Stroke remains a leading cause of long-term disability worldwide.There is an unmet need for neuromodulatory therapies that can mitigate against neurovascular injury and potentially promote neurological recovery.Transc...Stroke remains a leading cause of long-term disability worldwide.There is an unmet need for neuromodulatory therapies that can mitigate against neurovascular injury and potentially promote neurological recovery.Transcutaneous vagus nerve stimulation has been demonstrated to show potential therapeutic effects in both acute and chronic stroke.However,previously published research has only investigated a narrow range of stimulation settings and indications.In this review,we detail the ongoing studies of transcutaneous vagus nerve stimulation in stroke through systematic searches of registered clinical trials.We summarize the upcoming clinical trials of transcutaneous vagus nerve stimulation in stroke,highlighting their indications,parameter settings,scope,and limitations.We further explore the challenges and barriers associated with the implementation of transcutaneous vagus nerve stimulation in acute stroke and stroke rehabilitation,focusing on critical aspects such as stimulation settings,target groups,biomarkers,and integration with rehabilitation interventions.展开更多
Inflammatory bowel disease(IBD),comprising Crohn’s disease and ulcerative colitis,represents the two predominant clinical entities within this spectrum of gastrointestinal disorders.Current evidence indicates that th...Inflammatory bowel disease(IBD),comprising Crohn’s disease and ulcerative colitis,represents the two predominant clinical entities within this spectrum of gastrointestinal disorders.Current evidence indicates that the etiology of IBD is multifactorial,involving a complex interplay between host genetic susceptibility and environmental determinants.In recent years,non-pharmacological strategies such as physical exercise and vagus nerve stimulation have gained increasing attention as adjunctive therapeutic approaches.Vagus nerve stimulation has emerged as a promising therapeutic modality,particularly in conditions characterized by autonomic dysfunction and diminished vagal tone.Conversely,vagotomy,by disrupting vagal control,abolishes parasympathetic reflexes and may potentiate inflammatory responses and exacerbate IBD symptomatology under stress conditions.Physical exercise has likewise been investigated as a non-pharmacological intervention in Crohn’s disease and ulcerative colitis.Although the precise mechanisms remain to be fully elucidated,accumulating evidence suggests that skeletal muscle contractions promote the secretion of myokines,with recognized anti-inflammatory properties.These myokines act on the intestinal microenvironment,conferring protection against malignant transformation and modulating the composition and function of the gut microbiota.In this review,we critically examine the interplay between physical exercise,vagus nerve stimulation,and vagotomy in the pathophysiology and management of IBD,with particular emphasis on their immunomodulatory and therapeutic potential.展开更多
The laryngeal muscle evoked potential(LMEP)is a neurophysiological outcome parameter that guarantees integrity of the nerve-electrode interface during experiments with vagus nerve stimulation(VNS).This paper discusses...The laryngeal muscle evoked potential(LMEP)is a neurophysiological outcome parameter that guarantees integrity of the nerve-electrode interface during experiments with vagus nerve stimulation(VNS).This paper discusses a large series of minimally invasive LMEP recordings in 46 female Lewis rats,implanted with a custom-made VNS electrode around the left cervical vagus nerve.After a 3-week recovery,LMEPs were recorded twice in each animal,with swapping the anode and cathode positions of the VNS electrode(polarity inversion).A VNS-induced LMEP was identified as the initial negative peak wave post-stimulation artifact,consistently recorded in all sweeps at a given stimulation output current.Latency was defined as the time from stimulation onset to this negative peak,and stimulation threshold as the lowest current showing a clear and reproducible LMEP.An LMEP response was shown by 37/46 animals(80.4%),with stimulation intensity threshold of 0.37±0.27 mA and latency of 2.39±0.45 ms.Administering the cathodic pulse phase first at the caudal electrode contact resulted in the shortest LMEP latencies(MWU:p=0.049.2.36±0.43 ms vs.2.41±0.47 ms).Minimally invasive LMEP recording provides a feasible and reliable means for checking electrode functioning and correct implantation.展开更多
The vagus nerve plays a pivotal role in regulating blood pressure,making vagus nerve stimulation a promising therapy for refractory hypertension.Nevertheless,most current research on vagus nerve stimulation for hypert...The vagus nerve plays a pivotal role in regulating blood pressure,making vagus nerve stimulation a promising therapy for refractory hypertension.Nevertheless,most current research on vagus nerve stimulation for hypertension regulation employs rigid electrodes outside the nerve bundle,with limited exploration into the electrical stimulation paradigms.In this study,we employed the carbon nanotube yarn electrode,a flexible electrode,implanted in the left vagus nerve of rats to compare the modulatory effects of duty cycle and pulse width stimulation paradigms.Furthermore,we conducted a quantitative electrical stimulation experiment using the optimized duty cycle paradigm.The result showed that low-frequency stimulation yielded superior blood pressure regulation,whereas high-frequency stimulation resulted in apnea.In conclusion,intrafascicular vagus nerve stimulation with the duty-cycle paradigm demonstrated superior efficacy in reducing blood pressure compared to the pulse-width paradigm,with an optimal duty cycle identified at 20%.These findings offer valuable insights for optimizing vagus nerve stimulation protocols in the treatment of hypertension.展开更多
Stroke is a major disorder of the central nervous system that poses a serious threat to human life and quality of life.Many stro ke victims are left with long-term neurological dysfunction,which adversely affects the ...Stroke is a major disorder of the central nervous system that poses a serious threat to human life and quality of life.Many stro ke victims are left with long-term neurological dysfunction,which adversely affects the well-being of the individual and the broader socioeconomic impact.Currently,poststroke brain dysfunction is a major and difficult area of treatment.Vagus nerve stimulation is a Food and Drug Administration-approved exploratory treatment option for autis m,refractory depression,epilepsy,and Alzheimer’s disease.It is expected to be a novel therapeutic technique for the treatment of stroke owing to its association with multiple mechanisms such as alte ring neurotransmitters and the plasticity of central neuro ns.In animal models of acute ischemic stroke,vagus nerve stimulation has been shown to reduce infarct size,reduce post-stroke neurological damage,and improve learning and memory capacity in rats with stroke by reducing the inflammatory response,regulating bloodbrain barrier permeability,and promoting angiogenesis and neurogenesis.At present,vagus nerve stimulation includes both invasive and non-invasive vagus nerve stimulation.Clinical studies have found that invasive vagus nerve stimulation combined with rehabilitation therapy is effective in im proving upper limb motor and cognitive abilities in stroke patients.Further clinical studies have shown that non-invasive vagus nerve stimulation,including ear/ce rvical vagus nerve stimulation,can stimulate vagal projections to the central nervous system similarly to invasive vagus nerve stimulation and can have the same effect.In this paper,we first describe the multiple effects of vagus nerve stimulation in stroke,and then discuss in depth its neuroprotective mechanisms in ischemic stroke.We go on to outline the res ults of the current major clinical applications of invasive and non-invasive vagus nerve stimulation.Finally,we provide a more comprehensive evaluation of the advantages and disadvantages of different types of vagus nerve stimulation in the treatment of cerebral ischemia and provide an outlook on the developmental trends.We believe that vagus nerve stimulation,as an effective treatment for stroke,will be widely used in clinical practice to promote the recovery of stroke patients and reduce the incidence of disability.展开更多
