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有效的迷走神经刺激需要在每周的多个疗程中,每个疗程进行多次刺激,以改善躯体感觉的恢复。

Effective Delivery of Vagus Nerve Stimulation Requires Many Stimulations Per Session and Many Sessions Per Week Over Many Weeks to Improve Recovery of Somatosensation.

机构信息

Texas Biomedical Device Center, The University of Texas at Dallas, Richardson, TX, USA.

Erik Jonsson School of Engineering and Computer Science, The University of Texas at Dallas, Richardson, TX, USA.

出版信息

Neurorehabil Neural Repair. 2023 Sep;37(9):652-661. doi: 10.1177/15459683231197412. Epub 2023 Sep 11.


DOI:10.1177/15459683231197412
PMID:37694568
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10523825/
Abstract

BACKGROUND: Chronic sensory loss is a common and undertreated consequence of many forms of neurological injury. Emerging evidence indicates that vagus nerve stimulation (VNS) delivered during tactile rehabilitation promotes recovery of somatosensation. OBJECTIVE: Here, we characterize the amount, intensity, frequency, and duration of VNS therapy paradigms to determine the optimal dosage for VNS-dependent enhancement of recovery in a model of peripheral nerve injury (PNI). METHODS: Rats underwent transection of the medial and ulnar nerves in the forelimb, resulting in chronic sensory loss in the paw. Eight weeks after injury, rats were implanted with a VNS cuff and received tactile rehabilitation sessions consisting of repeated mechanical stimulation of the previously denervated forepaw paired with short bursts of VNS. Rats received VNS therapy in 1 of 6 systematically varied dosing schedules to identify a paradigm that balanced therapy effectiveness with a shorter regimen. RESULTS: Delivering 200 VNS pairings a day 4 days a week for 4 weeks produced the greatest percent improvement in somatosensory function compared to any of the 6 other groups (One Way analysis of variance at the end of therapy, [4 70] = .005). CONCLUSIONS: Our findings demonstrate that an effective VNS therapy dosage delivers many stimulations per session, with many sessions per week, over many weeks. These results provide a framework to inform the development of VNS-based therapies for sensory restoration.

摘要

背景:慢性感觉丧失是许多形式的神经损伤的常见且未得到充分治疗的后果。新出现的证据表明,在触觉康复过程中给予迷走神经刺激(VNS)可促进体感的恢复。

目的:在这里,我们描述了 VNS 治疗方案的数量、强度、频率和持续时间,以确定 VNS 依赖性增强周围神经损伤(PNI)模型中恢复的最佳剂量。

方法:大鼠在前肢中进行正中神经和尺神经的横断,导致爪子出现慢性感觉丧失。损伤后 8 周,大鼠植入 VNS 袖带,并接受触觉康复治疗,包括对先前去神经的前爪进行重复机械刺激,并伴有短暂的 VNS 爆发。大鼠接受 6 种不同剂量方案中的 1 种 VNS 治疗方案,以确定一种平衡治疗效果和较短方案的方案。

结果:与其他 6 组相比,每天进行 200 对 VNS 配对,每周 4 天,连续 4 周,体感功能的改善百分比最大(治疗结束时的单向方差分析,[4 70] =.005)。

结论:我们的发现表明,有效的 VNS 治疗剂量在每个疗程中提供多次刺激,每周多次,持续数周。这些结果为基于 VNS 的感觉恢复疗法的发展提供了框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37a/10523825/71e77619a0d4/10.1177_15459683231197412-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37a/10523825/f02ba884412f/10.1177_15459683231197412-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37a/10523825/8f2779ec3804/10.1177_15459683231197412-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37a/10523825/1b28953457c6/10.1177_15459683231197412-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37a/10523825/71e77619a0d4/10.1177_15459683231197412-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37a/10523825/f02ba884412f/10.1177_15459683231197412-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37a/10523825/8f2779ec3804/10.1177_15459683231197412-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37a/10523825/1b28953457c6/10.1177_15459683231197412-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e37a/10523825/71e77619a0d4/10.1177_15459683231197412-fig4.jpg

相似文献

[1]
Effective Delivery of Vagus Nerve Stimulation Requires Many Stimulations Per Session and Many Sessions Per Week Over Many Weeks to Improve Recovery of Somatosensation.

