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呼吸门控耳迷走神经刺激(RAVANS)对高血压患者自主神经输出的影响。

Respiratory-gated Auricular Vagal Afferent Nerve Stimulation (RAVANS) effects on autonomic outflow in hypertension.

作者信息

Sclocco Roberta, Garcia Ronald G, Gabriel Aileen, Kettner Norman W, Napadow Vitaly, Barbieri Riccardo

出版信息

Annu Int Conf IEEE Eng Med Biol Soc. 2017 Jul;2017:3130-3133. doi: 10.1109/EMBC.2017.8037520.


DOI:10.1109/EMBC.2017.8037520
PMID:29060561
Abstract

Transcutaneous stimulation of the auricular branch of the vagus nerve (ABVN) has been proposed as a non-invasive alternative to vagus nerve stimulation (VNS). However, its cardiovagal effects are inconsistent across studies, likely due to inhomogeneity in the stimulation parameters. Here, we evaluate respiratory-gated ABVN stimulation (Respiratory-gated Auricular Vagal Afferent Nerve Stimulation, RAVANS), where the stimuli are delivered in 1 s bursts during the exhalation phase of respiration, thus mimicking the breathing-induced modulation of cardiac vagal activity. In this study, we present preliminary results from an ongoing single-arm, open label trial investigating the effects of different intensities of RAVANS in hypertensive subjects. We found that a mid-intensity RAVANS stimulation (rated as a 5 on a 0-10 scale) increases the cardiovagal tone and reduces the sympathetic tone during a paced breathing task. The present results could contribute to optimize RAVANS as a non-invasive, low-cost therapeutic intervention for hypertension.

摘要

经皮刺激迷走神经耳支(ABVN)已被提议作为迷走神经刺激(VNS)的一种非侵入性替代方法。然而,其对心脏迷走神经的影响在不同研究中并不一致,这可能是由于刺激参数的不均匀性所致。在此,我们评估呼吸门控ABVN刺激(呼吸门控耳迷走传入神经刺激,RAVANS),即刺激在呼吸呼气阶段以1秒的脉冲形式发放,从而模拟呼吸诱导的心脏迷走神经活动调制。在本研究中,我们展示了一项正在进行的单臂、开放标签试验的初步结果,该试验旨在研究不同强度的RAVANS对高血压患者的影响。我们发现,中等强度的RAVANS刺激(在0至10的量表上评为5)在定频呼吸任务期间会增加心脏迷走神经张力并降低交感神经张力。目前的结果可能有助于优化RAVANS,使其成为一种用于高血压的非侵入性、低成本治疗干预措施。

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Respiratory-gated Auricular Vagal Afferent Nerve Stimulation (RAVANS) effects on autonomic outflow in hypertension.

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[4]
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[7]
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[9]
Optimization of respiratory-gated auricular vagus afferent nerve stimulation for the modulation of blood pressure in hypertension.

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[10]
International Consensus Based Review and Recommendations for Minimum Reporting Standards in Research on Transcutaneous Vagus Nerve Stimulation (Version 2020).

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