Search Our Scientific Publications & Authors

Cureus 2021 Apr 9;13(4):e14379. Epub 2021 Apr 9.

Pediatric Neurology, Lehigh Valley Health Network (LVHN) Lehigh Valley Reilly Children's Hospital, Allentown, USA.

An 11-year-old female presents to the sleep clinic for evaluation for possible sleep-disordered breathing (SDB). She has a history of frequently intractable seizures for which she was tried on multiple antiepileptic medications. She had vagus nerve stimulation (VNS) implantation two years ago to treat her focal seizures. Read More

Comp Biochem Physiol A Mol Integr Physiol 2021 May 10:110977. Epub 2021 May 10.

Department of Biological Sciences, University of North Texas, 1155 Union Circle #310559, Denton, TX 76203, United States of America. Electronic address:

Developmental hypoxia has been shown to result in significant changes in cardiovascular development of American alligators and common snapping turtles. These include similar effects on cardiac mass and aspects of cardiovascular function. However, given the distant phylogenetic relationship between crocodilians and chelonians, we hypothesized that snapping turtles would also exhibit differences in the effects of developmental hypoxia on cardiovascular regulation. Read More

Front Cardiovasc Med 2021 26;8:648910. Epub 2021 Apr 26.

State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

To evaluate whether low level left vagus nerve stimulation (LLVNS) in early stage of myocardial infarction (MI) could effectively prevent ventricular arrhythmias (VAs) and protect cardiac function, and explore the underlying mechanisms. After undergoing implantable cardioverter defibrillators (ICD) and left cervical vagal stimulators implantation and MI creation, 16 dogs were randomly divided into three groups: the MI ( = 6), MI+LLVNS ( = 5), and sham operation ( = 5) groups. LLVNS was performed for 3 weeks. Read More

Proc Natl Acad Sci U S A 2021 May;118(20)

Clinical Sciences and Services, The Royal Veterinary College, Hatfield AL9 7TA, United Kingdom;

Neuromodulation of immune function by stimulating the autonomic connections to the spleen has been demonstrated in rodent models. Consequently, neuroimmune modulation has been proposed as a new therapeutic strategy for the treatment of inflammatory conditions. However, demonstration of the translation of these immunomodulatory mechanisms in anatomically and physiologically relevant models is still lacking. Read More

Rinsho Ketsueki 2021 ;62(4):262-266

Department of Internal Medicine, Kohsei Chuo General Hospital.

A 71-year-old woman presented to a clinic with the chief complaint of facial edema and dyspnea; chest radiography showed mediastinal mass shadow and right pleural effusion. Computed tomography guided biopsy of the mediastinal mass had been performed by her previous doctor, and she was diagnosed with diffuse large B-cell lymphoma. She was referred to our hospital for chemotherapy. Read More

Front Neuroanat 2021 16;15:663399. Epub 2021 Apr 16.

Department of Neuroscience, Institute of Human Anatomy, University of Padua, Padua, Italy.

The Vagal Trigone, often referred to as Ala Cinerea, is a triangular-shaped area of the floor of the fourth ventricle that is strictly involved in the network of chardiochronotropic, baroceptive, respiratory, and gastrointestinal control systems of the medulla oblongata. While it is frequently identified as the superficial landmark for the underlying Dorsal Motor Nucleus of the Vagus, this correspondence is not univocal in anatomical literature and is often oversimplified in neuroanatomy textbooks and neurosurgical atlases. As the structure represents an important landmark for neurosurgical procedures involving the floor of the fourth ventricle, accurate morphological characterization is required to avoid unwanted side effects (e. Read More

Zhen Ci Yan Jiu 2021 Apr;46(4):335-41

Key Laboratory of Acupuncture and Medicine Research of Ministry of Education; School of Acupuncture and Tuina, School of Regimen and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing 210023, China.

Objective: To investigate the effect characteristics and mechanism of acupuncture in autonomic nerve regulation through a comprehensive literature analysis.

Methods: CNKI and PubMed databases were searched for the studies on acupuncture in autonomic nerve regulation in the past 30 years, and Excel was used to perform a descriptive analysis of research subjects, intervention methods, intervention sites (acupoint selection), intervention parameters, and effect mechanism of acupuncture.

