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