Missey Florian, Ejneby Malin Silverå, Ngom Ibrahima, Donahue Mary J, Trajlinek Jan, Acerbo Emma, Botzanowski Boris, Cassarà Antonino M, Neufeld Esra, Glowacki Eric D, Shangold Lee, Hanes William M, Williamson Adam
International Clinical Research Center, St. Anne's University Hospital Brno, Brno, 60200, Czech Republic.
Institute de Neurosciences des Systèmes (INS), INSERM, Aix-Marseille Université, Marseille, 13005, France.
Bioelectron Med. 2023 Aug 9;9(1):18. doi: 10.1186/s42234-023-00120-7.
Peripheral nerve stimulation is used in both clinical and fundamental research for therapy and exploration. At present, non-invasive peripheral nerve stimulation still lacks the penetration depth to reach deep nerve targets and the stimulation focality to offer selectivity. It is therefore rarely employed as the primary selected nerve stimulation method. We have previously demonstrated that a new stimulation technique, temporal interference stimulation, can overcome depth and focality issues.
Here, we implement a novel form of temporal interference, bilateral temporal interference stimulation, for bilateral hypoglossal nerve stimulation in rodents and humans. Pairs of electrodes are placed alongside both hypoglossal nerves to stimulate them synchronously and thus decrease the stimulation amplitude required to activate hypoglossal-nerve-controlled tongue movement.
Comparing bilateral temporal interference stimulation with unilateral temporal interference stimulation, we show that it can elicit the same behavioral and electrophysiological responses at a reduced stimulation amplitude. Traditional transcutaneous stimulation evokes no response with equivalent amplitudes of stimulation.
During first-in-man studies, temporal interference stimulation was found to be well-tolerated, and to clinically reduce apnea-hypopnea events in a subgroup of female patients with obstructive sleep apnea. These results suggest a high clinical potential for the use of temporal interference in the treatment of obstructive sleep apnea and other diseases as a safe, effective, and patient-friendly approach.
The protocol was conducted with the agreement of the International Conference on Harmonisation Good Clinical Practice (ICH GCP), applicable United States Code of Federal Regulations (CFR) and followed the approved BRANY IRB File # 22-02-636-1279.
外周神经刺激在临床和基础研究中均用于治疗和探索。目前,非侵入性外周神经刺激仍缺乏到达深部神经靶点的穿透深度以及提供选择性的刺激聚焦性。因此,它很少被用作主要的神经刺激方法。我们之前已经证明,一种新的刺激技术——时间干扰刺激,可以克服深度和聚焦性问题。
在此,我们实施了一种新型的时间干扰形式,即双侧时间干扰刺激,用于啮齿动物和人类的双侧舌下神经刺激。将成对电极放置在双侧舌下神经旁,以同步刺激它们,从而降低激活舌下神经控制的舌运动所需的刺激幅度。
将双侧时间干扰刺激与单侧时间干扰刺激进行比较,我们发现它可以在降低刺激幅度的情况下引发相同的行为和电生理反应。传统的经皮刺激在相同刺激幅度下不会引发反应。
在首次人体研究中,发现时间干扰刺激耐受性良好,并且在一组患有阻塞性睡眠呼吸暂停的女性患者中,临床上可减少呼吸暂停低通气事件。这些结果表明,时间干扰作为一种安全、有效且对患者友好的方法,在治疗阻塞性睡眠呼吸暂停和其他疾病方面具有很高的临床应用潜力。
该方案是在国际协调会议良好临床实践(ICH GCP)、适用的美国联邦法规(CFR)的同意下进行的,并遵循了批准的BRANY IRB文件编号#22 - 02 - 636 - 1279。