Neurorehabil Neural Repair. 2023-9

[2]
Vagus Nerve Stimulation Must Occur During Tactile Rehabilitation to Enhance Somatosensory Recovery.

Neuroscience. 2023-11-10

[3]
The tactile experience paired with vagus nerve stimulation determines the degree of sensory recovery after chronic nerve damage.

Behav Brain Res. 2021-1-1

[4]
Vagus nerve stimulation does not improve recovery of forelimb motor or somatosensory function in a model of neuropathic pain.

Sci Rep. 2022-6-11

[5]
Vagus Nerve Stimulation During Rehabilitative Training Improves Forelimb Recovery After Chronic Ischemic Stroke in Rats.

Neurorehabil Neural Repair. 2016-8

[6]
Restoration of Somatosensory Function by Pairing Vagus Nerve Stimulation with Tactile Rehabilitation.

Ann Neurol. 2020-1-7

[7]
Vagus Nerve Stimulation Paired With Rehabilitative Training Enhances Motor Recovery After Bilateral Spinal Cord Injury to Cervical Forelimb Motor Pools.

Neurorehabil Neural Repair. 2020-3

[8]
Neural mechanisms responsible for vagus nerve stimulation-dependent enhancement of somatosensory recovery.

Sci Rep. 2024-8-21

[9]
Vagus nerve stimulation paired with tactile training improved sensory function in a chronic stroke patient.

NeuroRehabilitation. 2018

[10]
Neural Mechanisms Responsible for Vagus Nerve Stimulation-Dependent Enhancement of Somatosensory Recovery.

Res Sq. 2024-1-29

引用本文的文献

[1]
Vagus nerve stimulation: innovative applications in the field of hand function rehabilitation.

Cogn Neurodyn. 2025-12

[2]
Closed-loop vagus nerve stimulation aids recovery from spinal cord injury.

Nature. 2025-5-21

[3]
Advice for translational neuroscience: move deliberately and build things.

Bioelectron Med. 2025-2-3

[4]
Vagus nerve stimulation for stroke rehabilitation: Neural substrates, neuromodulatory effects and therapeutic implications.

J Physiol. 2025-2

[5]
Neural mechanisms responsible for vagus nerve stimulation-dependent enhancement of somatosensory recovery.

Sci Rep. 2024-8-21

[6]
Characterization of an Algorithm for Autonomous, Closed-Loop Neuromodulation During Motor Rehabilitation.

Neurorehabil Neural Repair. 2024-7

本文引用的文献

[1]
Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): a randomised, blinded, pivotal, device trial.

Lancet. 2021-4-24

[2]
High intensity VNS disrupts VNS-mediated plasticity in motor cortex.

Brain Res. 2021-4-1

[3]
The tactile experience paired with vagus nerve stimulation determines the degree of sensory recovery after chronic nerve damage.

Behav Brain Res. 2021-1-1

[4]
Parametric characterization of the rat Hering-Breuer reflex evoked with implanted and non-invasive vagus nerve stimulation.

Exp Neurol. 2020-2-3

[5]
Restoration of Somatosensory Function by Pairing Vagus Nerve Stimulation with Tactile Rehabilitation.

Ann Neurol. 2020-1-7

[6]
Enhancing plasticity in central networks improves motor and sensory recovery after nerve damage.

Nat Commun. 2019-12-19

[7]
Inpatient rehabilitation facilities: The 3-hour rule.

Medicine (Baltimore). 2019-9

[8]
Norepinephrine and serotonin are required for vagus nerve stimulation directed cortical plasticity.

Exp Neurol. 2019-6-7

[9]
Effects of the amount of practice and time interval between practice sessions on the retention of internal models.

PLoS One. 2019-4-16

[10]
Protocol for Construction of Rat Nerve Stimulation Cuff Electrodes.

Methods Protoc. 2019-3

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