Correlation between sonographic morphology and function of the cervical vagus nerves

Belau, Elena; Menze, Ina; Woost, Timo B.; Claßen, Joseph; Weise, David

doi:10.1016/j.autneu.2019.05.004

Cited by 18 publications

(30 citation statements)

References 23 publications

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“…Studies are sorted by geographic region: 1, Europe; 2, United States; 3, Asia body side in some articles. A morphological asymmetry between both vagal nerves was described before [5], with the right one being larger than the left. A reason may be that the right vagal nerve predominantly innervates parts of the small intestine and the colon, whereas the left one innervates the stomach, the liver, and the superior part of the duodenum [22].…”

Section: Discussionmentioning

confidence: 98%

“…A reason may be that the right vagal nerve predominantly innervates parts of the small intestine and the colon, whereas the left one innervates the stomach, the liver, and the superior part of the duodenum [22]. Also, cardiovagal innervation was described as asymmetric [5]. We did not regard these side differences in our current analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Enlargement of the cross-sectional area (CSA) of cervical nerve roots was described in radiculopathy [1,2] as well as in inflammatory polyneuropathies such as chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy [3,4]. CSA of the vagal nerve might give information about involvement of the autonomic nervous system [5], and a reduction in comparison to healthy individuals was described in Parkinson disease [6]. Due to the increasing use of nerve ultrasound, several study groups published reference values for CSA measured by tracing nerve boundaries for a number of anatomic sites [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cross‐sectional area reference values for peripheral nerve ultrasound in adults: A systematic review and meta‐analysis—Part III: Cervical nerve roots and vagal nerve

Fisse

Katsanos

Gold

et al. 2021

Euro J of Neurology

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Background and purpose Measurement of the cross‐sectional area (CSA) of cervical nerve roots using ultrasound is useful in the evaluation of inflammatory polyneuropathies, and measurement of CSA of the vagal nerve might give information about involvement of the autonomic nervous system. We performed a systematic review and meta‐analysis of published CSA reference values for cervical nerve roots and vagal nerve. Methods We included available‐to‐date nerve ultrasound studies on healthy adults and provide meta‐analysis for CSA of the following nerves: cervical nerve roots C5, C6, and C7 as well as vagal nerve in the carotid sheath at the carotid bifurcation level. We report regression and correlation analyses for age, gender, height, weight, and geographic continent. Results We included 11 studies with 885 healthy volunteers (mean age = 42.7 years) and 3149 examined nerve sites. Calculated mean pooled CSA of C5 root was 5.6 mm2 (95% confidence interval [CI] = 4.6–6.7 mm2, n = 911), of C6 root was 8.8 mm2 (95% CI = 7.4–10.3 mm2, n = 909), of C7 root was 9.5 mm2 (95% CI = 8.0–10.9 mm2, n = 909), and of vagal nerve was 2.2 mm2 (95% CI = 1.5–2.9 mm2, n = 420). No heterogeneity was found across studies for any site. Subgroup analysis revealed no significant effects of age, gender, height, weight, and geographic continent on CSA for any of these nerve sites. Conclusions We provide the first meta‐analysis on CSA reference values for the cervical nerve roots and the vagal nerve, with no heterogeneity of reported CSA values at all nerve sites. Our data facilitate the goal of an international standardized evaluation protocol.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cross‐sectional area reference values for peripheral nerve ultrasound in adults: A systematic review and meta‐analysis—Part III: Cervical nerve roots and vagal nerve

Fisse

Katsanos

Gold

et al. 2021

Euro J of Neurology

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“…However, there are limited studies investigating the impact of biological sex on VNS-induced cardiac effects reflected by HRV. A recent investigation on the correlation between morphology of the cervical vagus nerve and parasympathetic activity characterized by HRV in healthy subjects has revealed that there is a significant correlation between morphology of the left cervical nerve and the autonomic regulation of the cardiovascular function, where among different demographic data including gender, only age was a significant cofactor ( Pelz et al, 2019 ). On VNS side effects, in a small cohort of epilepsy patients treated with VNS, the proportion of female subjects with respiratory side effects during exercise was significantly higher than that of males, where four out of total five patients with respiratory side effects were female ( Mulders et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Sex Differences in Vagus Nerve Stimulation Effects on Rat Cardiovascular and Immune Systems

