Ghent University Hospital, Laboratory for Experimental and Clinical Neurophysiology, De Pintelaan 185, 9000 Gent, Belgium.
J Neurosci Methods. 2011 Jun 15;198(2):287-93. doi: 10.1016/j.jneumeth.2011.04.007. Epub 2011 Apr 12.
RATIONALE: Vagus nerve stimulation (VNS) is an adjunctive treatment for patients with refractory epilepsy. In more than 30% of the patients VNS has no therapeutic effect. The goal of this study was to find an objective parameter that can be used as an indicator of effective stimulation of the vagus nerve. METHODS: The electrophysiological response to VNS was recorded from the vagus nerve, recurrent laryngeal nerve and larynx muscles. Nerve lesions and muscle relaxing agent were used to find the source of the electrophysiological response. A cuff-electrode for chronic stimulation and recording was implanted for chronic recording of the VNS-induced electrophysiological response after implantation. Dose-response curves were determined daily during a follow-up period of 2 months. RESULTS: VNS induced an electrophysiological response around 3 ms after start of the stimulation. This response was identified as a larynx compound action potential (LCMAP) LCMAP could be recorded immediately after surgery in 11/21 rats, while in the other 10/21 rats, a recovery period with an average of 25 days was required. Once the LCAMP could be recorded, the latency and overall characteristics of the doses response curves of the LCMAP remained stable during the entire follow-up period. CONCLUSIONS: In this study, we provide an objective electrophysiological parameter for vagus nerve activation. LCAMP may indicate recovery of the vagus nerve after implantation, which may help to determine when uptitration of VNS therapy can be initiated. LCAMP could be of value in future experiments for objectification of VNS in animal models for epilepsy.
背景:迷走神经刺激(VNS)是治疗耐药性癫痫患者的辅助治疗方法。在超过 30%的患者中,VNS 没有治疗效果。本研究的目的是寻找一种客观参数,可以作为迷走神经有效刺激的指标。
方法:从迷走神经、喉返神经和喉肌记录 VNS 的电生理反应。使用神经损伤和肌肉松弛剂来寻找电生理反应的来源。植入用于慢性刺激和记录的袖套电极,用于植入后慢性记录 VNS 诱导的电生理反应。在 2 个月的随访期间,每天确定剂量反应曲线。
结果:VNS 刺激开始后约 3 毫秒诱导电生理反应。该反应被鉴定为喉复合动作电位(LCMAP)。在 21 只大鼠中的 11 只中,手术后可以立即记录到 LCMAP,而在另外 10 只大鼠中,需要平均 25 天的恢复期。一旦可以记录到 LCAMP,LCAMP 的潜伏期和剂量反应曲线的整体特征在整个随访期间保持稳定。
结论:在这项研究中,我们提供了迷走神经激活的客观电生理参数。LCAMP 可能表明植入后迷走神经的恢复,这可能有助于确定何时可以开始增加 VNS 治疗的剂量。LCAMP 在未来的癫痫动物模型中 VNS 的客观化实验中可能具有价值。
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