Results: A total of 202 studies were included, among which there were 51 clinical studies, mostly on the nervous system and the circulatory system; Neiguan (PC6), Zusanli (ST36), Fengchi (GB20), and Hegu (LI4) were the most frequently used acupoints, manual acupuncture was the most common intervention method, most of the acupoints selected were in the extremities, head, face, and neck, and heart rate variability was the main parameter for evaluation. Read More

Clin Transl Med 2021 Apr;11(4):e397

Department of Biomedical Engineering, Columbia University, New York, New York, USA.

Alzheimer's disease (AD) poses a significant global health concern over the next several decades. Multiple hypotheses have been put forth that attempt to explain the underlying pathophysiology of AD. Many of these are briefly reviewed here, but to-date no disease-altering therapy has been achieved. Read More

Prog Brain Res 2021 1;262:451-467. Epub 2020 Oct 1.

Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, United States; Global Brain Health Institute & Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.

Vagus nerve stimulation is a promising new tool in the treatment of chronic tinnitus. Current protocols involve pairing sounds, which exclude the tinnitus frequency, with simultaneous vagus nerve stimulation (VNS). This is based on extensive preclinical animal studies that demonstrate that pairing non-tinnitus sounds with VNS results in a tonotopic map plasticity. Read More

Front Neurosci 2021 13;15:667036. Epub 2021 Apr 13.

Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.

Acute respiratory distress syndrome (ARDS) is the most severe form of acute lung injury. It is induced by sepsis, aspiration, and pneumonia, including that caused by SARS coronavirus and human influenza viruses. The main pathophysiological mechanism of ARDS is a systemic inflammatory response. Read More

Shock 2021 Apr 22. Epub 2021 Apr 22.

Department of Anesthesiology, General Hospital of Central Theater Command of PLA, Wuhan, China, 430070 The First School of Clinical Medicine, Southern Medical University, Guangzhou, China, 510006.

Introduction: Electrical vagal nerve stimulation is known to decrease gut permeability and alleviate gut injury caused by traumatic hemorrhagic shock. However, the specific mechanism of action remains unclear. Glycocalyx, located on the surface of the intestinal epithelium, is associated with the buildup of the intestinal barrier. Read More

Int Immunol 2021 Apr 29. Epub 2021 Apr 29.

Department of Medicine, Center for Bioelectronic Medicine, Bioclinicum, Karolinska Institutet, 171 64 Stockholm, Sweden.

The hallmark of inflammatory bowel diseases (IBD) is chronic intestinal inflammation with typical onset in adolescents and young adults. An abundance of neutrophils are seen in the inflammatory lesions, but adaptive immunity is also an important player in the chronicity of the disease. There is an unmet need for new treatment options since modern medicines such as biological therapy with anti-cytokine antibodies still leave a substantial number of patients with persisting disease activity. Read More

Epilepsy Behav Rep 2021 26;15:100437. Epub 2021 Mar 26.

Department of Neurosurgery, Charité - University Medicine Berlin, Germany.

With increasing use of vagus nerve stimulation (VNS) as an adjunct treatment for drug-resistant epilepsy, revision surgery of VNS grows in importance. Indications for revision surgery are diverse and extend of surgery varies. We report a retrospective review on indications and complications of VNS revision surgery at our center. Read More

Bioelectron Med 2020 Apr 10;6(1). Epub 2020 Apr 10.

Laboratory of Biomedical Science, Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA.

Background: Electrical stimulation of peripheral nerves is a widely used technique to treat a variety of conditions including chronic pain, motor impairment, headaches, and epilepsy. Nerve stimulation to achieve efficacious symptomatic relief depends on the proper selection of electrical stimulation parameters to recruit the appropriate fibers within a nerve. Recently, electrical stimulation of the vagus nerve has shown promise for controlling inflammation and clinical trials have demonstrated efficacy for the treatment of inflammatory disorders. Read More

Front Pharmacol 2021 8;12:596956. Epub 2021 Apr 8.

Emergency Institute for Cardiovascular Diseases and Transplantation Târgu Mureş, Târgu Mureş, Romania.

