Mechanisms underpinning sympathetic nervous activity and its modulation using transcutaneous vagus nerve stimulation.
Mechanisms underpinning sympathetic nervous activity and its modulation using transcutaneous vagus nerve stimulation.
复制标题
DOI：
10.1113/ep086433
复制
发表时间：
2018-03-01
影响因子：
2.7
通讯作者：
Deuchars J
中科院分区：
文献类型：
--
作者：
Deuchars SA;Lall VK;Clancy J;Mahadi M;Murray A;Peers L;Deuchars J
这项检讨的主题是什么？这篇综述简要讨论了是什么调节交感神经活动，以及它可能如何随着年龄的增长或在病理条件下发生变化。然后重点介绍经皮迷走神经刺激，这是自主心血管控制中的一种神经调节方法。它突出了哪些进步？本文综述了经皮迷走神经刺激引起自主神经平衡改变的途径与其他神经调节技术的关系。自主神经系统由交感和副交感神经分支组成，是维持体内平衡范围内心血管变量的主要因素。随着年龄的增长或在某些病理条件下，两个分支之间的平衡发生变化，使交感神经活动更占优势，这种占优势的变化与心力衰竭等疾病的预后呈负相关。我们已经证明，对耳屏的非侵入性刺激增加了副交感神经的活性，降低了交感神经的活性，而且这种影响的程度与不同受试者的基线心血管参数有关。这种影响可能归因于迷走神经传入分支的激活，也可能是该区域其他感觉神经的激活。这表明，在心脏自主神经活动受损的疾病中，耳屏刺激可能是一种可行的治疗方法。
What is the topic of this review? This review briefly considers what modulates sympathetic nerve activity and how it may change as we age or in pathological conditions. It then focuses on transcutaneous vagus nerve stimulation, a method of neuromodulation in autonomic cardiovascular control. What advances does it highlight? The review considers the pathways involved in eliciting the changes in autonomic balance seen with transcutaneous vagus nerve stimulation in relationship to other neuromodulatory techniques. The autonomic nervous system, consisting of the sympathetic and parasympathetic branches, is a major contributor to the maintenance of cardiovascular variables within homeostatic limits. As we age or in certain pathological conditions, the balance between the two branches changes such that sympathetic activity is more dominant, and this change in dominance is negatively correlated with prognosis in conditions such as heart failure. We have shown that non‐invasive stimulation of the tragus of the ear increases parasympathetic activity and reduces sympathetic activity and that the extent of this effect is correlated with the baseline cardiovascular parameters of different subjects. The effects could be attributable to activation of the afferent branch of the vagus and, potentially, other sensory nerves in that region. This indicates that tragus stimulation may be a viable treatment in disorders where autonomic activity to the heart is compromised.