Noller Crystal M, Levine Yaakov A, Urakov Timur M, Aronson Joshua P, Nash Mark S
The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL, United States.
Section of Neurosurgery, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States.
Front Neurosci. 2019 Sep 4;13:911. doi: 10.3389/fnins.2019.00911. eCollection 2019.
Over the last several decades, vagus nerve stimulation (VNS) has evolved from a treatment for select neuropsychiatric disorders to one that holds promise in treating numerous inflammatory conditions. Growing interest has focused on the use of VNS for other indications, such as heart failure, rheumatoid arthritis, inflammatory bowel disease, ischemic stroke, and traumatic brain injury. As pre-clinical research often guides expansion into new clinical avenues, animal models of VNS have also increased in recent years. To advance this promising treatment, however, there are a number of experimental parameters that must be considered when planning a study, such as physiology of the vagus nerve, electrical stimulation parameters, electrode design, stimulation equipment, and microsurgical technique. In this review, we discuss these important considerations and how a combination of clinically relevant stimulation parameters can be used to achieve beneficial therapeutic results in pre-clinical studies of sub-acute to chronic VNS, and provide a practical guide for performing this work in rodent models. Finally, by integrating clinical and pre-clinical research, we present indeterminate issues as opportunities for future research.
在过去几十年中,迷走神经刺激(VNS)已从一种用于特定神经精神疾病的治疗方法发展成为一种有望治疗多种炎症性疾病的方法。人们越来越关注将VNS用于其他适应症,如心力衰竭、类风湿性关节炎、炎症性肠病、缺血性中风和创伤性脑损伤。由于临床前研究通常会指导向新的临床途径拓展,近年来VNS的动物模型也有所增加。然而,为了推进这种有前景的治疗方法,在规划一项研究时必须考虑许多实验参数,如迷走神经的生理学、电刺激参数、电极设计、刺激设备和显微外科技术。在这篇综述中,我们讨论这些重要的考虑因素,以及如何在亚急性至慢性VNS的临床前研究中使用临床相关刺激参数的组合来实现有益的治疗效果,并为在啮齿动物模型中开展这项工作提供实用指南。最后,通过整合临床和临床前研究,我们将不确定的问题作为未来研究的机会呈现出来。