Objective Our previous work suggested that sensitivity of hippocampal neurons is changed in process of epileptic activities,and closely parallel to the dynamic characteristic of epileptic activity of the neurons.This ...Objective Our previous work suggested that sensitivity of hippocampal neurons is changed in process of epileptic activities,and closely parallel to the dynamic characteristic of epileptic activity of the neurons.This study investigated the sensitivity of epileptic brain to vagal nerve stimulation（VNS）in epileptic process.Methods Epileptic model was evoked by penicillin.Left vagal nerves were stimulated to inhibit the seizures induced by penicillin.The electrocorticography（ECoG）and electromyography（EMG）were recorded to analyze inhibiting effect of VNS in epileptic process.Results It was found that VNS could inhibit the seizures caused by penicillin,and the inhibiting effect of VNS to seizures increased as the vagal nerve stimulating time prolonged.It was also found that the inhibiting effect of VNS to seizures decreased in epileptic process.Conclusion The results suggested that the sensitivity of epileptic brain to VNS was different in epileptic process.The inhibiting effect of VNS to seizure decreased as the development of seizures.展开更多
Whether in the West or the East,the connection between the ear and the rest of the body has been explored for a long time.Especially in the past century or more,the relevant theoretical and applied research on the ear...Whether in the West or the East,the connection between the ear and the rest of the body has been explored for a long time.Especially in the past century or more,the relevant theoretical and applied research on the ear has greatly promoted the development of ear therapy,and finally the concept of transcutaneous auricular vagus nerve stimulation(taVNS)has been proposed.The purpose of taVNS is to treat a disease non-invasively by applying electrical current to the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear.In the past two decades,taVNS has been a topic of basic,clinical,and transformation research.It has been applied as an alternative to drug treatment for a variety of diseases.Based on the rapid understanding of the application of taVNS to human health and disease,some limitations in the development of this field have also been gradually exposed.Here,we comprehensively review the origin and research status of the field.展开更多
Transcutaneous auricular vagus nerve stimulation(ta-VNS)is a novel noninvasive treat-ment for stroke that directly stimulates the peripheral auricular branch of the vagus nerve.There have been recent reports that ta-V...Transcutaneous auricular vagus nerve stimulation(ta-VNS)is a novel noninvasive treat-ment for stroke that directly stimulates the peripheral auricular branch of the vagus nerve.There have been recent reports that ta-VNS combined with conventional rehabilitation training promotes the recovery of neurological function of patients with acute stroke.However,these were small-sample-sized studies on the recovery of neurological function in patients after percutaneous vagus nerve stimulation in the subacute and chronic phases after stroke.This double-blinded randomized controlled trial involved 60 acute ischemic or hemorrhagic stroke patients aged 18-80 years who received treatment in the Second Affiliated Hospital of Chongqing Medical University.The subjects were randomly assigned to receive ta-VNS or sham ta-VNS combined with conventional rehabilitation training.The follow-up results over 1 year revealed that ta-VNS combined with conventional rehabilitation training greatly improved the recovery of motor and sensory functions and emotional responses compared with sham ta-VNS combined with conventional rehabilitation training.There were no obvious side effects.These findings suggest that ta-VNS combined with conventional rehabilitation training for the treatment of acute ischemic or hemorrhagic stroke patients is safe and effective.展开更多
Orexins, produced in the lateral hypothalamus, are important neuropeptides that participate in the sleep/wake cycle, and their expres- sion coincides with the projection area of the vagus nerve in the brain. Vagus ner...Orexins, produced in the lateral hypothalamus, are important neuropeptides that participate in the sleep/wake cycle, and their expres- sion coincides with the projection area of the vagus nerve in the brain. Vagus nerve stimulation has been shown to decrease the amounts of daytime sleep and rapid eye movement in epilepsy patients with traumatic brain injury. In the present study, we investigated whether vagus nerve stimulation promotes wakefulness and affects orexin expression. A rat model of traumatic brain injury was established using the free fall drop method. In the stimulated group, rats with traumatic brain injury received vagus nerve stimulation （frequency, 30 Hz, current, 1.0 mA; pulse width, 0.5 ms; total stimulation time, 15 minutes）. In the antagonist group, rats with traumatic brain injury were intracerebroventricularly injected with the orexin receptor type 1 （OXIR） antagonist SB334867 and received vagus nerve stimulation. Changes in consciousness were observed after stimulation in each group. Enzyme-linked immunosorbent assay, western blot assay and immunohistochemistry were used to assess the levels of orexin-A and OX1R expression in the prefrontal cortex. In the stimulated group, consciousness was substantially improved, orexin-A protein expression gradually increased within 24 hours after injury and OX1R expres- sion reached a peak at 12 hours, compared with rats subjected to traumatic brain injury only. In the antagonist group, the wake-promoting effect of vagus nerve stimulation was diminished, and orexin-A and OX1R expression were decreased, compared with that of the stim- ulated group. Taken together, our findings suggest that vagus nerve stimulation promotes the recovery of consciousness in comatose rats after traumatic brain injury. The upregulation of orexin-A and OXIR expression in the prefrontal cortex might be involved in the wake-promoting effects of vagus nerve stimulation.展开更多
Microglia are the brain’s primary innate immune cells,and they are activated and affect pro-inflammatory phenotype or regulatory phenotype after ischemic stroke.Vagus nerve stimulation was shown to activate microglia...Microglia are the brain’s primary innate immune cells,and they are activated and affect pro-inflammatory phenotype or regulatory phenotype after ischemic stroke.Vagus nerve stimulation was shown to activate microglial phenotypic changes and exhibit neuroprotective effects in ischemia/reperfusion injury.In this study,we established rat models of ischemic stroke by occlusion of the middle cerebral artery and performed vagus nerve stimulation 30 minutes after modeling.We found that vagus nerve stimulation caused a shift from a pro-inflammatory phenotype to a regulatory phenotype in microglia in the ischemic penumbra.Vagus nerve stimulation decreased the levels of pro-inflammatory phenotype markers inducible nitric oxide synthase and tumor necrosis factorαand increased the expression of regulatory phenotype markers arginase 1 and transforming growth factorβthrough activatingα7 nicotinic acetylcholine receptor expression.Additionally,α7 nicotinic acetylcholine receptor blockade reduced the inhibition of Toll-like receptor 4/nuclear factor kappa-B pathwayassociated proteins,including Toll-like receptor 4,myeloid differentiation factor 88,I kappa B alpha,and phosphorylated-I kappa B alpha,and also weakened the neuroprotective effects of vagus nerve stimulation in ischemic stroke.Vagus nerve stimulation inhibited Toll-like receptor 4/nuclear factor kappa-B expression through activatingα7 nicotinic acetylcholine receptor and regulated microglial polarization after ischemic stroke,thereby playing a role in the treatment of ischemic stroke.Findings from this study confirm the mechanism underlying vagus nerve stimulation against ischemic stroke.展开更多
