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Related Concept Videos

Motor Unit Stimulation01:20

Motor Unit Stimulation

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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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Author Spotlight: Exploring Abdominal VNS for Inflammatory Conditions
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Vagus nerve stimulation using an endovascular electrode array.

Evan N Nicolai1, Jorge Arturo Larco2,3, Sarosh I Madhani4

  • 1Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States of America.

Journal of Neural Engineering
|June 5, 2023
PubMed
Summary

Endovascular vagus nerve stimulation (VNS) using electrodes in the jugular vein shows feasibility for treating neurological conditions. This approach may avoid unwanted motor nerve activation, improving VNS therapy.

Keywords:
electroneurographyendovascularintravascularminimally invasiveneuromodulationswinevagus nerve stimulation (VNS)

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Area of Science:

  • Biomedical Engineering
  • Neuroscience
  • Surgical Innovation

Background:

  • Vagus nerve stimulation (VNS) is clinically approved for epilepsy, depression, and stroke rehabilitation.
  • Current VNS methods involve surgical implantation of electrodes directly on the vagus nerve (VN).
  • A limitation of current VNS is the unintended activation of nearby motor nerve fibers, causing neck muscle contractions.

Purpose of the Study:

  • To investigate the feasibility of endovascular VNS using electrodes placed within the internal jugular vein (IJV).
  • To explore if endovascular VNS can target the VN at locations without motor nerve fibers.
  • To develop imaging tools for optimizing endovascular electrode placement.

Main Methods:

  • Acute intraoperative swine model used for experimentation.
  • Endovascular electrodes were placed within the IJV to stimulate the VN.
  • Recorded VN compound action potentials (CAPs) and neck muscle motor evoked potentials (MEPs).
  • Utilized fluoroscopy (cone beam CT mode) and ultrasound to guide electrode positioning.

Main Results:

  • Electrode position within the IJV is critical for effective VN activation.
  • Demonstrated the use of imaging techniques to precisely locate the endovascular electrode relative to the VN and IJV.
  • VN activation thresholds were higher with endovascular stimulation compared to direct nerve stimulation, but feasibility was established.

Conclusions:

  • Endovascular VNS is a feasible strategy for stimulating the VN.
  • This approach offers potential for VNS at locations lacking motor nerve fibers, minimizing side effects.
  • The study provides a foundation for developing less invasive VNS techniques and optimizing electrode placement.