identified using therapeutic electrical stimulation of the human vagus. Intraoperative measurements of NCP-induced action potentials may potentially provide a marker for therapeutic stimulation and better insight into mechanisms of vagus nerve stimulation (VNS) efficacy.

摘要

目的

尽管迷走神经电刺激被广泛用于癫痫治疗,但人类迷走神经的电生理特性尚未得到充分表征。我们的目的是在术中使用市售的发生器和电极系统(神经控制假体系统,NCP)通过刺激来测量人类迷走神经纤维群的复合动作电位。

材料与方法

在植入NCP期间,我们记录了通过NCP双极导联刺激左侧迷走神经所诱发的复合动作电位。电流强度从0.25毫安变化到3.0毫安。

结果

使用NCP脉冲发生器或标准诱发电位仪均可引出在A、Aδ和C速度范围内传导的迷走神经复合动作电位成分。所有神经中均可记录到A纤维电位,且通过非常低的刺激电流即可激活。Aδ和C纤维诱发的可靠性较低,C纤维需要最高的电流。

结论

通过对人类迷走神经进行治疗性电刺激可识别出三个明确的纤维群。术中测量NCP诱发的动作电位可能潜在地为治疗性刺激提供一个标志物,并更好地洞察迷走神经刺激(VNS)疗效的机制。

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