Previous studies have shown that vagus nerve stimulation can improve patients' locomotor function.The stimulation of the auricular vagus nerve,which is the only superficial branch of the vagus nerve,may have simil...Previous studies have shown that vagus nerve stimulation can improve patients' locomotor function.The stimulation of the auricular vagus nerve,which is the only superficial branch of the vagus nerve,may have similar effects to vagus nerve stimulation.However,the precise mechanisms remain poorly understood.In this study,rat models of cerebral ischemia/reperfusion injury were established by modified Longa ligation.Twenty-four hours later,7-day auricular vagus nerve stimulation was performed.The results showed that auricular vagus nerve stimulation promoted the secretion of acetylcholine,inhibited the secretion of interleukin-1β,interleukin-6,and tumor necrosis factor-α,and reduced connexin 43 phosphorylation in the ischemic penumbra and motor cortex,promoting locomotor function recovery in rats with cerebral ischemia/reperfusion injury.These findings suggested that auricular vagus nerve stimulation promotes the recovery of locomotor function in rats with cerebral ischemia/reperfusion injury by altering the secretion of acetylcholine and inflammatory factors and the phosphorylation of connexin 43.This study was approved by the Animal Use and Management Committee of Shanghai University of Traditional Chinese Medicine on November 8,2019(approval No.PZSHUTCM191108014).展开更多
Objective:To observe the influence of transcutaneous auricular vagus nerve stimulation(taVNS) on fasting plasma glucose(FPG) and serum insulin(INS) in Zucker diabetes fatty(ZDF) rats and explore the regulatory effect ...Objective:To observe the influence of transcutaneous auricular vagus nerve stimulation(taVNS) on fasting plasma glucose(FPG) and serum insulin(INS) in Zucker diabetes fatty(ZDF) rats and explore the regulatory effect of taVNS on blood glucose in ZDF rats.Methods:A total of 20 male ZDF rats were randomized into a model group and a taVNS group,10 rats in each one.Besides,the other 10 Zucker Lean(ZL) rats were selected to be a control group.The rats in the control group were fed with common forage and those in the model group and the taVNS group were fed with high-sugar and high-fat forage.The intervention of electric stimulation was applied in the rats of taVNS group,with 2/15 Hz in frequency,disperse-dense wave and 2 mA in intensity.Each intervention lasted 30 min,once a day,consecutively for 12 weeks.No any intervention was given in the control group and the model group.The body mass and FPG level were recorded once every 2 weeks in the rats.After the experiment,the rats were sacrificed and blood sample was collected.Enzyme linked immunosorbent assay(ELISA) was adopted to determine the level of serum INS in the rats.Results:After the modeling,compared with the control group,the body mass and FPG level were all higher(P <0.05,P <0.01) and the concentration of serum INS was lower(P <0.01) in the rats of the model group.After intervention,compared with the model group,the body mass was lower in week 6 to 10(P <0.01,P <0.05),FPG level was lower in week 8 to 12(P <0.01,P <0.05) and serum INS concentration was higher(P <0.01) in the rats of the taVNS group.Conclusion:TaVNS apparently improves in hyperglycemia in ZDF rats and increases serum insulin concentration in the rats.展开更多
OBJECTIVE:To evaluate the clinical effect of transcutaneous auricular vagus nerve nerve stimulation(ta VNS)on disorders of consciousness(DOC)patients with Coma Recovery Scale-Revised(CRS-R)and cerebral cortex activity...OBJECTIVE:To evaluate the clinical effect of transcutaneous auricular vagus nerve nerve stimulation(ta VNS)on disorders of consciousness(DOC)patients with Coma Recovery Scale-Revised(CRS-R)and cerebral cortex activity by electroencephalogram(EEG)detection.METHODS:Randomized controlled methods were used to evaluate the clinical effect of ta VNS on patients with DOC.Twelve patients with initial CRS-R of 6-10 were randomly divided into the treatment group of ta VNS and control group of transcutaneous non-auricular vague nerve stimulation(tn VNS).According to clinical diagnosis,the treatment group was divided into vegetative state(VS)group and minimally conscious state(MCS)group.RESULTS:The energy of delta and beta bands is positively correlated with the brain activity of patients.ta VNS has different regulatory effects on patients with different conscious States.In ta VNS group,the energy of delta band in local brain regions changed significantly.Significant changes in brain connection activity were limited to local brain regions.While in patients with MCS in the ta VNS group,delta and beta band energy significantly changed in multiple brain regions and crossbrain connection activity also changed significantly.CONCLUSION:These findings suggest that ta VNS may be a related extra method for arousing patients’awakening by improving brain connection activity.And the effect is remarkable in MCS patients.展开更多
Previous studies have shown that vagus nerve stimulation can improve the prognosis of trau- matic brain injury. The aim of this study was to elucidate the mechanism of the neuroprotective effects of vagus nerve stimul...Previous studies have shown that vagus nerve stimulation can improve the prognosis of trau- matic brain injury. The aim of this study was to elucidate the mechanism of the neuroprotective effects of vagus nerve stimulation in rabbits with brain explosive injury. Rabbits with brain ex- plosive injury received continuous stimulation （10 V, 5 Hz, 5 ms, 20 minutes） of the right cervical vagus nerve. Tumor necrosis factor-a, interleukin-l~ and interleukin-10 concentrations were detected in serum and brain tissues, and water content in brain tissues was measured. Results showed that vagus nerve stimulation could reduce the degree of brain edema, decrease tumor necrosis factor-a and interleukin-1β concentrations, and increase interleukin-10 concentration after brain explosive injury in rabbits. These data suggest that vagus nerve stimulation may exert neuroprotective effects against explosive injury via regulating the expression of tumor necrosis factor-a, interleukin-1 β and interleukin-10 in the serum and brain tissue.展开更多
A nerve stimulation-guided lumbar plexus block is a well-established technique.It is not clear whether ultrasound guidance has additional value for this deep block technique.This study aimed to examine whether ultraso...A nerve stimulation-guided lumbar plexus block is a well-established technique.It is not clear whether ultrasound guidance has additional value for this deep block technique.This study aimed to examine whether ultrasound guidance using a paramedian transverse scan through the intertransverse space(PMTS-ITS)approach in combination with nerve stimulation reduces the onset time of a complete sensory block.Forty-four patients who were scheduled to undergo arthroscopic knee surgery with an ultrasound visibility score(UVS)of≥10 for the lumbar plexus were enrolled and randomly allocated to the ultrasound guidance with nerve stimulation group(group U-N)or nerve stimulation group(group N)in this prospective,randomized,parallel-group,active-controlled study.The primary outcome was the onset time of a complete sensory block.The results showed that the onset time of a complete sensory block to pinprick and cold was 10(10–40)min and 10(10–40)min in group U-N,respectively,and 30(10–40)min and 20(10–40)min in group N(P=0.005,P=0.004),respectively.The performance time was 658±87 s in group U-N and 528±97 s in group N(P<0.001).There was no(0%)patient who required 5 or more needle passes in group U-N and 6(27.3%)in group N(P=0.028).The block failure rate was 9.1%in group U-N and 31.8%in group N(P>0.05).In conclusion,ultrasound guidance using the PMTS-ITS approach in combination with nerve stimulation led to a faster onset of a complete sensory block than nerve stimulation alone for a lumbar plexus block in patients with a UVS≥10.Ultrasound guidance with nerve stimulation significantly decreased the number of patients who required 5 or more needle passes.展开更多
Percutaneous electrical nerve stimulation of an injured nerve can promote and accelerate peripheral nerve regeneration and improve function.When performing acupuncture and moxibustion,locating the injured nerve using ...Percutaneous electrical nerve stimulation of an injured nerve can promote and accelerate peripheral nerve regeneration and improve function.When performing acupuncture and moxibustion,locating the injured nerve using ultrasound before percutaneous nerve stimulation can help prevent further injury to an already injured nerve.However,stimulation parameters have not been standardized.In this study,we constructed a multi-layer human forearm model using finite element modeling.Taking current density and activated function as optimization indicators,the optimal percutaneous nerve stimulation parameters were established.The optimal parameters were parallel placement located 3 cm apart with the injury site at the midpoint between the needles.To validate the efficacy of this regimen,we performed a randomized controlled trial in 23 patients with median nerve transection who underwent neurorrhaphy.Patients who received conventional rehabilitation combined with percutaneous electrical nerve stimulation experienced greater improvement in sensory function,motor function,and grip strength than those who received conventional rehabilitation combined with transcutaneous electrical nerve stimulation.These findings suggest that the percutaneous electrical nerve stimulation regimen established in this study can improve global median nerve function in patients with median nerve transection.展开更多