The complex interactions that exist between the pacemaker current, , and the parasympathetic nervous system could significantly influence the course of patients undergoing chronic therapy with the blocker ivabradine. We thus aimed to assess the effects of chronic ivabradine therapy on autonomic modulation and on the cardiovascular response to and parasympathetic stimulation. The right atrial expression of HCN genes, encoding proteins for , was also evaluated. Read More

Lancet 2021 Apr;397(10284):1545-1553

Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA, USA.

Background: Long-term loss of arm function after ischaemic stroke is common and might be improved by vagus nerve stimulation paired with rehabilitation. We aimed to determine whether this strategy is a safe and effective treatment for improving arm function after stroke.

Methods: In this pivotal, randomised, triple-blind, sham-controlled trial, done in 19 stroke rehabilitation services in the UK and the USA, participants with moderate-to-severe arm weakness, at least 9 months after ischaemic stroke, were randomly assigned (1:1) to either rehabilitation paired with active vagus nerve stimulation (VNS group) or rehabilitation paired with sham stimulation (control group). Read More

Lancet 2021 04;397(10284):1520-1521

Department of Neurology, Leiden University Medical Center, 2333ZA Leiden, Netherlands.

Neurosci Biobehav Rev 2021 Apr 21;127:37-53. Epub 2021 Apr 21.

Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address:

Brain diseases, including neurodegenerative, cerebrovascular and neuropsychiatric diseases, have posed a deleterious threat to human health and brought a great burden to society and the healthcare system. With the development of medical technology, vagus nerve stimulation (VNS) has been approved by the Food and Drug Administration (FDA) as an alternative treatment for refractory epilepsy, refractory depression, cluster headaches, and migraines. Furthermore, current evidence showed promising results towards the treatment of more brain diseases, such as Parkinson's disease (PD), autistic spectrum disorder (ASD), traumatic brain injury (TBI), and stroke. Read More

Neuromodulation 2021 Apr 22. Epub 2021 Apr 22.

Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Objectives: Constipation and opioid-induced constipation (OIC) are common with limited treatment options. We investigated whether a noninvasive method of auricular vagal nerve stimulation (aVNS) could be used for treating OIC and explored its potential mechanisms and neural pathways in a rodent model of OIC.

Materials And Methods: Sprague-Dawley were chronically implanted with one pair of auricular electrodes for aVNS. Read More

Acta Physiol (Oxf) 2021 Apr 21:e13663. Epub 2021 Apr 21.

Graduate Program in Pharmaceutical Sciences, Department of Biophysics and Physiology, Federal University of Piaui, Teresina, PI, Brazil.

Systemic arterial hypertension and heart failure are cardiovascular diseases that affect millions of individuals worldwide. They are characterized by a change in the autonomic nervous system balance, highlighted by an increase in sympathetic activity associated with a decrease in parasympathetic activity. Most therapeutic approaches seek to treat these diseases by medications that attenuate sympathetic activity. Read More

Clin Exp Nephrol 2021 Apr 20. Epub 2021 Apr 20.

Department of Physiology of Visceral Function and Body Fluid, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4, Sakamoto, Nagasaki, 852-8523, Japan.

The autonomic nervous system plays an important role in maintaining homeostasis in organisms. Recent studies have shown that it also controls inflammation by directly altering the function of the immune system. The cholinergic anti-inflammatory pathway (CAP) is one of the neural circuits operating through the vagus nerve. Read More

J Physiol 2021 Apr 19. Epub 2021 Apr 19.

Department of Physiology, Cardiovascular Autonomic Research Cluster, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

Key Points: Carotid body (CB) chemoreceptors are hyperactive in hypertension, and their acute activation produces bronchoconstriction. We show that the respiratory-modulated bronchiolar tone, pulmonary parasympathetic efferent activity, and the firing frequency and synaptic excitation of bronchoconstrictor motoneurones in the nucleus ambiguus were all enhanced in spontaneous hypertensive (SH) rats. In SH rats, CB denervation reduced the respiratory-related parasympathetic-mediated bronchoconstrictor tone to levels seen in normotensive rats. Read More

Laryngoscope Investig Otolaryngol 2021 Apr 26;6(2):346-353. Epub 2021 Feb 26.

Department of Head and Neck Surgery Kanazawa Medical University Kahoku Ishikawa Japan.

