Effects of vagal neuromodulation on feeding behavior.
Effects of vagal neuromodulation on feeding behavior.
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DOI：
10.1016/j.brainres.2018.02.003
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发表时间：
2018-08-15
期刊：
影响因子：
2.9
通讯作者：
Grill WM
中科院分区：
文献类型：
--
作者：
Pelot NA;Grill WM
植入迷走神经刺激(VNS)治疗肥胖症最近被FDA批准。然而，其疗效和作用机制尚不清楚。在这里，我们综合了VNS对喂养行为和能量平衡的临床和临床前影响，并讨论了理解和改进治疗的工程学考虑。临床颈部迷走神经(≤30赫兹)用于治疗癫痫或抑郁症，作为一种副作用，在减肥方面产生了混合效果，尽管是在非对照的回溯性研究中。相反，临床前研究(颈部和隔膜下VNS)大多报告食物摄入量减少，体重增加或减轻。最近的临床研究报告称，千赫兹频率的VNS应用于隔膜下迷走神经后，体重减轻，尽管有很大的安慰剂效应。这种疗法不是激发神经活动，而是阻断迷走神经的传导。总体而言，刺激参数缺乏系统的探索、优化和基于靶神经纤维和治疗结果的合理性。迷走神经在肠道和大脑之间传递、传递和整合重要的神经(传出和传入)、体液、能量和炎症信息。因此，加深对生物物理学、电生理学和(病理)生理学的了解，有可能推动VNS作为一种有效的治疗方法来治疗一系列疾病。
Implanted vagus nerve stimulation (VNS) for obesity was recently approved by the FDA. However, its efficacy and mechanisms of action remain unclear. Herein, we synthesize clinical and preclinical effects of VNS on feeding behavior and energy balance and discuss engineering considerations for understanding and improving the therapy. Clinical cervical VNS (≤30 Hz) to treat epilepsy or depression has produced mixed effects on weight loss as a side effect, albeit in uncontrolled, retrospective studies. Conversely, preclinical studies (cervical and subdiaphragmatic VNS) mostly report decreased food intake and either decreased weight gain or weight loss. More recent clinical studies report weight loss in response to kilohertz frequency VNS applied to the subdiaphragmatic vagi, albeit with a large placebo effect. Rather than eliciting neural activity, this therapy putatively blocks conduction in the vagus nerves. Overall, stimulation parameters lack systematic exploration, optimization, and justification based on target nerve fibers and therapeutic outcomes. The vagus nerve transduces, transmits, and integrates important neural (efferent and afferent), humoral, energetic, and inflammatory information between the gut and brain. Thus, improved understanding of the biophysics, electrophysiology, and (patho)physiology has the potential to advance VNS as an effective therapy for a wide range of diseases.
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影响因子：
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作者：
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