Objectives:To observe the clinical long-term therapeutic effect on functional dyspepsia(FD) in the comparative study of transcutaneous auricular vagus nerve stimulation(taVNS) with transcutaneous auricular none-vagus ...Objectives:To observe the clinical long-term therapeutic effect on functional dyspepsia(FD) in the comparative study of transcutaneous auricular vagus nerve stimulation(taVNS) with transcutaneous auricular none-vagus nerve stimulation(tnVNS).Methods:A total of 90 FD patients were randomized into a taVNS group and a tnVNS group,45 cases in each one.The patients in both the taNVS group and the tnVNS group were treated 5 times a week,30 min each time,for 4 weeks totally.Before treatment,after treatment and in follow-up visit,overall symptom points,functional dyspepsia-related quality of life questionnaire(FDQOL),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD) and self-rating depression scale(SDS) were adopted to evaluate the severity of the symptoms and observe the clinical therapeutic effect of patients.Results:Compared with the scores before treatment,the overall symptom points,FDDQL,HAMA,HAMD and SDS at each time point after treatment were all lower in the patients of the taVNS group.The scores of FDDQL after treatment were almost all higher than that before treatment in the self-comparison of each group.All of the above differences were significant statistically(all P <0.05).Compared with the tnVNS group,the overall symptom points,FDDQL, HAMA,HAMD and SDS at each time point after treatment were all lower in the taVNS group and the score of FDDQL was higher,indicating the statistical differences(all P<0.05).Conclusion:Transcutaneous auricular vagus nerve stimulation is applicable for the treatment of functional dyspepsia.Compared with the control group,taVNS obtains a better long-term effect.展开更多
Implantable cervical vagus nerve stimulation(i VNS) is a representative and promising neuromodulation.However,the invasive nature restricts its application.Traditional auricular acupuncture treatment has a long histor...Implantable cervical vagus nerve stimulation(i VNS) is a representative and promising neuromodulation.However,the invasive nature restricts its application.Traditional auricular acupuncture treatment has a long history.The auricular branch of the vagus nerve(ABVN) is a branch on the surface of the ear.Some studies demonstrates that transcutaneous auricular vagus nerve stimulation(ta VNS) would achieve similar effects as i VNS.Ta VNS and i VNS share a common anatomical basis and acting mechanism.In this article,we made a comparison between i VNS and ta VNS in indications and efficacy.The recent studies have revealed similar clinical efficacy of ta VNS,ta VNS would expand the indication of i VNS.Highquality clinical evidences are needed before ta VNS become be an alternative of i VNS.展开更多
OBJECTIVE： To investigate the effects of transcutaneous electrical nerve stimulation （TENS） through acupoints on the intraocular pressure （lOP） in patients with glaucoma. METHODS： A single-blinded, randomized ex...OBJECTIVE： To investigate the effects of transcutaneous electrical nerve stimulation （TENS） through acupoints on the intraocular pressure （lOP） in patients with glaucoma. METHODS： A single-blinded, randomized experimental design study was conducted. Patients from the North of Taipei Ophthalmology outpatient department diagnosed with intraocular hypertension were selected and were further enrolled if they met the research subject criteria. The patients who met all criteria, and who met no exclusion criteria became the participants. Participants were randomly assigned into the treated group, wherein the TENS electrodes （Qing Ming Medical Device Co., Ltd., New Taipei City, China） were applied with direct current （DC） on the acupoints Pucan （BL 61） and Shenmai （BL 62） for 20 min. The control group received no TENS electrode treatments. Measurements of lOP were taken four times using a pneumotonometer （Clinico Co., Ltd., New Taipei City, China）, before, immediately after, 30 min after, and 60 min after TENS electrode treatments. RESULTS： Eighty-two participants completed the experiment, lOP decreased more in the group treated with DC （P 〈 0.01） than in the control group.The lOPs were not affected by the age of the patients and their usage of medications. CONCLUSION： TENS of acupoints of Pucan （BL 61） and Shenmai （BL 62） could significantly reduce the lOP in patients with glaucoma.展开更多
BACKGROUND: Our previous research proved that vagus nerve stimulation(VNS) improved the neurological outcome after cardiopulmonary resuscitation(CPR) by activating α7 nicotinic acetylcholine receptor(α7nAChR) in a r...BACKGROUND: Our previous research proved that vagus nerve stimulation(VNS) improved the neurological outcome after cardiopulmonary resuscitation(CPR) by activating α7 nicotinic acetylcholine receptor(α7nAChR) in a rat model, but the underlying mechanism of VNS in neuroprotection after CPR remains unclear.METHODS: In vivo, we established a mouse model of cardiac arrest(CA)/CPR to observe the survival rate, and the changes in inflammatory factors and brain tissue after VNS treatment. In vitro, we examined the effects of α7nAChR agonist on ischemia/reperfusion(I/R)-induced inflammation in BV2 cells under oxygen-glucose deprivation/reoxygenation(OGD/R) conditions. We observed the changes in cell survival rate, the levels of inflammatory factors, and the expressions of α7nAChR/Janus kinase 2(JAK2) and toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB).RESULTS: In vivo, VNS preconditioning enhanced functional recovery, improved the survival rate, and reduced hippocampal CA1 cell damage, and the levels of inflammatory mediators after CA/CPR. The application of α7nAChR agonists provided similar effects against cerebral injury after the return of spontaneous circulation(ROSC), while α7nAChR antagonists reversed these neuroprotective impacts. The in vitro results mostly matched the findings in vivo. OGD/R increased the expression of tumor necrosis factor-alpha(TNF-α), TLR4 and NF-κB p65. When nicotine was added to the OGD/R model, the expression of TLR4, NF-κB p65, and TNF-α decreased, while the phosphorylation of JAK2 increased, which was prevented by preconditioning with α7nAChR or JAK2 antagonists.CONCLUSION: The neuroprotective effect of VNS correlated with the activation of α7nAChR. VNS may alleviate cerebral IR injury by inhibiting TLR4/NF-κB and activating the α7nAChR/JAK2 signaling pathway.展开更多
基金an Association of British Neurologists Doctoral Research Fellowship co-funded by the Berkeley Foundation and the Stroke Associationsupported by a NIHR Academic Clinical Lectureship in Neurology CL-2020-04-004 NIHR+3 种基金supported by the NIHR Sheffield Biomedical Research Centre(BRC)NIHR Sheffield Clinical Research Facility(CRF)supported by NIHR EME Project Grant NIHR133169funded by Alzheimer’s Research UK Senior Research Fellowship(ARUK-SRF2017B-1)。
文摘Stroke remains a leading cause of long-term disability worldwide.There is an unmet need for neuromodulatory therapies that can mitigate against neurovascular injury and potentially promote neurological recovery.Transcutaneous vagus nerve stimulation has been demonstrated to show potential therapeutic effects in both acute and chronic stroke.However,previously published research has only investigated a narrow range of stimulation settings and indications.In this review,we detail the ongoing studies of transcutaneous vagus nerve stimulation in stroke through systematic searches of registered clinical trials.We summarize the upcoming clinical trials of transcutaneous vagus nerve stimulation in stroke,highlighting their indications,parameter settings,scope,and limitations.We further explore the challenges and barriers associated with the implementation of transcutaneous vagus nerve stimulation in acute stroke and stroke rehabilitation,focusing on critical aspects such as stimulation settings,target groups,biomarkers,and integration with rehabilitation interventions.