et al. 2020

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Background: Investigations into the benefits of vagus nerve stimulation (VNS) through pre-clinical and clinical research have led to promising findings for treating several disorders. Despite proven effectiveness of VNS on conditions such as epilepsy and depression, understanding of off-target effects and contributing factors such as sex differences can be beneficial to optimize therapy design. New Methods: In this article, we assessed longitudinal effects of VNS on cardiovascular and immune systems, and studied potential sex differences using a rat model of longterm VNS. Rats were implanted with cuff electrodes around the left cervical vagus nerve for VNS, and wireless physiological monitoring devices for continuous monitoring of cardiovascular system using electrocardiogram (ECG) signals. ECG morphology and heart rate variability (HRV) features were extracted to assess cardiovascular changes resulting from VNS in short-term and long-term timescales. We also assessed VNS effects on expression of inflammatory cytokines in blood during the course of the experiment. Statistical analysis was performed to compare results between Treatment and Sham groups, and between male and female animals from Treatment and Sham groups. Results: Considerable differences between male and female rats in cardiovascular effects of VNS were observed in multiple cardiovascular features. However, the effects seemed to be transient with approximately 1-h recovery after VNS. While short-term cardiovascular effects were mainly observed in male rats, females in general showed more significant long-term effects even after VNS stopped. We did not observe notable changes or sex differences in systemic cytokine levels resulting from VNS. Comparison With Existing Methods: Compared to existing methods, our study design incorporated wireless physiological monitoring and systemic blood cytokine level analysis, along with long-term VNS experiments in unanesthetized rats to study sex differences. Conclusion: The contribution of sex differences for long-term VNS off-target effects on cardiovascular and immune systems was assessed using awake behaving rats. Although VNS did not change the concentration of inflammatory biomarkers in systemic circulation for male and female rats, we observed significant differences in cardiovascular effects of VNS characterized using ECG morphology and HRV analyses.

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“…There are also studies about morphological changes and function of VN. Grimm et al showed the enlargement of VN in the acute phase of the Guillain-Barré syndrome [24] and Pelz et al depicted the relationship between heart rate variabilities and VN area using ultrasound [25].…”

Section: Discussionmentioning

confidence: 99%

Transient postsurgical gastroparesis is accompanied by reversible changes of the cervical vagus nerve’s morphology after neck dissection – an ultrasound study

Özçağlayan

Ersözlü

2020

Med Ultrason

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Aims: During neck dissection (ND), the vagus nerve (VN) may be exposed to manipulation together with common carotid artery and internal jugular vein. The postsurgical gastroparesis was previous related to the VN injury. The aim of our study was to evaluate by ultrasound the VN changes in patients with unilateral and bilateral ND and to establish if there is a relationship between postoperative findings of VN and postsurgical gastroparesis.Material and methods: Seventeen patients in which 30 ND (4 unilateral and 13 bilateral) were performed, were enrolled in the study. The VN’s area and diameter were measured preoperative (baseline), one week (T1) and one month (T2) postoperative. Gastrointestinal symptoms were evaluated at T1 and T2 phases using the patient assessment of the upper gastrointestinal symptom severity index (PAGI-SYM).Results: There was a statistical difference between area and diameters of VN between T1 and baseline (p<0.001), and T1 and T2 phases (p<0.001), respectively. No statistical differences were detected at baseline and T2 phases in areas (p=0.934) and diameters (p>0.999). Gastrointestinal symptoms, found at the T1 phase regressed at T2 phase, were correlated with VN area and diameter changes (p<0.001).Conclusions: VN ultrasound clearly showed the transient dimensional changes of VN caused by manipulation in ND, which may lead to temporary gastrointestinal symptoms due to reversible dysfunction of VN.

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Correlation between sonographic morphology and function of the cervical vagus nerves

Cited by 18 publications

References 23 publications

Cross‐sectional area reference values for peripheral nerve ultrasound in adults: A systematic review and meta‐analysis—Part III: Cervical nerve roots and vagal nerve

Cross‐sectional area reference values for peripheral nerve ultrasound in adults: A systematic review and meta‐analysis—Part III: Cervical nerve roots and vagal nerve

Sex Differences in Vagus Nerve Stimulation Effects on Rat Cardiovascular and Immune Systems

Transient postsurgical gastroparesis is accompanied by reversible changes of the cervical vagus nerve’s morphology after neck dissection – an ultrasound study

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