Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA.
Exp Neurol. 2011 Jan;227(1):62-8. doi: 10.1016/j.expneurol.2010.09.011. Epub 2010 Sep 17.
Vagus nerve stimulation (VNS) is an approved treatment for epilepsy and depression, and it is currently under investigation for applications in Alzheimer's disease, anxiety, heart failure, and obesity. However, the mechanism(s) by which VNS has its effects are not clear, and the stimulation parameters for obtaining therapeutic outcomes appear highly variable. The purpose of this study was to quantify the excitation properties of the right cervical vagus nerve in adult dogs anesthetized with propofol and fentanyl. Input-output curves of the right cervical vagus nerve compound action potential and laryngeal muscle electromyogram were measured in response to VNS across a range of stimulation parameters: amplitudes of 0.02-50mA, pulsewidths of 10, 50, 100, 200, 300, 500, and 1,000μs, frequencies of 1-2Hz, and train lengths of 20 pulses with 3 different electrode configurations: monopolar cathode, proximal anode/distal cathode, and proximal cathode/distal anode. Electrode configuration and stimulation waveform (monophasic vs. asymmetric charge-balanced biphasic) did not affect the threshold or recruitment of the vagal nerve fibers that were activated. The rheobase currents of A- and B-fibers were 0.4mA and 0.7mA, respectively, and the chronaxie of both components was 180μs. Pulsewidth had little effect on the normalized threshold difference between activation of A- and B-fibers. The results provide insight into the complement of nerve fibers activated by VNS and guidance to clinicians for the selection of optimal stimulation parameters.
迷走神经刺激(Vagus nerve stimulation,VNS)是一种已被批准用于治疗癫痫和抑郁症的方法,目前正在研究将其应用于阿尔茨海默病、焦虑症、心力衰竭和肥胖症的治疗中。然而,VNS 产生疗效的确切机制尚不清楚,获得治疗效果的刺激参数似乎也存在很大差异。本研究的目的是量化在丙泊酚和芬太尼麻醉的成年犬的右侧颈迷走神经的兴奋特性。通过测量右侧颈迷走神经复合动作电位和喉肌肌电图对 VNS 的反应,得到了一系列刺激参数的输入-输出曲线:刺激幅度为 0.02-50mA,脉宽为 10、50、100、200、300、500 和 1000μs,频率为 1-2Hz,以及 3 种不同电极配置的 20 脉冲串:单极阴极、近端阳极/远端阴极和近端阴极/远端阳极。电极配置和刺激波形(单相 vs. 不对称平衡双相)并不影响被激活的迷走神经纤维的阈值或募集。A 纤维和 B 纤维的阈值电流分别为 0.4mA 和 0.7mA,两者的弛豫时间均为 180μs。脉宽对 A 纤维和 B 纤维激活的归一化阈值差异影响很小。这些结果为 VNS 激活的神经纤维成分提供了深入了解,并为临床医生选择最佳刺激参数提供了指导。
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