文摘Inflammatory bowel disease(IBD),comprising Crohn’s disease and ulcerative colitis,represents the two predominant clinical entities within this spectrum of gastrointestinal disorders.Current evidence indicates that the etiology of IBD is multifactorial,involving a complex interplay between host genetic susceptibility and environmental determinants.In recent years,non-pharmacological strategies such as physical exercise and vagus nerve stimulation have gained increasing attention as adjunctive therapeutic approaches.Vagus nerve stimulation has emerged as a promising therapeutic modality,particularly in conditions characterized by autonomic dysfunction and diminished vagal tone.Conversely,vagotomy,by disrupting vagal control,abolishes parasympathetic reflexes and may potentiate inflammatory responses and exacerbate IBD symptomatology under stress conditions.Physical exercise has likewise been investigated as a non-pharmacological intervention in Crohn’s disease and ulcerative colitis.Although the precise mechanisms remain to be fully elucidated,accumulating evidence suggests that skeletal muscle contractions promote the secretion of myokines,with recognized anti-inflammatory properties.These myokines act on the intestinal microenvironment,conferring protection against malignant transformation and modulating the composition and function of the gut microbiota.In this review,we critically examine the interplay between physical exercise,vagus nerve stimulation,and vagotomy in the pathophysiology and management of IBD,with particular emphasis on their immunomodulatory and therapeutic potential.
基金The Research Foundation Flanders(FWO),Grant/Award Number:1S25620NThe Charcot Research Fund。
文摘The laryngeal muscle evoked potential(LMEP)is a neurophysiological outcome parameter that guarantees integrity of the nerve-electrode interface during experiments with vagus nerve stimulation(VNS).This paper discusses a large series of minimally invasive LMEP recordings in 46 female Lewis rats,implanted with a custom-made VNS electrode around the left cervical vagus nerve.After a 3-week recovery,LMEPs were recorded twice in each animal,with swapping the anode and cathode positions of the VNS electrode(polarity inversion).A VNS-induced LMEP was identified as the initial negative peak wave post-stimulation artifact,consistently recorded in all sweeps at a given stimulation output current.Latency was defined as the time from stimulation onset to this negative peak,and stimulation threshold as the lowest current showing a clear and reproducible LMEP.An LMEP response was shown by 37/46 animals(80.4%),with stimulation intensity threshold of 0.37±0.27 mA and latency of 2.39±0.45 ms.Administering the cathodic pulse phase first at the caudal electrode contact resulted in the shortest LMEP latencies(MWU:p=0.049.2.36±0.43 ms vs.2.41±0.47 ms).Minimally invasive LMEP recording provides a feasible and reliable means for checking electrode functioning and correct implantation.
基金the Science and Technology Project of the State Grid Shanghai Municipal Electric Power Company(No.52094022000U)the National Key Research and Development Program of China(No.2022ZD0208601)the National Natural Science Foundation of China(No.62176158)。
文摘The vagus nerve plays a pivotal role in regulating blood pressure,making vagus nerve stimulation a promising therapy for refractory hypertension.Nevertheless,most current research on vagus nerve stimulation for hypertension regulation employs rigid electrodes outside the nerve bundle,with limited exploration into the electrical stimulation paradigms.In this study,we employed the carbon nanotube yarn electrode,a flexible electrode,implanted in the left vagus nerve of rats to compare the modulatory effects of duty cycle and pulse width stimulation paradigms.Furthermore,we conducted a quantitative electrical stimulation experiment using the optimized duty cycle paradigm.The result showed that low-frequency stimulation yielded superior blood pressure regulation,whereas high-frequency stimulation resulted in apnea.In conclusion,intrafascicular vagus nerve stimulation with the duty-cycle paradigm demonstrated superior efficacy in reducing blood pressure compared to the pulse-width paradigm,with an optimal duty cycle identified at 20%.These findings offer valuable insights for optimizing vagus nerve stimulation protocols in the treatment of hypertension.
基金supported by the Natural Science Foundation of Hubei Province,No.2022CBF680Independent Scientific Research Project of Wuhan University,No.2042022kf1119(both to LD)。
文摘Stroke is a major disorder of the central nervous system that poses a serious threat to human life and quality of life.Many stro ke victims are left with long-term neurological dysfunction,which adversely affects the well-being of the individual and the broader socioeconomic impact.Currently,poststroke brain dysfunction is a major and difficult area of treatment.Vagus nerve stimulation is a Food and Drug Administration-approved exploratory treatment option for autis m,refractory depression,epilepsy,and Alzheimer’s disease.It is expected to be a novel therapeutic technique for the treatment of stroke owing to its association with multiple mechanisms such as alte ring neurotransmitters and the plasticity of central neuro ns.In animal models of acute ischemic stroke,vagus nerve stimulation has been shown to reduce infarct size,reduce post-stroke neurological damage,and improve learning and memory capacity in rats with stroke by reducing the inflammatory response,regulating bloodbrain barrier permeability,and promoting angiogenesis and neurogenesis.At present,vagus nerve stimulation includes both invasive and non-invasive vagus nerve stimulation.Clinical studies have found that invasive vagus nerve stimulation combined with rehabilitation therapy is effective in im proving upper limb motor and cognitive abilities in stroke patients.Further clinical studies have shown that non-invasive vagus nerve stimulation,including ear/ce rvical vagus nerve stimulation,can stimulate vagal projections to the central nervous system similarly to invasive vagus nerve stimulation and can have the same effect.In this paper,we first describe the multiple effects of vagus nerve stimulation in stroke,and then discuss in depth its neuroprotective mechanisms in ischemic stroke.We go on to outline the res ults of the current major clinical applications of invasive and non-invasive vagus nerve stimulation.Finally,we provide a more comprehensive evaluation of the advantages and disadvantages of different types of vagus nerve stimulation in the treatment of cerebral ischemia and provide an outlook on the developmental trends.We believe that vagus nerve stimulation,as an effective treatment for stroke,will be widely used in clinical practice to promote the recovery of stroke patients and reduce the incidence of disability.