Objectives: Recurrent laryngeal nerve (RLN) injury is one of the severe complications in thyroid surgery. Therefore, intraoperative nerve monitoring (IONM) has been widely used to identify the RLN and confirm its integrity. Recently, the usefulness of continuous IONM (CIONM) with automatic, periodic stimulation to the vagus nerve during thyroid surgery was reported. Read More

J Neurosurg Pediatr 2020 Nov 31;26(5):525-532. Epub 2020 Jul 31.

Department of Neurosurgery, Mount Sinai West.

Objective: Approximately 75% of pediatric patients who suffer from epilepsy are successfully treated with antiepileptic drugs, while the disease is drug resistant in the remaining patients, who continue to have seizures. Patients with drug-resistant epilepsy (DRE) may have options to undergo invasive treatment such as resection, laser ablation of the epileptogenic focus, or vagus nerve stimulation. To date, treatment with responsive neurostimulation (RNS) has not been sufficiently studied in the pediatric population because the FDA has not approved the RNS device for patients younger than 18 years of age. Read More

Front Hum Neurosci 2020 23;14:568051. Epub 2021 Mar 23.

Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation (tVNS) across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation(VNS) and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between studies, replication of studies, as well as enhancing study participant safety. Read More

Neurology 2021 Apr 13. Epub 2021 Apr 13.

From the Epilepsy Program (P.J.), Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Division of Pediatric Neurology (P.J.), Department of Pediatrics, Danat Al Emarat Hospital for Women and Children, Abu Dhabi, United Arab Emirates; Comprehensive Epilepsy Center (R.A.), Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; and Department of Pediatrics (R.A.), University of Cincinnati College of Medicine, Cincinnati, OH.

Objective: We synthesized evidence for effectiveness of vagus nerve stimulation (VNS) as adjuvant therapy in pediatric drug-resistant epilepsy (DRE) by obtaining pooled estimates for seizure outcomes and analyzing their determinants.

Methods: MEDLINE, EMBASE, and Cochrane databases were searched up to July 2019, for original research on VNS in pediatric (≤18 years-of-age) epilepsy. The primary outcome was 50% responder rate (50%-RR), the proportion of patients with ≥50% seizure reduction, at the last reported follow-up. Read More

Seizure 2021 May 5;88:116-124. Epub 2021 Apr 5.

Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5; Neuro-Epidemiology Unit, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5. Electronic address:

Purpose: To provide a descriptive analysis on the presurgical evaluation and surgical management of a cohort of patients with stroke related epilepsy (SRE).

Methods: We retrospectively examined the clinical characteristics, results of non-invasive and invasive presurgical evaluation, surgical management and outcome of consecutive patients with drug-resistant SRE in our institution from January 1, 2013 to January 1, 2020.

Results: Twenty-one of 420 patients (5%) who underwent intracranial EEG (iEEG), resective epilepsy surgery and/or vagus nerve stimulation (VNS) placement, had SRE. Read More

Neuroradiology 2021 Apr 12. Epub 2021 Apr 12.

Division of Pediatric Neurology, Department of Pediatrics, Friedrich-Alexander Universität Erlangen-Nürnberg, Loschgestr. 15, 91054, Erlangen, Germany.

Purpose: Vagus nerve stimulation (VNS) is an effective adjunctive treatment for drug-resistant epilepsy (DRE) and difficult-to-treat depression (DTD). More than 125.000 patients have been implanted with VNS Therapy® System (LivaNova PLC) since initial approval. Read More

Sci Rep 2021 Apr 12;11(1):7906. Epub 2021 Apr 12.

Department of Epileptology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.

Transcutaneous auricular vagus nerve stimulation (taVNS) is a novel non-invasive brain stimulation technique considered as a potential supplementary treatment option for subjects with refractory epilepsy. Its exact mechanism of action is not yet fully understood. We developed an examination schedule to probe for immediate taVNS-induced modifications of large-scale epileptic brain networks and accompanying changes of cognition and behaviour. Read More

Exp Neurol 2021 Apr 15;341:113718. Epub 2021 Apr 15.

Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080, United States; School of Behavioral Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080, United States.

Studies in rodents indicate that pairing vagus nerve stimulation (VNS) with extinction training enhances fear extinction. However, the role of stimulation parameters on the effects of VNS remains largely unknown. Identifying the optimal stimulation intensity is a critical step in clinical translation of neuromodulation-based therapies. Read More