35 results match your criteria cervical nvns


Two-Week Cervical Vagus Nerve Stimulation in Chronic Pancreatitis Patients Induces Functional Connectivity Changes of Limbic Structures.

Neuromodulation 2021 Jun 14. Epub 2021 Jun 14.

Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark.

Objectives: Noninvasive vagus nerve stimulation (nVNS) has not only shown antinociceptive effects, but also demonstrated anti-inflammatory and antidepressant effects. These effects could be beneficial in chronic pancreatitis (CP) patients suffering from chronic abdominal pain, even though the underlying central mechanisms remain unclear. The aim was to investigate the effect of cervical nVNS in patients with painful CP on brain functional connectivity and cerebral metabolites. Read More

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Noninvasive vagus nerve stimulation to reduce ileus after major colorectal surgery: early development study.

Colorectal Dis 2021 May 21;23(5):1225-1232. Epub 2021 Feb 21.

Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.

Aim: Vagus nerve stimulation has emerged as a plausible intervention to reduce ileus after surgery. An early development study was undertaken with the aim of exploring the feasibility of self-administered, noninvasive vagus nerve stimulation (nVNS) after major colorectal surgery.

Method: A parallel-group, randomized controlled trial was undertaken between 1 January 2018 and 31 August 2019. Read More

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Noninvasive vagus nerve stimulation and morphine transiently inhibit trigeminal pain signaling in a chronic headache model.

Pain Rep 2020 Nov-Dec;5(6):e881. Epub 2020 Dec 17.

Missouri State University, Center for Biomedical and Life Sciences, Springfield, MO, USA.

Introduction: Chronic headache conditions are characterized by persistent sensitization of the trigeminal system, which involves dysfunction of descending pain modulation. We previously reported that noninvasive vagus nerve stimulation (nVNS) inhibits trigeminal nociception in models of episodic migraine through a mechanism involving enhanced serotonergic and GABAergic descending pain signaling.

Objectives: The analgesic effectiveness of nVNS and morphine were investigated in an animal model of chronic headache mediated by the combination of the 3 migraine risk factors of neck muscle tension, paradoxical sleep deprivation, and pungent odors. Read More

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December 2020

Effects of Noninvasive Cervical Vagal Nerve Stimulation on Cognitive Performance But Not Brain Activation in Healthy Adults.

Neuromodulation 2020 Nov 25. Epub 2020 Nov 25.

San Diego Department of Psychiatry, University of California, San Diego, CA, USA.

Objectives: While preliminary evidence suggests that noninvasive vagal nerve stimulation (nVNS) may enhance cognition, to our knowledge, no study has directly assessed the effects of nVNS on brain function and cognitive performance in healthy individuals. The aim of this study was therefore to assess whether nVNS enhances complex visuospatial problem solving in a normative sample. Functional magnetic resonance imaging (fMRI) was used to examine underlying neural substrates. Read More

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November 2020

Feasibility of Non-Invasive Vagus Nerve Stimulation (gammaCore VET™) for the Treatment of Refractory Seizure Activity in Dogs.

Front Vet Sci 2020 16;7:569739. Epub 2020 Sep 16.

Friendship Hospital for Animals, Washington, DC, United States.

Idiopathic epilepsy is the most common chronic neurologic condition in dogs. Approximately 20-30% of those dogs are refractory to standard medical therapy and commonly experience side effects from antiepileptic drugs. Non-invasive vagus nerve stimulation (nVNS) has been frequently used in human medicine as an adjunct seizure therapy with low incidence of adverse events. Read More

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September 2020

NOn-invasive Vagus nerve stimulation in acute Ischemic Stroke (NOVIS): a study protocol for a randomized clinical trial.

Trials 2020 Oct 26;21(1):878. Epub 2020 Oct 26.

Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.

Background: Secondary damage due to neurochemical and inflammatory changes in the penumbra in the first days after ischemic stroke contributes substantially to poor clinical outcome. In animal models, vagus nerve stimulation (VNS) inhibits these detrimental changes and thereby reduces tissue injury. The aim of this study is to investigate whether non-invasive cervical VNS (nVNS) in addition to the current standard treatment can improve penumbral recovery and limit final infarct volume. Read More

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October 2020

Update on noninvasive neuromodulation for migraine treatment-Vagus nerve stimulation.

Prog Brain Res 2020 6;255:249-274. Epub 2020 Jul 6.

Headache Unit, IRCCS Neuromed, Pozzilli (IS), Italy.

Noninvasive neurostimulation methods are particularly suited for migraine treatment thanks to their most favorable adverse event profile. Among them, noninvasive vagus nerve stimulation (nVNS) has raised great hope because of the role the vagus nerve is known to play in pain modulation, inflammation and brain excitability. We will critically review the clinical studies performed for migraine attack treatment and migraine prevention with the GammaCore® device, which allows cervical vagus nerve stimulation. Read More

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Non-invasive vagal nerve stimulation decreases brain activity during trauma scripts.

Brain Stimul 2020 Sep - Oct;13(5):1333-1348. Epub 2020 Jul 10.

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA.

Background: Traumatic stress can have lasting effects on neurobiology and result in psychiatric conditions such as posttraumatic stress disorder (PTSD). We hypothesize that non-invasive cervical vagal nerve stimulation (nVNS) may alleviate trauma symptoms by reducing stress sympathetic reactivity. This study examined how nVNS alters neural responses to personalized traumatic scripts. Read More

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A Randomized Sham-Controlled Cross-Over Study on the Short-Term Effect of Non-Invasive Cervical Vagus Nerve Stimulation on Spinal and Supraspinal Nociception in Healthy Subjects.

