Compound action potential and personalized parameter regulation of vagus nerve stimulation

YUAN Yuan; HAO Hongwei; LI Luming

doi:10.16511/j.cnki.qhdxxb.2017.22.004

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Journal of Tsinghua University(Science and Technology) ›› 2017, Vol. 57 ›› Issue (2) : 134-140. DOI: 10.16511/j.cnki.qhdxxb.2017.22.004

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Compound action potential and personalized parameter regulation of vagus nerve stimulation

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Abstract

Vagus nerve stimulation (VNS) is widely used to treat various refractory diseases, such as epilepsy and depression. Personalized treatment is very important in these clinical applications. The intraoperative compound action potential (CAP) response of the vagus nerve is analyzed here to evaluate the personalized parameter regulation. A CAP detection system with in vivo experiments with pigs is used to analyze the relationship between the CAP and the VNS parameters, including the current amplitude, pulse width and frequency. The results indicate the selection criteria and the ranges of the stimulation parameters for individual-based treatment. Tests demonstrate that the personalized parameters of the VNS treatment for epilepsy and depression are based on the different response characteristics of the A and B components of the CAP. These results offer a foundation for improving the therapeutic efficacy and for developing closed-loop VNS therapies.

Key words

vagus nerve stimulation / parameter regulation / compound action potential / personalized treatment / in vivo experiment

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YUAN Yuan, HAO Hongwei, LI Luming. Compound action potential and personalized parameter regulation of vagus nerve stimulation[J]. Journal of Tsinghua University(Science and Technology). 2017, 57(2): 134-140 https://doi.org/10.16511/j.cnki.qhdxxb.2017.22.004

