Surgically implanted and non-invasive vagus nerve stimulation: a review of efficacy, safety and tolerability.
Surgically implanted and non-invasive vagus nerve stimulation: a review of efficacy, safety and tolerability.
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DOI：
10.1111/ene.12629
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发表时间：
2015-09
影响因子：
5.1
通讯作者：
Silberstein S
中科院分区：
文献类型：
--
作者：
Ben-Menachem E;Revesz D;Simon BJ;Silberstein S
迷走神经刺激（VNS）对难治性癫痫和抑郁症有效，并且正在研究心力衰竭、头痛、胃动力障碍和哮喘。第一个迷走神经刺激装置需要手术植入电极和刺激器。不良事件（AE）通常与植入或连续开关刺激相关。感染是最严重的植入相关AE。在植入过程中也有心动过缓和心搏停止的描述，声带麻痹也有，这可能持续长达6个月，取决于手术技巧和经验。最常见的刺激相关AE包括声音改变、感觉异常、咳嗽、头痛、呼吸困难、咽炎和疼痛，可能需要降低刺激强度或间歇性或永久性停用器械。较新的无创VNS输送系统不需要手术，并允许患者按需给予刺激。这些非侵入性VNS系统提高了VNS的安全性和耐受性，使其更容易获得，并促进了更广泛用途的进一步研究。
Vagus nerve stimulation (VNS) is effective in refractory epilepsy and depression and is being investigated in heart failure, headache, gastric motility disorders and asthma. The first VNS device required surgical implantation of electrodes and a stimulator. Adverse events (AEs) are generally associated with implantation or continuous on−off stimulation. Infection is the most serious implantation‐associated AE. Bradycardia and asystole have also been described during implantation, as has vocal cord paresis, which can last up to 6 months and depends on surgical skill and experience. The most frequent stimulation‐associated AEs include voice alteration, paresthesia, cough, headache, dyspnea, pharyngitis and pain, which may require a decrease in stimulation strength or intermittent or permanent device deactivation. Newer non‐invasive VNS delivery systems do not require surgery and permit patient‐administered stimulation on demand. These non‐invasive VNS systems improve the safety and tolerability of VNS, making it more accessible and facilitating further investigations across a wider range of uses.
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