文摘Objective Our previous work suggested that sensitivity of hippocampal neurons is changed in process of epileptic activities,and closely parallel to the dynamic characteristic of epileptic activity of the neurons.This study investigated the sensitivity of epileptic brain to vagal nerve stimulation（VNS）in epileptic process.Methods Epileptic model was evoked by penicillin.Left vagal nerves were stimulated to inhibit the seizures induced by penicillin.The electrocorticography（ECoG）and electromyography（EMG）were recorded to analyze inhibiting effect of VNS in epileptic process.Results It was found that VNS could inhibit the seizures caused by penicillin,and the inhibiting effect of VNS to seizures increased as the vagal nerve stimulating time prolonged.It was also found that the inhibiting effect of VNS to seizures decreased in epileptic process.Conclusion The results suggested that the sensitivity of epileptic brain to VNS was different in epileptic process.The inhibiting effect of VNS to seizure decreased as the development of seizures.
基金This review was supported by the National Key R&D Program of China(2018YFC1705800)the National Natural Science Foundation of China(81803872,81674072)+1 种基金the Joint Sino-German Research Project(GZ1236)the Fundamental Research Funds for the Central Public Welfare Research Institutes(ZZ201813006).
文摘Whether in the West or the East,the connection between the ear and the rest of the body has been explored for a long time.Especially in the past century or more,the relevant theoretical and applied research on the ear has greatly promoted the development of ear therapy,and finally the concept of transcutaneous auricular vagus nerve stimulation(taVNS)has been proposed.The purpose of taVNS is to treat a disease non-invasively by applying electrical current to the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear.In the past two decades,taVNS has been a topic of basic,clinical,and transformation research.It has been applied as an alternative to drug treatment for a variety of diseases.Based on the rapid understanding of the application of taVNS to human health and disease,some limitations in the development of this field have also been gradually exposed.Here,we comprehensively review the origin and research status of the field.
基金supported by the Medical Scientific Research Project of Chongqing Municipal Health Commission of China,Nos.2018ZDXM022,2019MSXM017 and 2020MSXM106a grant from Chongqing General Hospital of China,No.2019ZDXM03(all to LCN and JXM).
文摘Transcutaneous auricular vagus nerve stimulation(ta-VNS)is a novel noninvasive treat-ment for stroke that directly stimulates the peripheral auricular branch of the vagus nerve.There have been recent reports that ta-VNS combined with conventional rehabilitation training promotes the recovery of neurological function of patients with acute stroke.However,these were small-sample-sized studies on the recovery of neurological function in patients after percutaneous vagus nerve stimulation in the subacute and chronic phases after stroke.This double-blinded randomized controlled trial involved 60 acute ischemic or hemorrhagic stroke patients aged 18-80 years who received treatment in the Second Affiliated Hospital of Chongqing Medical University.The subjects were randomly assigned to receive ta-VNS or sham ta-VNS combined with conventional rehabilitation training.The follow-up results over 1 year revealed that ta-VNS combined with conventional rehabilitation training greatly improved the recovery of motor and sensory functions and emotional responses compared with sham ta-VNS combined with conventional rehabilitation training.There were no obvious side effects.These findings suggest that ta-VNS combined with conventional rehabilitation training for the treatment of acute ischemic or hemorrhagic stroke patients is safe and effective.
基金supported by the Natural Science Foundation of China,No.81260295the Graduate Student Innovation Fund of Jiangxi Province of China,No.YC2015-S090
文摘Orexins, produced in the lateral hypothalamus, are important neuropeptides that participate in the sleep/wake cycle, and their expres- sion coincides with the projection area of the vagus nerve in the brain. Vagus nerve stimulation has been shown to decrease the amounts of daytime sleep and rapid eye movement in epilepsy patients with traumatic brain injury. In the present study, we investigated whether vagus nerve stimulation promotes wakefulness and affects orexin expression. A rat model of traumatic brain injury was established using the free fall drop method. In the stimulated group, rats with traumatic brain injury received vagus nerve stimulation （frequency, 30 Hz, current, 1.0 mA; pulse width, 0.5 ms; total stimulation time, 15 minutes）. In the antagonist group, rats with traumatic brain injury were intracerebroventricularly injected with the orexin receptor type 1 （OXIR） antagonist SB334867 and received vagus nerve stimulation. Changes in consciousness were observed after stimulation in each group. Enzyme-linked immunosorbent assay, western blot assay and immunohistochemistry were used to assess the levels of orexin-A and OX1R expression in the prefrontal cortex. In the stimulated group, consciousness was substantially improved, orexin-A protein expression gradually increased within 24 hours after injury and OX1R expres- sion reached a peak at 12 hours, compared with rats subjected to traumatic brain injury only. In the antagonist group, the wake-promoting effect of vagus nerve stimulation was diminished, and orexin-A and OX1R expression were decreased, compared with that of the stim- ulated group. Taken together, our findings suggest that vagus nerve stimulation promotes the recovery of consciousness in comatose rats after traumatic brain injury. The upregulation of orexin-A and OXIR expression in the prefrontal cortex might be involved in the wake-promoting effects of vagus nerve stimulation.
基金supported by the Natural Science Foundation of Chongqing,No.cstc2019jcyj-msxm X0026the Medical Scientific Research Projects Foundation of Chongqing,No.2021ZY023818the Natural Science Foundation of Chongqing,No.cstc2018jcyj AX0180(all to GWJ)。
文摘Microglia are the brain’s primary innate immune cells,and they are activated and affect pro-inflammatory phenotype or regulatory phenotype after ischemic stroke.Vagus nerve stimulation was shown to activate microglial phenotypic changes and exhibit neuroprotective effects in ischemia/reperfusion injury.In this study,we established rat models of ischemic stroke by occlusion of the middle cerebral artery and performed vagus nerve stimulation 30 minutes after modeling.We found that vagus nerve stimulation caused a shift from a pro-inflammatory phenotype to a regulatory phenotype in microglia in the ischemic penumbra.Vagus nerve stimulation decreased the levels of pro-inflammatory phenotype markers inducible nitric oxide synthase and tumor necrosis factorαand increased the expression of regulatory phenotype markers arginase 1 and transforming growth factorβthrough activatingα7 nicotinic acetylcholine receptor expression.Additionally,α7 nicotinic acetylcholine receptor blockade reduced the inhibition of Toll-like receptor 4/nuclear factor kappa-B pathwayassociated proteins,including Toll-like receptor 4,myeloid differentiation factor 88,I kappa B alpha,and phosphorylated-I kappa B alpha,and also weakened the neuroprotective effects of vagus nerve stimulation in ischemic stroke.Vagus nerve stimulation inhibited Toll-like receptor 4/nuclear factor kappa-B expression through activatingα7 nicotinic acetylcholine receptor and regulated microglial polarization after ischemic stroke,thereby playing a role in the treatment of ischemic stroke.Findings from this study confirm the mechanism underlying vagus nerve stimulation against ischemic stroke.
