Tosato M, Yoshida K, Toft E, Struijk J J
Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Fredrik Bajersvej 7D, DK 9220, Aalborg East, Denmark.
J Neural Eng. 2007 Sep;4(3):205-12. doi: 10.1088/1741-2560/4/3/005. Epub 2007 Apr 20.
The stimulation of the vagus nerve has been used as an anti-epileptic treatment for over a decade, and its use for depression and chronic heart failure is currently under investigation. Co-activation of the intrinsic laryngeal muscles may limit the clinical use of vagal stimulation, especially in the case of prolonged activation. To prevent this, the use of a selective stimulation paradigm has been tested in seven acute pig experiments. Quasi-trapezoidal pulses successfully blocked the population of the largest and fastest vagal myelinated fibers being responsible for the co-activation. The first response in the vagus compound action potential was reduced by 75 +/- 22% (mean +/- SD) and the co-activated muscle action potential by 67 +/- 25%. The vagal bradycardic effects remained unchanged during the selective block, confirming the leading role of thin nerve fibers for the vagal control of the heart. Quasi-trapezoidal pulses may be an alternative to rectangular pulses in clinical vagal stimulation when the co-activation of laryngeal muscles must be avoided.
迷走神经刺激作为一种抗癫痫治疗方法已应用了十多年，目前其在抑郁症和慢性心力衰竭治疗中的应用正在研究中。喉内肌的共同激活可能会限制迷走神经刺激的临床应用，尤其是在长时间激活的情况下。为防止这种情况，已在七项急性猪实验中测试了选择性刺激模式。准梯形脉冲成功阻断了负责共同激活的最大和最快迷走有髓纤维群。迷走复合动作电位的首次反应降低了75±22%（平均值±标准差），共同激活的肌肉动作电位降低了67±25%。在选择性阻断期间，迷走神经的心动过缓效应保持不变，证实了细神经纤维在迷走神经对心脏控制中的主导作用。当必须避免喉肌共同激活时，准梯形脉冲可能是临床迷走神经刺激中矩形脉冲的替代方法。