References

[1] 郭松铎, 陶月玉, 林尚楠. 心脏病学词典[M]. 北京:中国医药科技出版社, 1998.GUO Songduo, TAO Yueyu, LIN Shangnan. Cardiology Dictionary[M]. Beijing:China Medical Science Press, 1998. (in Chinese) [2] 孟凡刚, 张建国. 迷走神经刺激与癫痫的治疗[J]. 立体定向和功能性神经外科杂志, 2009(3):188-192.MENG Fangang, ZHANG Jianguo. Vagus nerve stimulation and treatment of epilepsy[J]. Chin J Stereotact Funct Neurosurg, 2009(3):188-192. (in Chinese) [3] Amar A P, Apuzzo M L, Liu C Y. Vagus nerve stimulation therapy after failed cranial surgery for intractable epilepsy:Results from the vagus nerve stimulation therapy patient outcome registry[J]. Neurosurgery, 2008, 62(S2):506-513. [4] Elliott R E, Morsi A, Tanweer O, et al. Efficacy of vagus nerve stimulation over time:Review of 65 consecutive patients with treatment-resistant epilepsy treated with VNS > 10 years[J]. Epilepsy Behav, 2011, 20(3):478-483. [5] Spanaki M V, Allen L S, Mueller W M, et al. Vagus nerve stimulation therapy:5-Year or greater outcome at a university-based epilepsy center[J]. Seizure, 2004, 13(8):587-590. [6] Rush A J, Sackeim H A, Marangell L B, et al. Effects of 12 months of vagus nerve stimulation in treatment-resistant depression:A naturalistic study[J]. Biol Psychiat, 2005, 58(5):355-363. [7] Conway C R, Chibnall J T, Gebara M A, et al. Association of cerebral metabolic activity changes with vagus nerve stimulation antidepressant response in treatment-resistant depression[J]. Brain Stimulation, 2013, 6(5):788-797. [8] Bergey G K. Neurostimulation in the treatment of epilepsy[J]. Exp Neurol, 2013, 244:87-95. [9] Heck C, Helmers S L, DeGiorgio C M. Vagus nerve stimulation therapy, epilepsy, and device parameters:Scientific basis and recommendations for use[J]. Neurology, 2002, 59(6S4):S31-S37. [10] Mu Q, Bohning D E, Nahas Z, et al. Acute vagus nerve stimulation using different pulse widths produces varying brain effects[J]. Biol Psychiat, 2004, 55(8):816-825. [11] Labiner D M, Ahern G L. Vagus nerve stimulation therapy in depression and epilepsy:Therapeutic parameter settings[J]. Acta Neurol Scand, 2007, 115(1):23-33. [12] Müller H H, Kornhuber J, Maler J M, et al. The effects of stimulation parameters on clinical outcomes in patients with vagus nerve stimulation implants with major depression[J]. J ECT, 2013, 29(3):e40-e42. [13] Aaronson S T, Carpenter L L, Conway C R, et al. Vagus nerve stimulation therapy randomized to different amounts of electrical charge for treatment-resistant depression:Acute and chronic effects[J]. Brain Stimul, 2013, 6(4):631-640. [14] De Ferrari G M, Schwartz P J. Vagus nerve stimulation:From pre-clinical to clinical application:Challenges and future directions[J]. Heart Fail Rev, 2011, 16(2):195-203. [15] Evans M S, Verma-Ahuja S, Naritoku D K, et al. Intraoperative human vagus nerve compound action potentials[J]. Acta Neurol Scand, 2004, 110(4):232-238. [16] Usami K, Kawai K, Sonoo M, et al. Scalp-recorded evoked potentials as a marker for afferent nerve impulse in clinical vagus nerve stimulation[J]. Brain Stimul, 2013, 6(4):615-623. [17] Tosato M, Yoshida K, Toft E, et al. Closed-loop control of the heart rate by electrical stimulation of the vagus nerve[J]. Med Biol Eng Comput, 2006, 44(3):161-169. [18] Hopkins D A, Gootman P M, Gootman N, et al. Anatomy of medullary and peripheral autonomic neurons innervating the neonatal porcine heart[J]. J Autonom Nerv Sys, 1997, 64(2):74-84. [19] Anholt T A, Ayal S, Goldberg J A. Recruitment and blocking properties of the CardioFit stimulation lead[J]. J Neural Eng, 2011, 8(3), 034004. [20] Ordelman S C M A, Kornet L, Cornelussen R, et al. An indirect component in the evoked compound action potential of the vagal nerve[J]. J Neural Eng, 2010, 7(6), 066001. [21] Grill W M, Norman S E, Bellamkonda R V. Implanted neural interfaces:Biochallenges and engineered solutions[J]. Annu Rev Biomed Eng, 2009, 11:1-24. [22] Durand D. Electric Stimulation of Excitable Tissue:The Biomedical Engineering Handbook[M]. New York:CRC Press, 2000. [23] 郝为强. 电刺激下神经纤维动作电位的仿真研究[D]. 上海:同济大学, 2003.HAO Weiqiang. Simulation Study of Action Potential of Nerve Fiber under Electrical Stimulation[D]. Shanghai:Tongji University, 2003. (in Chinese) [24] Han J S, Chen X H, Sun S L, et al. Effect of low-and high-frequency TENS on Met-enkephalin-Arg-Phe and dynorphin A immunoreactivity in human lumbar CSF[J]. Pain, 1991, 47(3):295-298. [25] Jia F, Guo Y, Wan S, et al. Variable frequency stimulation of subthalamic nucleus for freezing of gait in Parkinson's disease[J]. Parkinsonism Rel D, 2015, 21(12):1471-1472. [26] Grimonprez A, Raedt R, Baeken C, et al. The antidepressant mechanism of action of vagus nerve stimulation:Evidence from preclinical studies[J]. Neurosci Biobehav Rev, 2015, 56:26-34. [27] Lulic D, Ahmadian A, Baaj A A, et al. Vagus nerve stimulation[J]. Neurosurg Focus, 2009, 27(3), E5. [28] Salinsky M C, Burchiel K J. Vagus nerve stimulation has no effect on awake EEG rhythms in humans[J]. Epilepsia, 1993, 34(2):299-304. [29] Rutecki P. Anatomical, physiological, and theoretical basis for the antiepileptic effect of vagus nerve stimulation[J]. Epilepsia, 1990, 31(S2):S1-S6. [30] Mollet L, Grimonprez A, Raedt R, et al. Intensity-dependent modulatory effects of vagus nerve stimulation on cortical excitability[J]. Acta Neurol Scand, 2013, 128(6):391-396.