How to fail with paired VNS therapy.
How to fail with paired VNS therapy.
复制标题
配对 VNS 疗法如何失败。
DOI：
10.1016/j.brs.2023.08.009
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发表时间：
2023
影响因子：
7.7
通讯作者：
Kilgard,MichaelP
中科院分区：
文献类型：
--
作者：
Hays,SethA;Rennaker2nd,RobertL;Kilgard,MichaelP
迷走神经刺激（VNS）作为一种有前途的生物电子疗法获得了巨大的牵引力。特别是，VNS的提供与促进神经变化的训练相结合，已经证明了中风恢复的临床成功，并在其他领域（从自闭症到精神疾病到正常学习）中找到了深远的应用。配对VNS的成功已被广泛记录。在这里，我们考虑一个更不寻常的问题：为什么VNS有如此广泛的效用，也许更重要的是，当VNS不工作？我们提出了一个讨论的概念，VNS治疗和研究选集，描述了这些概念被违反和VNS失败的条件。我们特别关注植入VNS的机制，以及刺激参数、刺激方法、药理学操作、伴随的合并症和并发训练的具体情况如何与这些机制相互作用，从而影响VNS治疗的疗效。随着成对VNS疗法越来越多地转化为临床实施，清楚地了解它起作用的条件，关键是，它不起作用是这种方法成功的基础。
Vagus nerve stimulation (VNS) has gained enormous traction as a promising bioelectronic therapy. In particular, the delivery of VNS paired with training to promote neural changes has demonstrated clinical success for stroke recovery and found far-reaching application in other domains, from autism to psychiatric disorders to normal learning. The success of paired VNS has been extensively documented. Here, we consider a more unusual question: why does VNS have such broad utility, and perhaps more importantly, when does VNS not work? We present a discussion of the concepts that underlie VNS therapy and an anthology of studies that describe conditions in which these concepts are violated and VNS fails. We focus specifically on the mechanisms engaged by implanted VNS, and how the parameters of stimulation, stimulation method, pharmacological manipulations, accompanying comorbidities, and specifics of concurrent training interact with these mechanisms to impact the efficacy of VNS therapy. As paired VNS therapy is increasing translated to clinical implementation, a clear understanding of the conditions in which it does, and critically, does not work is fundamental to the success of this approach.