Sevcencu Cristian, Nielsen Thomas N, Struijk Johannes J
Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), Aalborg University, Aalborg, Denmark.
Department of Health Science and Technology, Medical Informatics, Aalborg University, Aalborg, Denmark.
Neuromodulation. 2018 Dec;21(8):777-786. doi: 10.1111/ner.12758. Epub 2018 Feb 14.
As the left vagus nerve (LVN) mediates a baroreflex blood pressure (BP) decrease, LVN stimulation (LVNS) could be a therapy for hypertension. Moreover, LVNS could elegantly be adjusted to the patient's actual BP and physical activity by using the neural information about BP and respiration extractable from LVN. However, unselective LVNS will trigger undesirable side-effects and therefore we here investigated the feasibility of using an intraneural electrode for extracting BP and respiration markers from the LVN and for selective LVNS.
Experiments were performed on six anesthetized pigs from which the BP was recorded using arterial catheters and the respiratory cycles by recording the airway pressure. An electrode comprising four tripolar channels was inserted longitudinally in the LVN of the animals to extract BP and respiration markers from the LVN and for selective LVNS.
BP-related and respiratory-related neural profiles (BPnPs and RnPs, respectively) were derived from at least two electrode channels in all pigs. The BPnPs accurately resembled the BP waves and the RnPs accurately resembled the respiratory cycles, which suggests that those profiles could serve as BP and respiration markers, respectively. The BP was decreased by intraneural LVNS in all pigs and in four of those pigs such an effect was induced without major cardiac changes through a channel-selective stimulation.
This study shows that it is feasible to extract BP and respiratory markers from the LVN with the tested intraneural electrode and suggests that this electrode could also be used for selective LVNS.
由于左迷走神经(LVN)介导压力反射性血压(BP)降低,左迷走神经刺激(LVNS)可能是一种治疗高血压的方法。此外,通过利用可从左迷走神经提取的有关血压和呼吸的神经信息,左迷走神经刺激可以很好地根据患者的实际血压和身体活动进行调整。然而,非选择性的左迷走神经刺激会引发不良副作用,因此我们在此研究了使用神经内电极从左迷走神经提取血压和呼吸标记物以及进行选择性左迷走神经刺激的可行性。
对六只麻醉猪进行实验,使用动脉导管记录血压,通过记录气道压力记录呼吸周期。将一个包含四个三极通道的电极纵向插入动物的左迷走神经,以从左迷走神经提取血压和呼吸标记物并进行选择性左迷走神经刺激。
在所有猪中,至少从两个电极通道获得了与血压相关和与呼吸相关的神经图谱(分别为BPnP和RnP)。BPnP与血压波精确相似,RnP与呼吸周期精确相似,这表明这些图谱可分别作为血压和呼吸标记物。通过神经内左迷走神经刺激,所有猪的血压均降低,其中四只猪通过通道选择性刺激诱导了这种效果,且没有重大心脏变化。
本研究表明,使用测试的神经内电极从左迷走神经提取血压和呼吸标记物是可行的,并表明该电极也可用于选择性左迷走神经刺激。