Headache 2020 Sep 27;60(8):1616-1631. Epub 2020 Jun 27.

Department of Neurology, University of Munich, Munich, Germany.

Objective: The aim of the present study was to test the effects of vagus nerve stimulation (VNS) on the descending pain inhibition, quantified by the nociceptive flexor (RIII) reflex and the conditioned pain modulation (CPM) paradigm, and on supraspinal nociceptive responses, assessed by pain intensity and unpleasantness ratings and late somatosensory evoked potentials (SEPs), in healthy subjects.

Background: Non-invasive vagus nerve stimulation (nVNS) showed promising effects on headache and pain treatment. Underlying mechanisms are only incompletely understood but may include the activation of the descending pain inhibitory system and/or the modification of emotional responses to pain. Read More

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September 2020

Inhibition of Trigeminal Nociception by Non-invasive Vagus Nerve Stimulation: Investigating the Role of GABAergic and Serotonergic Pathways in a Model of Episodic Migraine.

Front Neurol 2020 5;11:146. Epub 2020 Mar 5.

Center for Biomedical and Life Sciences, Missouri State University, Springfield, MO, United States.

Migraine is a prevalent neurological disease that is characterized by unpredictable episodic attacks of intense head pain. The underlying pathology involves sensitization and activation of the trigeminal system. Although non-invasive vagus nerve stimulation (nVNS) is recommended for the treatment of migraine, the abortive mechanism of action is not well-understood. Read More

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Cervical Noninvasive Vagus Nerve Stimulation for Migraine and Cluster Headache: A Systematic Review and Meta-Analysis.

Neuromodulation 2020 Aug 12;23(6):721-731. Epub 2020 Mar 12.

Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Background: Noninvasive vagus nerve stimulation (nVNS) has been proposed as a new neuromodulation therapy to treat primary headache disorders. The purpose of this study was to analyze the effectiveness and safety of peripheral nerve stimulation of the cervical branch of the vagal nerve for primary headache disorders.

Methods: A systematic review and meta-analysis of the literature was carried out on randomized controlled trials of nVNS for treating headaches. Read More

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Concerning Auricular Vagal Nerve Stimulation: Occult Neural Networks.

Front Hum Neurosci 2019 12;13:421. Epub 2019 Dec 12.

Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand.

Auricular vagal nerve stimulation (AVNS) is an evolving neuromodulation technology that has a wide range of therapeutic applications across multiple disciplines of medical science. To date, AVNS results had been interpreted in the context of a monolog concept of the auricular branch of the vagus nerve (ABVN): that this is the sole network of the mechanism of action and/or structure in the auricular area of the stimulation in the context of activations in the brainstem nuclei, including the nucleus tractus solitarius (NTS), locus coeruleus (LC), trigeminal brainstem nuclei, and the nucleus cuneatus. This review considers the overlooked aspects of neural networks, connections, hijacking axons from cranial nerves and cervical sympathetic ganglions, the inhomogeneous distribution of perivascular sympathetic nerves, and intrinsic/extrinsic auricular muscles in the auricular zone that can explain the vagal and non-vagal nucleus activations in AVNS. Read More

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December 2019

Non-invasive vagus nerve stimulation (nVNS) for the preventive treatment of episodic migraine: The multicentre, double-blind, randomised, sham-controlled PREMIUM trial.

Cephalalgia 2019 Oct 15;39(12):1475-1487. Epub 2019 Sep 15.

Leiden University Medical Center, Leiden, The Netherlands.

Introduction: Non-invasive vagus nerve stimulation (nVNS; gammaCore®) has the potential to prevent migraine days in patients with migraine on the basis of mechanistic rationale and pilot clinical data.

Methods: This multicentre study included a 4-week run-in period, a 12-week double-blind period of randomised treatment with nVNS or sham, and a 24-week open-label period of nVNS. Patients were to administer two 120-second stimulations bilaterally to the neck three times daily (6-8 hours apart). Read More

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October 2019

nVNS sham significantly affects the trigeminal-autonomic reflex: A randomized controlled study.

Neurology 2019 07 26;93(5):e518-e521. Epub 2019 Jun 26.

From the Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany.

Objective: To determine whether high placebo effects observed in recently published clinical noninvasive vagal nerve stimulation (nVNS) trials can be attributed to an active modulation of the trigeminal-autonomic reflex by the sham device.

Methods: Twenty-eight healthy participants were investigated in a randomized, controlled, single-blind, within-participant design. The 4 different conditions of no stimulation, regular nVNS of the left cervical vagal nerve, stimulation of the posterior neck with the same device (sham I), and stimulation of the left cervical vagal nerve with a sham device (sham II) were applied in randomized order. Read More

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Saliva molecular inflammatory profiling in female migraine patients responsive to adjunctive cervical non-invasive vagus nerve stimulation: the MOXY Study.

J Transl Med 2019 02 22;17(1):53. Epub 2019 Feb 22.

Department of Psychiatry, University Hospital Bonn, Bonn, Germany.

Background: Rising evidence indicate that oxytocin and IL-1β impact trigemino-nociceptive signaling. Current perspectives on migraine physiopathology emphasize a cytokine bias towards a pro-inflammatory status. The anti-nociceptive impact of oxytocin has been reported in preclinical and human trials. