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Strategies for precision vagus neuromodulation
The vagus nerve is involved in the autonomic regulation of physiological homeostasis, through vast innervation of cervical, thoracic and abdominal visceral organs. Stimulation of the vagus with bioelectronic devices represents a therapeutic opportunity for several disorders implicating the autonomic...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9150383/ https://www.ncbi.nlm.nih.gov/pubmed/35637543 http://dx.doi.org/10.1186/s42234-022-00091-1 |
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author | Ahmed, Umair Chang, Yao-Chuan Zafeiropoulos, Stefanos Nassrallah, Zeinab Miller, Larry Zanos, Stavros |
author_facet | Ahmed, Umair Chang, Yao-Chuan Zafeiropoulos, Stefanos Nassrallah, Zeinab Miller, Larry Zanos, Stavros |
author_sort | Ahmed, Umair |
collection | PubMed |
description | The vagus nerve is involved in the autonomic regulation of physiological homeostasis, through vast innervation of cervical, thoracic and abdominal visceral organs. Stimulation of the vagus with bioelectronic devices represents a therapeutic opportunity for several disorders implicating the autonomic nervous system and affecting different organs. During clinical translation, vagus stimulation therapies may benefit from a precision medicine approach, in which stimulation accommodates individual variability due to nerve anatomy, nerve-electrode interface or disease state and aims at eliciting therapeutic effects in targeted organs, while minimally affecting non-targeted organs. In this review, we discuss the anatomical and physiological basis for precision neuromodulation of the vagus at the level of nerve fibers, fascicles, branches and innervated organs. We then discuss different strategies for precision vagus neuromodulation, including fascicle- or fiber-selective cervical vagus nerve stimulation, stimulation of vagal branches near the end-organs, and ultrasound stimulation of vagus terminals at the end-organs themselves. Finally, we summarize targets for vagus neuromodulation in neurological, cardiovascular and gastrointestinal disorders and suggest potential precision neuromodulation strategies that could form the basis for effective and safe therapies. |
format | Online Article Text |
id | pubmed-9150383 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-91503832022-06-01 Strategies for precision vagus neuromodulation Ahmed, Umair Chang, Yao-Chuan Zafeiropoulos, Stefanos Nassrallah, Zeinab Miller, Larry Zanos, Stavros Bioelectron Med Review The vagus nerve is involved in the autonomic regulation of physiological homeostasis, through vast innervation of cervical, thoracic and abdominal visceral organs. Stimulation of the vagus with bioelectronic devices represents a therapeutic opportunity for several disorders implicating the autonomic nervous system and affecting different organs. During clinical translation, vagus stimulation therapies may benefit from a precision medicine approach, in which stimulation accommodates individual variability due to nerve anatomy, nerve-electrode interface or disease state and aims at eliciting therapeutic effects in targeted organs, while minimally affecting non-targeted organs. In this review, we discuss the anatomical and physiological basis for precision neuromodulation of the vagus at the level of nerve fibers, fascicles, branches and innervated organs. We then discuss different strategies for precision vagus neuromodulation, including fascicle- or fiber-selective cervical vagus nerve stimulation, stimulation of vagal branches near the end-organs, and ultrasound stimulation of vagus terminals at the end-organs themselves. Finally, we summarize targets for vagus neuromodulation in neurological, cardiovascular and gastrointestinal disorders and suggest potential precision neuromodulation strategies that could form the basis for effective and safe therapies. BioMed Central 2022-05-30 /pmc/articles/PMC9150383/ /pubmed/35637543 http://dx.doi.org/10.1186/s42234-022-00091-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Review Ahmed, Umair Chang, Yao-Chuan Zafeiropoulos, Stefanos Nassrallah, Zeinab Miller, Larry Zanos, Stavros Strategies for precision vagus neuromodulation |
title | Strategies for precision vagus neuromodulation |
title_full | Strategies for precision vagus neuromodulation |
title_fullStr | Strategies for precision vagus neuromodulation |
title_full_unstemmed | Strategies for precision vagus neuromodulation |
title_short | Strategies for precision vagus neuromodulation |
title_sort | strategies for precision vagus neuromodulation |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9150383/ https://www.ncbi.nlm.nih.gov/pubmed/35637543 http://dx.doi.org/10.1186/s42234-022-00091-1 |
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