基金supported by the National Natural Science Foundation of China,Nos.81704163 (to JJZ),81874035 (to CLS)the National Key R&D Program of China,No.2018YFC2001600 (to CLS)+1 种基金the Shanghai Health Commission Accelerated the Development of Traditional Chinese Medicine ThreeYear Action Plan Project of China,No.ZY(2018-2020)-CCCX-2001-06/2004-05 (to CLS)the Program of Shanghai Academic Research Leader of China,No.19XD1403600 (to CLS)。
文摘Previous studies have shown that vagus nerve stimulation can improve patients' locomotor function.The stimulation of the auricular vagus nerve,which is the only superficial branch of the vagus nerve,may have similar effects to vagus nerve stimulation.However,the precise mechanisms remain poorly understood.In this study,rat models of cerebral ischemia/reperfusion injury were established by modified Longa ligation.Twenty-four hours later,7-day auricular vagus nerve stimulation was performed.The results showed that auricular vagus nerve stimulation promoted the secretion of acetylcholine,inhibited the secretion of interleukin-1β,interleukin-6,and tumor necrosis factor-α,and reduced connexin 43 phosphorylation in the ischemic penumbra and motor cortex,promoting locomotor function recovery in rats with cerebral ischemia/reperfusion injury.These findings suggested that auricular vagus nerve stimulation promotes the recovery of locomotor function in rats with cerebral ischemia/reperfusion injury by altering the secretion of acetylcholine and inflammatory factors and the phosphorylation of connexin 43.This study was approved by the Animal Use and Management Committee of Shanghai University of Traditional Chinese Medicine on November 8,2019(approval No.PZSHUTCM191108014).
基金Supported by National Natural Science Foundation of China:81674072Sino-German Cooperative Research Project of National Natural Science Foundation of China:GZ1236National Natural Science Foundation of China Youth Project:82004181。
文摘Objective:To observe the influence of transcutaneous auricular vagus nerve stimulation(taVNS) on fasting plasma glucose(FPG) and serum insulin(INS) in Zucker diabetes fatty(ZDF) rats and explore the regulatory effect of taVNS on blood glucose in ZDF rats.Methods:A total of 20 male ZDF rats were randomized into a model group and a taVNS group,10 rats in each one.Besides,the other 10 Zucker Lean(ZL) rats were selected to be a control group.The rats in the control group were fed with common forage and those in the model group and the taVNS group were fed with high-sugar and high-fat forage.The intervention of electric stimulation was applied in the rats of taVNS group,with 2/15 Hz in frequency,disperse-dense wave and 2 mA in intensity.Each intervention lasted 30 min,once a day,consecutively for 12 weeks.No any intervention was given in the control group and the model group.The body mass and FPG level were recorded once every 2 weeks in the rats.After the experiment,the rats were sacrificed and blood sample was collected.Enzyme linked immunosorbent assay(ELISA) was adopted to determine the level of serum INS in the rats.Results:After the modeling,compared with the control group,the body mass and FPG level were all higher(P <0.05,P <0.01) and the concentration of serum INS was lower(P <0.01) in the rats of the model group.After intervention,compared with the model group,the body mass was lower in week 6 to 10(P <0.01,P <0.05),FPG level was lower in week 8 to 12(P <0.01,P <0.05) and serum INS concentration was higher(P <0.01) in the rats of the taVNS group.Conclusion:TaVNS apparently improves in hyperglycemia in ZDF rats and increases serum insulin concentration in the rats.
基金Supported by the Fundamental Research Funds for the Central Public Welfare Research Institutes:Brain Effects and Multimodal Imaging Mechanism of Transcutaneous Auricular Vagus Nerve Stimulation in Patients with Disorder of Consciousness(No.CI2021A03305)
文摘OBJECTIVE:To evaluate the clinical effect of transcutaneous auricular vagus nerve nerve stimulation(ta VNS)on disorders of consciousness(DOC)patients with Coma Recovery Scale-Revised(CRS-R)and cerebral cortex activity by electroencephalogram(EEG)detection.METHODS:Randomized controlled methods were used to evaluate the clinical effect of ta VNS on patients with DOC.Twelve patients with initial CRS-R of 6-10 were randomly divided into the treatment group of ta VNS and control group of transcutaneous non-auricular vague nerve stimulation(tn VNS).According to clinical diagnosis,the treatment group was divided into vegetative state(VS)group and minimally conscious state(MCS)group.RESULTS:The energy of delta and beta bands is positively correlated with the brain activity of patients.ta VNS has different regulatory effects on patients with different conscious States.In ta VNS group,the energy of delta band in local brain regions changed significantly.Significant changes in brain connection activity were limited to local brain regions.While in patients with MCS in the ta VNS group,delta and beta band energy significantly changed in multiple brain regions and crossbrain connection activity also changed significantly.CONCLUSION:These findings suggest that ta VNS may be a related extra method for arousing patients’awakening by improving brain connection activity.And the effect is remarkable in MCS patients.
文摘Previous studies have shown that vagus nerve stimulation can improve the prognosis of trau- matic brain injury. The aim of this study was to elucidate the mechanism of the neuroprotective effects of vagus nerve stimulation in rabbits with brain explosive injury. Rabbits with brain ex- plosive injury received continuous stimulation （10 V, 5 Hz, 5 ms, 20 minutes） of the right cervical vagus nerve. Tumor necrosis factor-a, interleukin-l~ and interleukin-10 concentrations were detected in serum and brain tissues, and water content in brain tissues was measured. Results showed that vagus nerve stimulation could reduce the degree of brain edema, decrease tumor necrosis factor-a and interleukin-1β concentrations, and increase interleukin-10 concentration after brain explosive injury in rabbits. These data suggest that vagus nerve stimulation may exert neuroprotective effects against explosive injury via regulating the expression of tumor necrosis factor-a, interleukin-1 β and interleukin-10 in the serum and brain tissue.
文摘A nerve stimulation-guided lumbar plexus block is a well-established technique.It is not clear whether ultrasound guidance has additional value for this deep block technique.This study aimed to examine whether ultrasound guidance using a paramedian transverse scan through the intertransverse space(PMTS-ITS)approach in combination with nerve stimulation reduces the onset time of a complete sensory block.Forty-four patients who were scheduled to undergo arthroscopic knee surgery with an ultrasound visibility score(UVS)of≥10 for the lumbar plexus were enrolled and randomly allocated to the ultrasound guidance with nerve stimulation group(group U-N)or nerve stimulation group(group N)in this prospective,randomized,parallel-group,active-controlled study.The primary outcome was the onset time of a complete sensory block.The results showed that the onset time of a complete sensory block to pinprick and cold was 10(10–40)min and 10(10–40)min in group U-N,respectively,and 30(10–40)min and 20(10–40)min in group N(P=0.005,P=0.004),respectively.The performance time was 658±87 s in group U-N and 528±97 s in group N(P<0.001).There was no(0%)patient who required 5 or more needle passes in group U-N and 6(27.3%)in group N(P=0.028).The block failure rate was 9.1%in group U-N and 31.8%in group N(P>0.05).In conclusion,ultrasound guidance using the PMTS-ITS approach in combination with nerve stimulation led to a faster onset of a complete sensory block than nerve stimulation alone for a lumbar plexus block in patients with a UVS≥10.Ultrasound guidance with nerve stimulation significantly decreased the number of patients who required 5 or more needle passes.
