Access to Vagal Projections via Cutaneous Electrical Stimulation of the Neck: fMRI Evidence in Healthy Humans
Access to Vagal Projections via Cutaneous Electrical Stimulation of the Neck: fMRI Evidence in Healthy Humans
复制标题
DOI：
10.1016/j.brs.2016.10.008
复制
发表时间：
2017-01-01
影响因子：
7.7
通讯作者：
Komisaruk, Barry R.
中科院分区：
文献类型：
--
作者：
Frangos, Eleni;Komisaruk, Barry R.
背景：通过植入电极刺激迷走神经目前被用于治疗难治性癫痫和抑郁症。最近，一种非侵入性的迷走神经刺激方法已经证明了类似的有益效果，但尚不清楚这些效果是否通过迷走神经传入纤维的激活来介导。目的：本研究旨在确定通过经皮电刺激覆盖迷走神经路线的颈部前外侧表面是否可以无创地获得传入迷走神经投射。方法：13名健康受试者在一个疗程内接受2次功能磁共振成像扫描。在扫描#1期间，经皮电刺激于颈部右侧后外侧表面（对照条件，胸锁乳突肌刺激：“SCM”），在扫描#2期间，经皮电刺激于颈部右侧前外侧表面（实验条件，无创迷走神经刺激：“nVNS”），持续2分钟。使用FSL（全脑和脑干；校正，p < 0.01）进行了两项分析，以确定与基线和SCM刺激相比，nVNS是否激活了脑干和前脑的迷走神经投射。结果：与基线和对照（SCM）刺激相比，nVNS显著激活了初级迷走神经投射，包括：孤立束核（迷走神经传入初级中枢中继）、臂旁区、初级感觉皮层和脑岛。基底神经节和额叶皮层区域也被显著激活。海马、视觉皮层和脊髓三叉神经核失活。结论：本研究结果为人类颈部迷走神经传入神经提供了证据，表明通过经皮电刺激颈部前外侧表面可以无创地到达颈部迷走神经传入神经，这为刺激迷走神经传入神经提供了一种可行的替代方法。Elsevier Inc.出版。
Background: Stimulation of the vagus nerve via implanted electrodes is currently used to treat refractory epilepsy and depression. Recently, a non-invasive approach to vagal stimulation has demonstrated similar beneficial effects, but it remains unclear whether these effects are mediated via activation of afferent vagal fibers.Objective: The present study was designed to ascertain whether afferent vagal projections can be accessed non-invasively by transcutaneous electrical stimulation of the antero-lateral surface of the neck, which overlies the course of the vagus nerve.Methods: Thirteen healthy subjects underwent 2 fMRI scans in one session. Transcutaneous electrical stimulation was applied for 2 min to the right postero-lateral surface of the neck during scan #1 (control condition, sternocleidomastoid stimulation: "SCM") and to the right antero-lateral surface of the neck during scan #2 (experimental condition, non-invasive vagus nerve stimulation: "nVNS"). Two analyses were conducted using FSL (whole-brain and brainstem; corrected, p < 0.01) to determine whether nVNS activated vagal projections in the brainstem and forebrain, compared to baseline and SCM stimulation.Results: Compared to baseline and control (SCM) stimulation, nVNS significantly activated primary vagal projections including: nucleus of the solitary tract (primary central relay of vagal afferents), parabrachial area, primary sensory cortex, and insula. Regions of the basal ganglia and frontal cortex were also significantly activated. Deactivations were found in the hippocampus, visual cortex, and spinal trigeminal nucleus.Conclusion: The present findings provide evidence in humans that cervical vagal afferents can be accessed non-invasively via transcutaneous electrical stimulation of the antero-lateral surface of the neck, which overlies the course of the nerve, suggesting an alternative and feasible method of stimulating vagal afferents. Published by Elsevier Inc.