The Effects of Noninvasive Vagus Nerve Stimulation on Fatigue and Immune Responses in Patients With Primary Sjögren’s Syndrome

Tarn, Jessica; Legg, Sarah; Mitchell, Sheryl; Simon, Bruce J.; Ng, Wan‐Fai

doi:10.1111/ner.12879

Cited by 81 publications

(64 citation statements)

References 33 publications

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“…Noninvasive devices apply an electrical stimulation waveform through electrodes placed on the surface of the skin, which are typically intended to interface electrically with deeper neural structures ( Figure B). Although some impressive therapeutic responses have been demonstrated using noninvasive stimulation paradigms targeted to specific nerves, the unintended stimulation of nerve and muscle fibers superficial to the deep target often leads to therapy limiting side effects . Additionally, the electric field falls off rapidly with distance from the stimulating electrode, which limits the depth at which structures can be reliably stimulated, at least without intolerable activation of cutaneous pain fibers …”

Section: Introductionmentioning

confidence: 99%

An Injectable Neural Stimulation Electrode Made from an In‐Body Curing Polymer/Metal Composite

Trevathan

Baumgart

Nicolai

et al. 2019

Adv Healthcare Materials

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Implanted neural stimulation and recording devices hold vast potential to treat a variety of neurological conditions, but the invasiveness, complexity, and cost of the implantation procedure greatly reduce access to an otherwise promising therapeutic approach. To address this need, a novel electrode that begins as an uncured, flowable prepolymer that can be injected around a neuroanatomical target to minimize surgical manipulation is developed. Referred to as the Injectrode, the electrode conforms to target structures forming an electrically conductive interface which is orders of magnitude less stiff than conventional neuromodulation electrodes. To validate the Injectrode, detailed electrochemical and microscopy characterization of its material properties is performed and the feasibility of using it to stimulate the nervous system electrically in rats and swine is validated. The silicone-metal-particle composite performs very similarly to pure wire of the same metal (silver) in all measures, including exhibiting a favorable cathodic charge storage capacity (CSC C ) and charge injection limits compared to the clinical LivaNova stimulation electrode and silver wire electrodes. By virtue of its simplicity, the Injectrode has the potential to be less invasive, more robust, and more cost-effective than traditional electrode designs, which could increase the adoption of neuromodulation therapies for existing and new indications.

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Section: Introductionmentioning

confidence: 99%

An Injectable Neural Stimulation Electrode Made from an In‐Body Curing Polymer/Metal Composite

Trevathan

Baumgart

Nicolai

et al. 2019

Adv Healthcare Materials

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“…Background: Primary Sjögren's syndrome (pSS) sufferers have rated physical and mental fatigue ('brain fog') as the most important symptoms needing improvement. Previous data from our group suggest that stimulation of the vagus nerve can invoke immunological responses and concurrently an improvement of patient reported symptoms of fatigue 1 . Objectives: This follow up study uses the gammaCore device (electroCore) and a sham device to assess the effects of non-invasive vagus nerve stimulation (nVNS) on patient reported symptoms of fatigue in pSS.…”

Section: Asymptomatic Vertebral Fractures Worsen Organ Damage In Womementioning

confidence: 64%

Ab0192 asymptomatic Vertebral Fractures Worsen Organ Damage in Women With Systemic Lupus Erythematosus

Shkireeva

Lesnyak

Зоткин

2019

Abstracts Accepted for Publication

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Background ObjectivesTo investigate the influence of asymptomatic vertebral fractures on organ damage and to identify risk factors associated with critical organ damage in women with systemic lupus erythematosus (SLE).Methods207 women with SLE were included in this study. Bone mineral density (BMD) measurements of the hip and spine were performed using the dual energy X-ray absorptiometry (DXA). Vertebral fracture assessment (VFA) was done for detection vertebral fractures using a method described by Genant. Accumulated damage was scored using the SLICC/ACR damage index (SDI). Critical organ damage was defined as SDI>3.ResultsVertebral fractures were developed in 55 (26.5%) women with SLE. Half of all women with SLE (n=31, 15.0%) had asymptomatic vertebral fractures which were diagnosed for the first time in this study. 131 (63.3%) women with SLE had critical organ damage (SDI>3). Average SDI before and after morphometry was 4,5±2,1 and 5,4±2,5 respectively. Multivariate analysis showed age (p=0,01) and cumulative dose of glucocorticoids (p=0,00005) were significantly associated with critical damage in women with SLE.ConclusionDetection of vertebral fractures helps in counting accumulated organ damage correctly. VFA in the combination with DXA in women with SLE is an effective method for diagnostic asymptomatic vertebral fractures.Disclosure of InterestsNone declared

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“…Therefore, activation of this nucleus, both pharmacologically, by activating the alpha 7 nicotinic receptors, and electrically, through vagus nerve stimulation (VNS), appear to be promising therapeutic strategies to balance the ANS and produce a balanced autonomic response [33][34][35]. Several studies have already tested VNS in patients with immune system disorders, sepsis and COVID-19 with promising results [36,37], and some clinical trials have started over the last few months [38,39]. This is the rst study carried out with certain real-life limitations during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Heart Rate Variability Using The Analgesia Nociception Index as A Predictor of Illness Severity and Mortality in Critically Ill Patients with COVID-19.

Aragón-Benedí

Oliver-Forniés

Galluccio

et al. 2020

Preprint

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Introduction A balance between the autonomic nervous system and the immune system against SARS-COV-2 is critical in the resolution of its severe macrophage proinflammatory activation. To demonstrate that most severely ill COVID-19 patients will show a depletion of the sympathetic nervous system and a predominance of parasympathetic tone. We hypothesized that a low energy of an autonomic nervous system and a high level of the high frequency component of heart rate variability may be related to the number of proinflammatory cytokines and could have a predictive value in terms of severity and mortality in critically ill patients suffering from COVID-19; Materials and Methods Single-centre, prospective, observational pilot study which included COVID-19 patients admitted to the Surgical Intensive Care Unit. High frequency (HF) component of heart rate variability (HRV) and energy of the autonomic nervous system were recorded using analgesia nociception index monitor (ANI). To estimate the severity and mortality we used the SOFA score and the date of discharge or date of death.Results A total of fourteen patients were finally included in the study. High-frequency component of heart rate variability (ANIm) were higher in the non-survivor group (p = 0.003) and were correlated with higher IL-6 levels (p = 0.002) Energy was inversely correlated with SOFA (p = 0.029). Limit value at 80 of ANIm, predicted mortalities with the sensitivity of 100% and specificity of 85.7%. In the case of energy, a limit value of 0.41 predicted mortality with all predictive values of 71.4%.Conclusion The different components of the spectral analysis of HRV allow us to infer the association between the autonomic nervous system and critically ill patients’ immune system. A low autonomic nervous system activity and a predominance of the parasympathetic system due to sympathetic depletion in patients are associated with a worse prognosis and higher mortality.

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The Effects of Noninvasive Vagus Nerve Stimulation on Fatigue and Immune Responses in Patients With Primary Sjögren’s Syndrome

Cited by 81 publications

References 33 publications

An Injectable Neural Stimulation Electrode Made from an In‐Body Curing Polymer/Metal Composite

An Injectable Neural Stimulation Electrode Made from an In‐Body Curing Polymer/Metal Composite

Ab0192 asymptomatic Vertebral Fractures Worsen Organ Damage in Women With Systemic Lupus Erythematosus

Heart Rate Variability Using The Analgesia Nociception Index as A Predictor of Illness Severity and Mortality in Critically Ill Patients with COVID-19.

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