Restoration of Somatosensory Function by Pairing Vagus Nerve Stimulation with Tactile Rehabilitation.
Restoration of Somatosensory Function by Pairing Vagus Nerve Stimulation with Tactile Rehabilitation.
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DOI：
10.1002/ana.25664
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发表时间：
2020-02
影响因子：
11.2
通讯作者：
Hays, Seth A.
中科院分区：
文献类型：
--
作者：
Darrow, Michael J.;Mian, Tabarak M.;Torres, Miranda;Haider, Zainab;Danaphongse, Tanya;Rennaker, Robert L., Jr.;Kilgard, Michael P.;Hays, Seth A.
感觉功能障碍是多种形式的神经损伤的常见后果。结合感觉再训练的康复模式可以提供适度的好处，但大多数患者留下了持久的感觉丧失。我们开发了一种新的策略，使用闭环迷走神经刺激（VNS）配合运动康复来促进神经损伤后的恢复。VNS驱动稳健的、相激活的神经调节网络与康复同时进行，以增强突触可塑性和支持恢复。一份临床病例报告提供了初步证据，表明类似的闭环VNS与触觉康复方案相结合可以改善体感觉功能的恢复。在此，我们试图在这一有希望的初步临床数据的基础上，严格评估VNS与触觉康复相结合的能力，以改善慢性感觉丧失的动物模型的恢复。研究设计，包括计划样本量、评估和统计比较，在开始数据收集之前进行了预登记（https://osf.io/xsnj5/）。视觉刺激与触觉康复相结合可显著且几乎完全恢复机械感觉戒断阈值。无VNS的等效触觉康复不能改善感觉功能。这种依赖vns的感觉阈值恢复在刺激停止后维持了几个月，说明了长期的益处。此外，VNS与触觉康复相结合，可以显著改善前肢感觉运动功能的其他指标，包括前肢使用不对称和前爪位置。鉴于VNS治疗的安全性和耐受性，这些研究结果表明，将VNS与感觉再训练结合到康复方案中可能是一种促进神经损伤后感觉功能恢复的全新方法。
Sensory dysfunction is a common consequence of many forms of neurological injury. Rehabilitative paradigms that incorporate sensory retraining can provide modest benefits, but the majority of patients are left with lasting sensory loss. We have developed a novel strategy that uses closed-loop vagus nerve stimulation (VNS) paired with motor rehabilitation to facilitate recovery after neurological injury. VNS drives robust, phasic activation of neuromodulatory networks concurrent with rehabilitation to enhance synaptic plasticity and support recovery. A clinical case report provides initial evidence that a similar implementation of closed-loop VNS paired with a tactile rehabilitation regimen could improve recovery of somatosensory function. Here, we sought to build on this promising initial clinical data and rigorously evaluate the ability of VNS paired with tactile rehabilitation to improve recovery in an animal model of chronic sensory loss. The study design, including planned sample size, assessments, and statistical comparisons, was preregistered prior to beginning data collection (https://osf.io/xsnj5/). VNS paired with tactile rehabilitation resulted in a significant and nearly complete recovery of mechanosensory withdrawal thresholds. Equivalent tactile rehabilitation without VNS failed to improve sensory function. This VNS-dependent restoration of sensory thresholds was maintained for several months after the cessation of stimulation, illustrating long-term benefits. Moreover, VNS paired with tactile rehabilitation resulted in significant generalized improvements in other measures of forelimb sensorimotor function, including forelimb use asymmetry and paw placement. Given the safety and tolerability of VNS therapy, these findings suggest that incorporating VNS paired with sensory retraining into rehabilitative regimens may represent a fundamentally new method to increase recovery of sensory function after neurological injury.
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影响因子：
4.2
作者：
Byl, N;Roderick, J;Abrams, G
通讯作者：
Abrams, G
影响因子：
4.2
作者：
Hays SA;Ruiz A;Bethea T;Khodaparast N;Carmel JB;Rennaker RL 2nd;Kilgard MP
通讯作者：
Kilgard MP
影响因子：
3.7
作者：
Furmaga H;Carreno FR;Frazer A
通讯作者：
Frazer A
DOI：
10.1016/j.apmr.2007.08.001
发表时间：
2007-11-01
影响因子：
4.3
作者：
Celnik, Pablo;Hummel, Friedhelm;Cohen, Leonardo G.
通讯作者：
Cohen, Leonardo G.
影响因子：
3.8
作者：
Galtrey, Clare M.;Fawcett, James W.
通讯作者：
Fawcett, James W.