Effects of vagus nerve stimulation on symptoms of depression in patients with difficult-to-treat epilepsy

Spindler, Philipp; Bohlmann, K.; Straub, Hans-Beatus; Vajkoczy, Peter; Schneider, Ulf C.

doi:10.1016/j.seizure.2019.04.001

Cited by 32 publications

(30 citation statements)

References 9 publications

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“…A class of therapies that has gained considerable interest in recent years is bioelectronic medicine, which targets autonomic nerves to detect and alter neural activity for restoring autonomic functions 14 – 16 . The variety of bioelectronic medicine applications that target the vagus nerve have led to clinical trials on vagus nerve stimulation (VNS) for patients with epilepsy 17 , stroke 18 , depression 19 , rheumatoid arthritis 20 , obesity 21 , and type-2 diabetes 22 , among others. Despite the therapeutic benefits of VNS and bioelectronic medicine, stimulation patterns are generally selected by experimenting with different parameters without monitoring the physiological signaling in the nerve.…”

Section: Introductionmentioning

confidence: 99%

Multi-channel intraneural vagus nerve recordings with a novel high-density carbon fiber microelectrode array

Jiman

Ratze

Welle

et al. 2020

Sci Rep

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Autonomic nerves convey essential neural signals that regulate vital body functions. Recording clearly distinctive physiological neural signals from autonomic nerves will help develop new treatments for restoring regulatory functions. However, this is very challenging due to the small nature of autonomic nerves and the low-amplitude signals from their small axons. We developed a multi-channel, high-density, intraneural carbon fiber microelectrode array (CFMA) with ultra-small electrodes (8–9 µm in diameter, 150–250 µm in length) for recording physiological action potentials from small autonomic nerves. In this study, we inserted CFMA with up to 16 recording carbon fibers in the cervical vagus nerve of 22 isoflurane-anesthetized rats. We recorded action potentials with peak-to-peak amplitudes of 15.1–91.7 µV and signal-to-noise ratios of 2.0–8.3 on multiple carbon fibers per experiment, determined conduction velocities of some vagal signals in the afferent (0.7–4.4 m/s) and efferent (0.7–8.8 m/s) directions, and monitored firing rate changes in breathing and blood glucose modulated conditions. Overall, these experiments demonstrated that CFMA is a novel interface for in-vivo intraneural action potential recordings. This work is considerable progress towards the comprehensive understanding of physiological neural signaling in vital regulatory functions controlled by autonomic nerves.

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Section: Introductionmentioning

confidence: 99%

Multi-channel intraneural vagus nerve recordings with a novel high-density carbon fiber microelectrode array

Jiman

Ratze

Welle

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…A class of therapies that has gained considerable interest in recent years is bioelectronic medicine, which targets autonomic nerves to detect and alter neural activity for restoring autonomic functions [14][15][16] . The variety of bioelectronic medicine applications that target the vagus nerve have led to clinical trials on vagus nerve stimulation (VNS) for patients with epilepsy 17 , stroke 18 , depression 19 , rheumatoid arthritis 20 , obesity 21 , and type-2 diabetes 22 , among others.…”

Section: Introductionmentioning

confidence: 99%

Multi-channel intraneural vagus nerve recordings with a novel high-density carbon fiber microelectrode array

Jiman

Ratze

Welle

et al. 2020

Preprint

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25Autonomic nerves convey essential neural signals that regulate vital body functions. Recording 26 clearly distinctive physiological neural signals from autonomic nerves will help develop new 27 treatments for restoring regulatory functions. However, this is very challenging due to the small 28 nature of autonomic nerves and the low-amplitude signals from their small axons. We developed 29 a multi-channel, high-density, intraneural carbon fiber microelectrode array (CFMA) with ultra-30 small electrodes (8-9 µm in diameter, 150-250 µm in length) for recording physiological action 31 potentials from small autonomic nerves. In this study, we inserted CFMA with up to 16 32 recording carbon fibers in the cervical vagus nerve of 22 isoflurane-anesthetized rats. We 33 recorded action potentials with peak-to-peak amplitudes of 15.1-91.7 µV and signal-to-noise 34 ratios of 2.0-8.3 on multiple carbon fibers per experiment, determined conduction velocities of 35 some vagal signals in the afferent (0.7-1.0 m/sec) and efferent (0.7-8.8 m/sec) directions, and 36 monitored firing rate changes in breathing and blood glucose modulated conditions. Overall, 37 these experiments demonstrated that CFMAs are a novel interface for in-vivo intraneural action 38 potential recordings from autonomic nerves. This work is a milestone towards the 39 comprehensive understanding of physiological neural signaling and the development of 40 innovative treatment modalities for restoring vital functions controlled by autonomic nerves. 41 42

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“…The impact of VNS on QALY was assessed taking into account the following: the difference in the average utility score of QoL between the post-VNS period and the 6-months pre-VNS period; age; gender; and life expectancy in the entire VNS population [ 106 ]. VNS improved different health-related quality of life (HRQOL) domains—mainly cognitive, psychological, and social [ 92 , 107 , 108 , 109 ]—but it also improved memory, mood, behavior, alertness, achievement, and verbal skills [ 97 , 98 , 110 , 111 , 112 , 113 ].…”

Section: Resultsmentioning

confidence: 99%

Health Technology Assessment Report on Vagus Nerve Stimulation in Drug-Resistant Epilepsy

Marras

Colicchio

Palma

et al. 2020

IJERPH

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Background: Vagus nerve stimulation (VNS) is a palliative treatment for medical intractable epileptic syndromes not eligible for resective surgery. Health technology assessment (HTA) represents a modern approach to the analysis of technologies used for healthcare. The purpose of this study is to assess the clinical, organizational, financial, and economic impact of VNS therapy in drug-resistant epilepsies and to establish the congruity between costs incurred and health service reimbursement. Methods: The present study used an HTA approach. It is based on an extensive detailed bibliographic search on databases (Medline, Pubmed, Embase and Cochrane, sites of scientific societies and institutional sites). The HTA study includes the following issues: (a) social impact and costs of the disease; (b) VNS eligibility and clinical results; (c) quality of life (QoL) after VNS therapy; (d) economic impact and productivity regained after VNS; and (e) costs of VNS. Results: Literature data indicate VNS as an effective treatment with a potential positive impact on social aspects and on quality of life. The diagnosis-related group (DRG) financing, both on national and regional levels, does not cover the cost of the medical device. There was an evident insufficient coverage of the DRG compared to the full cost of implanting the device. Conclusions: VNS is a palliative treatment for reducing seizure frequency and intensity. Despite its economic cost, VNS should improve patients’ quality of life and reduce care needs.

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Effects of vagus nerve stimulation on symptoms of depression in patients with difficult-to-treat epilepsy

Cited by 32 publications

References 9 publications

Multi-channel intraneural vagus nerve recordings with a novel high-density carbon fiber microelectrode array

Multi-channel intraneural vagus nerve recordings with a novel high-density carbon fiber microelectrode array

Multi-channel intraneural vagus nerve recordings with a novel high-density carbon fiber microelectrode array

Health Technology Assessment Report on Vagus Nerve Stimulation in Drug-Resistant Epilepsy

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