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一种实时神经记录与刺激系统及其在血压调节中的潜在应用。

A system of real-time neural recording and stimulation and its potential application in blood pressure modulation.

作者信息

Shen Anruo, Li Runhuan, Li Yiran, Guo Jinyao, Wang Jiguang, Sui Xiaohong

机构信息

School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.

School of Medicine, Tsinghua University, Beijing, China.

出版信息

Front Med Technol. 2022 Aug 10;4:941686. doi: 10.3389/fmedt.2022.941686. eCollection 2022.

Abstract

Hypertension is one of the most prevalent chronic diseases that affects more than 20% of the adult population worldwide, but fortunately, most of their blood pressure can be effectively controlled drug treatment. However, there still remains 5-30% of patients clinically who do not respond well to conventional medication, while the non-drug treatments currently existing are struggling with major drawbacks like irreversible nerve damage, huge side effects, and even non-effectiveness. In this study, based on the physiological regulation mechanism of blood pressure and state-of-the-art neuromodulation technique, we worked along with the vagus nerve stimulation scheme, developed, and explored whether and how a real-time neural recording and stimulation system could provide an insight into self-adaptive modulation in the blood pressure, in the hope to crack a crevice in the closed-loop treatment for resistant hypertension. Unlike traditional neuromodulation devices, additional signal recording and real-time wireless transmission functions are added to the same device to realize the features of a dynamic monitor and modulator. The system is tested both and , showing decent electrical performance of 8 kHz sampling rate and flexible stimulation outputs which sufficiently covers our needs in manipulating neural activities of interest. A relatively stable drop in the blood pressure resulting from stimulation was observed and specific patterns in the vagus nerve signals relating to blood pressure could also be primarily identified. This laid a solid foundation for further studies on the final realization of closed-loop automatic adjustment for resistive hypertension treatment.

摘要

高血压是最常见的慢性疾病之一,影响着全球超过20%的成年人口,但幸运的是,他们中的大多数人的血压可以通过药物治疗得到有效控制。然而,临床上仍有5%-30%的患者对传统药物反应不佳,而目前现有的非药物治疗方法存在诸如不可逆的神经损伤、巨大的副作用甚至无效等主要缺点。在本研究中,基于血压的生理调节机制和最先进的神经调节技术,我们采用迷走神经刺激方案,开发并探索了实时神经记录和刺激系统是否以及如何能够洞察血压的自适应调节,以期在顽固性高血压的闭环治疗中打开一个突破口。与传统的神经调节设备不同,同一设备增加了额外的信号记录和实时无线传输功能,以实现动态监测器和调节器的功能。该系统在体外和体内均进行了测试,显示出8kHz采样率的良好电气性能和灵活的刺激输出,足以满足我们对感兴趣的神经活动进行操控的需求。观察到刺激导致血压相对稳定下降,并且还初步识别出与血压相关的迷走神经信号中的特定模式。这为进一步研究最终实现顽固性高血压治疗的闭环自动调节奠定了坚实基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c882/9399767/a3598f270e97/fmedt-04-941686-g0001.jpg

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