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Motor Unit Stimulation01:20

Motor Unit Stimulation

When the neuron of a motor unit fires an action potential, it triggers a series of events, leading to a twitch contraction in the muscle fibers. The process of excitation-contraction coupling is crucial in relaying the action potential to the muscle fibers.
The latent period of contraction marks the onset of excitation-contraction coupling, when the action potential propagates across the sarcolemma, preparing the muscle fibers for contraction. As the fibers enter the contraction phase, the...

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Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
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Stimulation parameters after vagus nerve stimulator replacement.

Douglas Labar1, Laura Ponticello, Blagovest Nikolov

  • 1Comprehensive Epilepsy Center, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA.

Neuromodulation : Journal of the International Neuromodulation Society
|December 14, 2011
PubMed
Summary

Vagus nerve stimulator (VNS) generator replacement often prevents patients from tolerating previous settings. However, this inability to return to baseline stimulation current does not increase seizure frequency in epilepsy patients.

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Area of Science:

  • Neurology
  • Biomedical Engineering

Background:

  • Vagus nerve stimulation (VNS) is an established therapy for refractory epilepsy.
  • Pulse generator replacement is a common procedure for VNS therapy.

Purpose of the Study:

  • To evaluate the tolerability and efficacy of VNS stimulation parameters following pulse generator replacement.
  • To assess changes in stimulation current settings and their impact on seizure control post-replacement.

Main Methods:

  • An observational, retrospective study was conducted.
  • Data from 28 epilepsy patients undergoing VNS generator replacement were reviewed.
  • Postoperative stimulation parameters were compared to preoperative baseline settings.

Main Results:

  • 17 out of 28 patients could not tolerate preoperative baseline current settings one year after generator replacement.
  • No significant difference in pre- vs. postoperative seizure rates was observed between patients who could or could not return to baseline settings.
  • Failure to return to baseline current was not associated with VNS duration, battery type, or medication changes.

Conclusions:

  • Patients commonly experience reduced tolerance to VNS stimulation current after generator replacement.
  • This reduced tolerance does not negatively impact seizure control in epilepsy patients.
  • A potential chronic modification in vagus nerve sensitivity to stimulation adjustments is hypothesized.