A novel transcutaneous vagus nerve stimulation leads to brainstem and cerebral activations measured by functional MRI
A novel transcutaneous vagus nerve stimulation leads to brainstem and cerebral activations measured by functional MRI
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DOI：
10.1515/bmt.2008.022
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发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Ringler, Ralf
中科院分区：
文献类型：
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作者：
Dietrich, Stefan;Smith, James;Ringler, Ralf
背景：使用植入的神经控制性假体(NCP(R))进行左颈迷走神经刺激(VNS)可以减少癫痫发作，最近被证明在治疗难治性抑郁症方面取得了良好的结果。为了解决这种最先进的VNS设备的缺点，研究了另一种用于肌肉刺激的经皮电神经刺激技术。功能磁共振成像(MRI)已被用于测试与迷走神经系统相关的非侵入性通路神经结构。由于缺少脑干激活，结果及其影响都不令人满意。然而，这些激活对于推理是强制性的，迷走神经结构的皮质下和皮质下更高的激活是强制性的。本研究的目的是测试一种新的参数设置和一种新的装置，用于在耳屏内侧进行特定的(受控的)经皮VNS(TVNS)。本文通过血氧水平依赖的功能磁共振成像(BOLD FMRI)显示了这些方法的可行性以及它们在脑和脑活动中的潜力。材料和方法：总共4名健康的成年男性在1.5Tesla磁共振扫描仪中接受了左侧耳屏TVNS的扫描。我们确保我们新开发的TVNS刺激器被改装成MR安全的刺激装置。结果：刺激迷走神经传入通路高阶中继核相关的脑区，即左侧蓝斑、丘脑(Left>；>；Right)、左侧前额叶皮质、左右中央后回、左侧后扣带回和左侧岛叶，均可检测到BOLD反应阳性。在右侧伏核和右侧小脑半球发现失活。结论：该方法和装置分别适用于进入大脑迷走神经结构。由于功能模式与fMRI BOLD有相同的特征，因此讨论了以前用NCP研究的影响，并假设了tVNS的新可能性。
Background: Left cervical vagus nerve stimulation (VNS) using the implanted NeuroCybernetic Prosthesis (NCP (R)) can reduce epileptic seizures and has recently been shown to give promising results for treating therapyresistant depression. To address a disadvantage of this state-of-the-art VNS device, the use of an alternative transcutaneous electrical nerve stimulation technique ' designed for muscular stimulation, was studied. Functional magnetic resonance imaging (MRI) has been used to test non-invasively access nerve structures associated with the vagus nerve system. The results and their impact are unsatisfying due to missing brainstem activations. These activations, however, are mandatory for reasoning, higher subcortical and cortical activations of vagus nerve structures. The objective of this study was to test a new parameter setting and a novel device for performing specific (wel I -controlled) transcutaneous VNS (tVNS) at the inner side of the tragus. This paper shows the feasibility of these and their potential for brainstern and cerebral activations as measured by blood oxygenation level dependent functional MRI (BOLD fMRI).Materials and methods: In total, four healthy male adults were scanned inside a 1.5-Tesla MR scanner while undergoing tVNS at the left tragus. We ensured that our newly developed tVNS stimulator was adapted to be an MR-safe stimulation device. In the experiment, cortical and brainstern representations during WINS were compared to a baseline.Results: A positive BOLD response was detected during stimulation in brain areas associated with higher order relay nuclei of vagal afferent pathways, respectively the left locus coeruleus, the thalamus (left>>right), the left prefrontal cortex, the right and the left postcentral gyrus, the left posterior cingulated gyrus and the left insula. Deactivations were found in the right nucleus accumbens and the right cerebellar hemisphere.Conclusion: The method and device are feasible and appropriate for accessing cerebral vagus nerve structures, respectively. As functional patterns share features with fMRI BOLD, the effects previously studied with the NCP` ' are discussed and new possibilities of tVNS are hypothesised.