A novel implantable vagus nerve stimulation system (ADNS-300) for combined stimulation and recording of the vagus nerve: Pilot trial at Ghent University Hospital

Tahry, Riëm El; Raedt, Robrecht; Mollet, Lies; Herdt, Veerle De; Wyckuys, Tine; Dycke, Annelies Van; Meurs, Alfred; Dewaele, Frank; Roost, Dirk Van; Doguet, Pascal; Delbeke, Jean; Wadman, Wytse J.; Vonck, Kristl; Boon, Paul

doi:10.1016/j.eplepsyres.2010.10.007

Cited by 22 publications

(11 citation statements)

References 45 publications

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“…However, it is worthwhile to extrapolate the implications of our findings to human VNS therapy. Combination of VNS and recording of vagal nerve compound action potentials could help to decide at what level this change in strategy should be applied in individual patients .…”

Section: Discussionmentioning

confidence: 99%

Intensity-dependent modulatory effects of vagus nerve stimulation on cortical excitability

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Intensity-dependent modulatory effects of vagus nerve stimulation on cortical excitability

et al. 2013

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“…Development of remote monitoring and telemedicine capabilities for the vagus stimulator is in progress. The ADNS‐300 stimulator system79 can record VNS compound action potentials, affording possible enhancement of understanding of the physiology of vagus stimulation for epilepsy and perhaps better individualization of stimulation parameters. Recording from the VNS also holds the possibility of early detection or even anticipation of seizures.…”

Section: Neurostimulationmentioning

confidence: 99%

Therapeutic devices for epilepsy

Fisher

2012

Annals of Neurology

113

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Therapeutic devices provide new options for treating drug-resistant epilepsy. These devices act by a variety of mechanisms to modulate neuronal activity. Only vagus nerve stimulation, which continues to develop new technology, is approved for use in the United States. Deep brain stimulation (DBS) of anterior thalamus for partial epilepsy recently was approved in Europe and several other countries. Responsive neurostimulation, which delivers stimuli to one or two seizure foci in response to a detected seizure, recently completed a successful multicenter trial. Several other trials of brain stimulation are in planning or underway. Transcutaneous magnetic stimulation (TMS) may provide a noninvasive method to stimulate cortex. Controlled studies of TMS split on efficacy, and may depend on whether a seizure focus is near a possible region for stimulation. Seizure detection devices in the form of “shake” detectors via portable accelerometers can provide notification of an ongoing tonic-clonic seizure, or peace of mind in the absence of notification. Prediction of seizures from various aspects of EEG is in early stages. Prediction appears to be possible in a subpopulation of people with refractory seizures and a clinical trial of an implantable prediction device is underway. Cooling of neocortex or hippocampus reversibly can attenuate epileptiform EEG activity and seizures, but engineering problems remain in its implementation. Optogenetics is a new technique that can control excitability of specific populations of neurons with light. Inhibition of epileptiform activity has been demonstrated in hippocampal slices, but use in humans will require more work. In general, devices provide useful palliation for otherwise uncontrollable seizures, but with a different risk profile than with most drugs. Optimizing the place of devices in therapy for epilepsy will require further development and clinical experience.

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“…thousands of patients with intractable forms of epilepsy have implants for vagus nerve stimulation (VNS) (El Tahry et al 2010;Elliott et al 2011;Lund et al 2011;McLachlan 1997;Vale et al 2010). Although not a sole effect, VNS in patients and in animals elevates levels of norepinephrine (NE) in the brain.…”

mentioning

confidence: 99%

β-Adrenergic modulation of spontaneous spatiotemporal activity patterns and synchrony in hyperexcitable hippocampal circuits

Hazra

Rosenbaum

Bodmann

et al. 2012

Journal of Neurophysiology

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Hazra A, Rosenbaum R, Bodmann B, Cao S, Josić K, Žiburkus J. ␤-Adrenergic modulation of spontaneous spatiotemporal activity patterns and synchrony in hyperexcitable hippocampal circuits. J Neurophysiol 108: 658 -671, 2012. First published April 11, 2012 doi:10.1152/jn.00708.2011.-A description of healthy and pathological brain dynamics requires an understanding of spatiotemporal patterns of neural activity and characteristics of its propagation between interconnected circuits. However, the structure and modulation of the neural activation maps underlying these patterns and their propagation remain elusive. We investigated effects of ␤-adrenergic receptor (␤-AR) stimulation on the spatiotemporal characteristics of emergent activity in rat hippocampal circuits. Synchronized epileptiform-like activity, such as interictal bursts (IBs) and ictal-like events (ILEs), were evoked by 4-aminopyridine (4-AP), and their dynamics were studied using a combination of electrophysiology and fast voltage-sensitive dye imaging. Dynamic characterization of the spontaneous IBs showed that they originated in dentate gyrus/CA3 border and propagated toward CA1. To determine how ␤-AR modulates spatiotemporal characteristics of the emergent IBs, we used the ␤-AR agonist isoproterenol (ISO). ISO significantly reduced the spatiotemporal extent and propagation velocity of the IBs and significantly altered network activity in the 1-to 20-Hz range. Dual whole cell recordings of the IBs in CA3/CA1 pyramidal cells and optical analysis of those regions showed that ISO application reduced interpyramidal and interregional synchrony during the IBs. In addition, ISO significantly reduced duration not only of the shorter duration IBs but also the prolonged ILEs in 4-AP. To test whether the decrease in ILE duration was model dependent, we used a different hyperexcitability model, zero magnesium (0 Mg 2ϩ ). Prolonged ILEs were readily formed in 0 Mg 2ϩ , and addition of ISO significantly reduced their durations. Taken together, these novel results provide evidence that ␤-AR activation dynamically reshapes the spatiotemporal activity patterns in hyperexcitable circuits by altering network rhythmogenesis, propagation velocity, and intercellular/regional synchronization. Although not a sole effect, VNS in patients and in animals elevates levels of norepinephrine (NE) in the brain. This additional NE is thought to be anticonvulsive (Giorgi et al. 2004;Krahl et al. 1998;Roosevelt et al. 2006;Szot et al. 1999Szot et al. , 2001Weinshenker and Szot 2002).In the brain, noradrenergic fibers densely innervate polymorphic hippocampal, neocortical, and cerebellar tissues (Cox et al. 2008;Giorgi et al. 2004;Grant and Redmond 1981;Milner et al. 2000;Weinshenker and Szot 2002). Actions of NE are mediated by ␣-adrenergic (␣-AR) and ␤-adrenergic receptors (␤-AR) and their respective subtypes (Mueller and Dunwiddie 1983;Mueller et al. 1981Mueller et al. , 1982Weinshenker and Szot 2002). ␣-AR mostly has been shown to be anticonvulsive, but a number of studies have descri...

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A novel implantable vagus nerve stimulation system (ADNS-300) for combined stimulation and recording of the vagus nerve: Pilot trial at Ghent University Hospital

Cited by 22 publications

References 45 publications

Intensity-dependent modulatory effects of vagus nerve stimulation on cortical excitability

Intensity-dependent modulatory effects of vagus nerve stimulation on cortical excitability

Therapeutic devices for epilepsy

β-Adrenergic modulation of spontaneous spatiotemporal activity patterns and synchrony in hyperexcitable hippocampal circuits

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