基金supported by the National Natural Science Foundation of China,No.81801787(to XZS)China Postdoctoral Science Foundation,No.2018M640238(to XZS)the Natural Science Foundation of Tianjin,No.20JCQNJC01690(to XLC)。
文摘Percutaneous electrical nerve stimulation of an injured nerve can promote and accelerate peripheral nerve regeneration and improve function.When performing acupuncture and moxibustion,locating the injured nerve using ultrasound before percutaneous nerve stimulation can help prevent further injury to an already injured nerve.However,stimulation parameters have not been standardized.In this study,we constructed a multi-layer human forearm model using finite element modeling.Taking current density and activated function as optimization indicators,the optimal percutaneous nerve stimulation parameters were established.The optimal parameters were parallel placement located 3 cm apart with the injury site at the midpoint between the needles.To validate the efficacy of this regimen,we performed a randomized controlled trial in 23 patients with median nerve transection who underwent neurorrhaphy.Patients who received conventional rehabilitation combined with percutaneous electrical nerve stimulation experienced greater improvement in sensory function,motor function,and grip strength than those who received conventional rehabilitation combined with transcutaneous electrical nerve stimulation.These findings suggest that the percutaneous electrical nerve stimulation regimen established in this study can improve global median nerve function in patients with median nerve transection.
基金Supported by National Natural Science Foundation:81674072Beijing Municipal Administration of Hospitals Incubating Program:PZ2021001。
文摘Objectives:To observe the clinical long-term therapeutic effect on functional dyspepsia(FD) in the comparative study of transcutaneous auricular vagus nerve stimulation(taVNS) with transcutaneous auricular none-vagus nerve stimulation(tnVNS).Methods:A total of 90 FD patients were randomized into a taVNS group and a tnVNS group,45 cases in each one.The patients in both the taNVS group and the tnVNS group were treated 5 times a week,30 min each time,for 4 weeks totally.Before treatment,after treatment and in follow-up visit,overall symptom points,functional dyspepsia-related quality of life questionnaire(FDQOL),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD) and self-rating depression scale(SDS) were adopted to evaluate the severity of the symptoms and observe the clinical therapeutic effect of patients.Results:Compared with the scores before treatment,the overall symptom points,FDDQL,HAMA,HAMD and SDS at each time point after treatment were all lower in the patients of the taVNS group.The scores of FDDQL after treatment were almost all higher than that before treatment in the self-comparison of each group.All of the above differences were significant statistically(all P <0.05).Compared with the tnVNS group,the overall symptom points,FDDQL, HAMA,HAMD and SDS at each time point after treatment were all lower in the taVNS group and the score of FDDQL was higher,indicating the statistical differences(all P<0.05).Conclusion:Transcutaneous auricular vagus nerve stimulation is applicable for the treatment of functional dyspepsia.Compared with the control group,taVNS obtains a better long-term effect.
基金Supported by the China Academy of Chinese Medical Sciences Innovation Fund:Brain Effects and Multimodal Imaging Mechanism of Transcutaneous Auricular Vagus Nerve Stimulation in Patients with Disorder of Consciousness(CI2021A03305)the National Key Research and Development Program:Optimization and Effect Mechanism of Transcutaneous Electrical Cranial-auricular Acupoint Stimulation(TECAS) on Depression(No.2018YFC1705800)。
文摘Implantable cervical vagus nerve stimulation(i VNS) is a representative and promising neuromodulation.However,the invasive nature restricts its application.Traditional auricular acupuncture treatment has a long history.The auricular branch of the vagus nerve(ABVN) is a branch on the surface of the ear.Some studies demonstrates that transcutaneous auricular vagus nerve stimulation(ta VNS) would achieve similar effects as i VNS.Ta VNS and i VNS share a common anatomical basis and acting mechanism.In this article,we made a comparison between i VNS and ta VNS in indications and efficacy.The recent studies have revealed similar clinical efficacy of ta VNS,ta VNS would expand the indication of i VNS.Highquality clinical evidences are needed before ta VNS become be an alternative of i VNS.
文摘OBJECTIVE： To investigate the effects of transcutaneous electrical nerve stimulation （TENS） through acupoints on the intraocular pressure （lOP） in patients with glaucoma. METHODS： A single-blinded, randomized experimental design study was conducted. Patients from the North of Taipei Ophthalmology outpatient department diagnosed with intraocular hypertension were selected and were further enrolled if they met the research subject criteria. The patients who met all criteria, and who met no exclusion criteria became the participants. Participants were randomly assigned into the treated group, wherein the TENS electrodes （Qing Ming Medical Device Co., Ltd., New Taipei City, China） were applied with direct current （DC） on the acupoints Pucan （BL 61） and Shenmai （BL 62） for 20 min. The control group received no TENS electrode treatments. Measurements of lOP were taken four times using a pneumotonometer （Clinico Co., Ltd., New Taipei City, China）, before, immediately after, 30 min after, and 60 min after TENS electrode treatments. RESULTS： Eighty-two participants completed the experiment, lOP decreased more in the group treated with DC （P 〈 0.01） than in the control group.The lOPs were not affected by the age of the patients and their usage of medications. CONCLUSION： TENS of acupoints of Pucan （BL 61） and Shenmai （BL 62） could significantly reduce the lOP in patients with glaucoma.
基金supported by research grants from the National Natural Science Foundation of China (grant no. 81571866 and grant no. 82072137)。
文摘BACKGROUND: Our previous research proved that vagus nerve stimulation(VNS) improved the neurological outcome after cardiopulmonary resuscitation(CPR) by activating α7 nicotinic acetylcholine receptor(α7nAChR) in a rat model, but the underlying mechanism of VNS in neuroprotection after CPR remains unclear.METHODS: In vivo, we established a mouse model of cardiac arrest(CA)/CPR to observe the survival rate, and the changes in inflammatory factors and brain tissue after VNS treatment. In vitro, we examined the effects of α7nAChR agonist on ischemia/reperfusion(I/R)-induced inflammation in BV2 cells under oxygen-glucose deprivation/reoxygenation(OGD/R) conditions. We observed the changes in cell survival rate, the levels of inflammatory factors, and the expressions of α7nAChR/Janus kinase 2(JAK2) and toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB).RESULTS: In vivo, VNS preconditioning enhanced functional recovery, improved the survival rate, and reduced hippocampal CA1 cell damage, and the levels of inflammatory mediators after CA/CPR. The application of α7nAChR agonists provided similar effects against cerebral injury after the return of spontaneous circulation(ROSC), while α7nAChR antagonists reversed these neuroprotective impacts. The in vitro results mostly matched the findings in vivo. OGD/R increased the expression of tumor necrosis factor-alpha(TNF-α), TLR4 and NF-κB p65. When nicotine was added to the OGD/R model, the expression of TLR4, NF-κB p65, and TNF-α decreased, while the phosphorylation of JAK2 increased, which was prevented by preconditioning with α7nAChR or JAK2 antagonists.CONCLUSION: The neuroprotective effect of VNS correlated with the activation of α7nAChR. VNS may alleviate cerebral IR injury by inhibiting TLR4/NF-κB and activating the α7nAChR/JAK2 signaling pathway.
