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Transauricular Vagus Nerve Stimulation and Electroencephalographic Assessment in Disorders of Consciousness
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Empirically Based Guidelines for Selecting Vagus Nerve Stimulation Parameters in Epilepsy and Heart Failure
Eric D Musselman1, Nicole A Pelot1, Warren M Grill1,2,3,4
1Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708.
Cold Spring Harbor Perspectives in Medicine
|September 6, 2018
Summary
Optimizing vagus nerve stimulation (VNS) parameters can improve epilepsy treatment and heart failure therapy. Understanding fiber activation is key to enhancing VNS efficacy and reducing side effects for broader disease applications.
Area of Science:
- Neuroscience
- Biomedical Engineering
- Clinical Medicine
Background:
- Vagus nerve stimulation (VNS) shows promise for epilepsy and heart failure.
- Stimulation parameters critically influence VNS efficacy and tolerability.
- Translating preclinical findings to clinical success requires careful parameter selection.
Purpose of the Study:
- To evaluate the translation of VNS stimulation parameters from preclinical models to human clinical use for epilepsy and heart failure.
- To identify how parameter selection impacts patient outcomes and side effects.
- To explore mechanisms for improving VNS therapy.
Main Methods:
- Review of preclinical studies and clinical trials on VNS for epilepsy and heart failure.
- Analysis of patient outcomes, including seizure reduction and heart failure metrics.
- Assessment of stimulation-induced side effects and their relation to fiber activation.
Main Results:
- Increased VNS frequency/duty cycle and closed-loop systems may improve seizure reduction in epilepsy.
- VNS for heart failure is challenged by co-activation of therapeutic and side effect-inducing fibers.
- Preclinical success in heart failure models did not fully translate to clinical efficacy.
Conclusions:
- Optimizing VNS parameters is crucial for enhancing therapeutic benefits in epilepsy and heart failure.
- A deeper understanding of the relationship between stimulation parameters and fiber recruitment is needed.
- Further research can expand VNS applications and elucidate its mechanisms of action.
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