Inhibition of Histamine-Induced Bronchoconstriction in Guinea Pig and Swine by Pulsed Electrical Vagus Nerve Stimulation

Hoffmann, Thomas J.; Mendez, Steven; Staats, Peter S.; Emala, Charles W.; Guo, Puyun

doi:10.1111/j.1525-1403.2009.00234.x

Cited by 15 publications

(18 citation statements)

References 44 publications

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“…This is a relatively low amplitude signal, significantly below the threshold required to stimulate efferent vagus fibres that would evoke bronchoconstriction or bradycardia [6]. Our results support the recent findings of Miner et al, who demonstrated improvements in FEV1 and work of breathing, little impact on haemodynamic stability, and the absence of serious adverse events when using a percutaneous device for vagal nerve stimulation in 25 patients with asthma exacerbations reporting to the emergency department [3].…”

Section: Resultssupporting

confidence: 88%

“…Although the traditional view has held that stimulation of the vagus nerve results in increased airway resistance and decreased compliance [4,5], an electrical stimulus signal that reduced histamine-induced bronchoconstriction in guineapig and swine has recently been described [6]. This is a relatively low amplitude signal, significantly below the threshold required to stimulate efferent vagus fibres that would evoke bronchoconstriction or bradycardia [6].…”

Section: Resultsmentioning

confidence: 99%

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Non-invasive vagus nerve stimulation for the treatment of acute asthma exacerbations—results from an initial case series

Steyn¹,

Mohamed²,

Husselman

2013

Int J Emerg Med

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A prospective multicentre clinical study was initiated to evaluate the safety and potential clinical benefit of non-invasive vagus nerve stimulation (nVNS) for the treatment of bronchoconstriction exacerbations in asthmatics. Due to slow enrolment and design changes of the device, the study was prematurely terminated after enrolment of four eligible patients. Three of the four patients were considered treatment successes based on improvement in FEV1, improvement in VAS dyspnoea scoring, and the absence of device-related adverse events.Trial RegistrationClinicalTrials.gov Identifier: NCT01385306

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Section: Resultssupporting

confidence: 88%

Section: Resultsmentioning

confidence: 99%

Non-invasive vagus nerve stimulation for the treatment of acute asthma exacerbations—results from an initial case series

Steyn¹,

Mohamed²,

Husselman

2013

Int J Emerg Med

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“…19 However, it was necessary to confirm safety of VNS treatment in a clinical setting in light of previous reports linking vagus nerve activity to bronchoconstriction 26 and implanted vagus nerve stimulators with dyspnea in some patients treated for seizures [27][28][29] or depression. 30 In addition, the vagus nerve innervates the heart, raising concerns that stimulation could trigger cardiac symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…In previous animal studies, a low-voltage VNS signal had induced small but significant increases in blood pressure and heart rate and attenuated histamine-induced bronchoconstriction responses. 19,20 In contrast, stimulation at substantially higher voltages could induce bradycardia and bronchoconstriction. 17,18,33,34 The low-voltage VNS bronchodilation and the high-voltage VNS bradycardia with bronchoconstriction responses could be differentiated, however, by investigating the stimulation pathway rather than the applied voltages.…”

Section: Discussionmentioning

confidence: 99%

“…However, an electrical stimulus signal that reduced histamine-induced bronchoconstriction in guinea pig and swine was recently described. 19 Although the specific mechanism had not been confirmed, iNANC nerve responses or possibly adrenergic outflow from adjacent sympathetic innervated vasculature were suggested. Recent preliminary animal data, 20 however, suggest that stimulation may activate afferent nerves, leading to catecholamine release from the adrenal medulla.…”

mentioning

confidence: 99%

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Feasibility of Percutaneous Vagus Nerve Stimulation for the Treatment of Acute Asthma Exacerbations

Miner

Lewis

Mosnaim

et al. 2012

Academic Emergency Medicine

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Objectives: This study assessed the feasibility of an investigational vagus nerve stimulation (VNS) device for treating acute asthma exacerbations in patients not responding to at least 1 hour of initial standard care therapy.Methods: This was a prospective, nonrandomized study of patients treated in the ED for moderate to severe acute asthma (forced expiratory volume in 1 second [FEV 1 ] 25% to 70% of predicted). Treatment entailed percutaneous placement of an electrode near the right carotid sheath and 60 minutes of VNS and continued standard care. VNS voltage was adjusted to perceived improvement, muscle twitching, or adverse events (AEs). All AEs, vital signs, FEV 1 , perceived work of breathing (WOB), and final disposition were recorded.Results: Twenty-five subjects were enrolled. There were no serious AEs and no significant changes in vital signs. No subject required terminating VNS. One patient had minor bleeding from the procedure, and one had a hematoma and withdrew prior to VNS. AEs related to VNS were temporary and included cough (1 of 24), swallowing difficulty (2 of 24), voice change (2 of 24), and muscle twitching (14 of 24). These resolved when VNS ended. The FEV 1 improved at 15 minutes (median = 15.8%, 95% confidence interval [CI] = 9.3% to 22.4%), 30 minutes (median = 21.3%, 95% CI = 8.1% to 36.5%), and 60 minutes (median = 27.5%, 95% CI = 11.3% to 43.5%). WOB improved at 15 minutes (median = 53.9%, 95% CI = 33.7% to 73.9%), 30 minutes (median = 69.1%, 95% CI = 56.4% to 81.8%), and 60 minutes (median = 81.0%, 95% CI = 68.5% to 93.5%).Conclusions: Percutaneous VNS did not result in serious AEs and was associated with improvements in FEV 1 and perceived dyspnea. Percutaneous VNS appears to be feasible for use in the treatment of moderate to severe acute asthma in patients unresponsive to initial standard care treatment.

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Transcutaneous Electrical Nerve Stimulation as a Treatment for Neuropathic Cough: A Tolerability and Feasibility Study

et al. 2021

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Transcutaneous electrical nerve stimulation (TENS) is a form of electroanalgesia used for neuropathic pain disorders. Refractory chronic cough, or ''neuropathic cough,'' may be physiologically similar to other neuropathic pain conditions. This study explored the tolerability and feasibility of using TENS as a treatment for neuropathic cough. Laryngeal TENS was administered to five subjects with neuropathic cough. One electrode was placed over the lateral thyrohyoid membrane, and a second over the cricothyroid space. A frequency of 120 Hz was applied for 30 min. Participants rated symptoms pre-, during, and post-TENS treatment using a Likert scale. Laryngeal TENS was well tolerated by all subjects. Adverse effects included brief neck discomfort when increasing TENS intensity and an event of mild post-treatment hoarseness. The self-reported scores trended toward a reduction in symptom severity during and after treatment. Controlled trials using this method would elucidate the use of TENS for treatment of patients suffering from chronic cough.

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Inhibition of Histamine-Induced Bronchoconstriction in Guinea Pig and Swine by Pulsed Electrical Vagus Nerve Stimulation

Cited by 15 publications

References 44 publications

Non-invasive vagus nerve stimulation for the treatment of acute asthma exacerbations—results from an initial case series

Non-invasive vagus nerve stimulation for the treatment of acute asthma exacerbations—results from an initial case series

Feasibility of Percutaneous Vagus Nerve Stimulation for the Treatment of Acute Asthma Exacerbations

Transcutaneous Electrical Nerve Stimulation as a Treatment for Neuropathic Cough: A Tolerability and Feasibility Study

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