Anodal block permits directional vagus nerve stimulation
Anodal block permits directional vagus nerve stimulation
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DOI：
10.1038/s41598-020-66332-y
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发表时间：
2020-06-08
影响因子：
4.6
通讯作者：
Zanos, Stavros
中科院分区：
文献类型：
--
作者：
Ahmed, Umair;Chang, Yao-Chuan;Zanos, Stavros
迷走神经刺激（VNS）是一种针对大脑和周围器官疾病的生物电子疗法，也是研究自主神经回路生理学的工具。选择性激活迷走神经传入或传出纤维可以最大限度地提高迷走神经的疗效，减少迷走神经的脱靶效应。阳极阻滞（ABL）已被用于在神经刺激中实现定向纤维激活。然而，关于ABL的定向迷走神经的证据很少且不一致，而且ABL是否允许定向纤维激活对迷走神经的功能影响尚不清楚。通过一系列的迷走神经切除，我们建立了VNS激活传入和输出纤维的生理标记：刺激引起的呼吸速率（Delta BR）和心率（Delta HR）的变化。两极性的双极性VNS训练均引起混合的δ HR和δ BR反应。正极头端极性引起传入模式的反应（相对较强的δ BR），而正极尾端引起传出模式的反应（较强的δ HR）。此外，左侧VNS引起更大的传入反应，右侧VNS引起更大的传出反应。通过分析刺激诱发的复合神经电位，我们证实了VNS功能反应的极性差异可以用A-和b -纤维激活的ABL来解释。我们得出结论，ABL是一种可以用于定向迷走神经的机制。
Vagus nerve stimulation (VNS) is a bioelectronic therapy for disorders of the brain and peripheral organs, and a tool to study the physiology of autonomic circuits. Selective activation of afferent or efferent vagal fibers can maximize efficacy and minimize off-target effects of VNS. Anodal block (ABL) has been used to achieve directional fiber activation in nerve stimulation. However, evidence for directional VNS with ABL has been scarce and inconsistent, and it is unknown whether ABL permits directional fiber activation with respect to functional effects of VNS. Through a series of vagotomies, we established physiological markers for afferent and efferent fiber activation by VNS: stimulus-elicited change in breathing rate (Delta BR) and heart rate (Delta HR), respectively. Bipolar VNS trains of both polarities elicited mixed Delta HR and Delta BR responses. Cathode cephalad polarity caused an afferent pattern of responses (relatively stronger Delta BR) whereas cathode caudad caused an efferent pattern (stronger Delta HR). Additionally, left VNS elicited a greater afferent and right VNS a greater efferent response. By analyzing stimulus-evoked compound nerve potentials, we confirmed that such polarity differences in functional responses to VNS can be explained by ABL of A- and B-fiber activation. We conclude that ABL is a mechanism that can be leveraged for directional VNS.