First‐in‐human microelectrode recordings from the vagus nerve during clinical vagus nerve stimulation
Abstract Introduction Vagus nerve stimulation (VNS) is an effective treatment for people with drug‐resistant epilepsy. However, its mechanisms of action are poorly understood, including which nerve fibers are activated in humans during VNS in typical clinical settings and which are required for clin...
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| Format: | Article |
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Wiley
2024-12-01
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| Series: | Epilepsia Open |
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| Online Access: | https://doi.org/10.1002/epi4.13083 |
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| author | Mikaela Patros David G. S. Farmer Kegan Moneghetti Matteo M. Ottaviani Shobi Sivathamboo Hugh D. Simpson Terence J. O'Brien Vaughan G. Macefield |
| author_facet | Mikaela Patros David G. S. Farmer Kegan Moneghetti Matteo M. Ottaviani Shobi Sivathamboo Hugh D. Simpson Terence J. O'Brien Vaughan G. Macefield |
| author_sort | Mikaela Patros |
| collection | DOAJ |
| description | Abstract Introduction Vagus nerve stimulation (VNS) is an effective treatment for people with drug‐resistant epilepsy. However, its mechanisms of action are poorly understood, including which nerve fibers are activated in humans during VNS in typical clinical settings and which are required for clinical efficacy. In particular, there have been no intraneural recordings of vagus nerve fiber activation in awake humans undergoing chronic VNS. In this study, for the first time, we report recordings from the vagus nerve in this setting. Methods The recordings were performed using a sterile tungsten microelectrode inserted percutaneously into the cervical vagus nerve under ultrasound guidance. The clinical VNS systems were used to deliver stimulation while activity in the vagus nerve was recorded. Results In addition to activating myelinated axons at low currents, we provide evidence that VNS can also activate unmyelinated C fibers in the vagus nerve at currents <1 mA. Conclusions These results add to our understanding of how VNS exerts its beneficial effects in drug‐resistant epilepsy. Plain Language Statement Here we describe for the first time, electrical recordings from the vagus nerve in awake drug‐resistant epilepsy patients with an implanted vagus nerve stimulation (VNS) device. We found that the VNS device was able to activate both myelinated and unmyelinated fibers within the vagus nerve, which contributes to our understanding of how VNS works in the context of drug‐resistant epilepsy. |
| format | Article |
| id | doaj-art-983e15a040fe4acb9e909462a8ebfdd2 |
| institution | DOAJ |
| issn | 2470-9239 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Epilepsia Open |
| spelling | doaj-art-983e15a040fe4acb9e909462a8ebfdd22025-08-20T02:50:04ZengWileyEpilepsia Open2470-92392024-12-01962522252710.1002/epi4.13083First‐in‐human microelectrode recordings from the vagus nerve during clinical vagus nerve stimulationMikaela Patros0David G. S. Farmer1Kegan Moneghetti2Matteo M. Ottaviani3Shobi Sivathamboo4Hugh D. Simpson5Terence J. O'Brien6Vaughan G. Macefield7Department of Neuroscience, School of Translational Medicine, The Alfred Centre Monash University Melbourne Victoria AustraliaDepartment of Neuroscience, School of Translational Medicine, The Alfred Centre Monash University Melbourne Victoria AustraliaBaker Heart and Diabetes Institute Melbourne Victoria AustraliaDepartment of Neurosurgery Università Politecnica Delle Marche, Ospedali Riuniti Torrette di Ancona Ancona ItalyDepartment of Neuroscience, School of Translational Medicine, The Alfred Centre Monash University Melbourne Victoria AustraliaDepartment of Neuroscience, School of Translational Medicine, The Alfred Centre Monash University Melbourne Victoria AustraliaDepartment of Neuroscience, School of Translational Medicine, The Alfred Centre Monash University Melbourne Victoria AustraliaDepartment of Neuroscience, School of Translational Medicine, The Alfred Centre Monash University Melbourne Victoria AustraliaAbstract Introduction Vagus nerve stimulation (VNS) is an effective treatment for people with drug‐resistant epilepsy. However, its mechanisms of action are poorly understood, including which nerve fibers are activated in humans during VNS in typical clinical settings and which are required for clinical efficacy. In particular, there have been no intraneural recordings of vagus nerve fiber activation in awake humans undergoing chronic VNS. In this study, for the first time, we report recordings from the vagus nerve in this setting. Methods The recordings were performed using a sterile tungsten microelectrode inserted percutaneously into the cervical vagus nerve under ultrasound guidance. The clinical VNS systems were used to deliver stimulation while activity in the vagus nerve was recorded. Results In addition to activating myelinated axons at low currents, we provide evidence that VNS can also activate unmyelinated C fibers in the vagus nerve at currents <1 mA. Conclusions These results add to our understanding of how VNS exerts its beneficial effects in drug‐resistant epilepsy. Plain Language Statement Here we describe for the first time, electrical recordings from the vagus nerve in awake drug‐resistant epilepsy patients with an implanted vagus nerve stimulation (VNS) device. We found that the VNS device was able to activate both myelinated and unmyelinated fibers within the vagus nerve, which contributes to our understanding of how VNS works in the context of drug‐resistant epilepsy.https://doi.org/10.1002/epi4.13083epilepsymicroelectrodenerve fibersvagus nerve stimulationVNS |
| spellingShingle | Mikaela Patros David G. S. Farmer Kegan Moneghetti Matteo M. Ottaviani Shobi Sivathamboo Hugh D. Simpson Terence J. O'Brien Vaughan G. Macefield First‐in‐human microelectrode recordings from the vagus nerve during clinical vagus nerve stimulation Epilepsia Open epilepsy microelectrode nerve fibers vagus nerve stimulation VNS |
| title | First‐in‐human microelectrode recordings from the vagus nerve during clinical vagus nerve stimulation |
| title_full | First‐in‐human microelectrode recordings from the vagus nerve during clinical vagus nerve stimulation |
| title_fullStr | First‐in‐human microelectrode recordings from the vagus nerve during clinical vagus nerve stimulation |
| title_full_unstemmed | First‐in‐human microelectrode recordings from the vagus nerve during clinical vagus nerve stimulation |
| title_short | First‐in‐human microelectrode recordings from the vagus nerve during clinical vagus nerve stimulation |
| title_sort | first in human microelectrode recordings from the vagus nerve during clinical vagus nerve stimulation |
| topic | epilepsy microelectrode nerve fibers vagus nerve stimulation VNS |
| url | https://doi.org/10.1002/epi4.13083 |
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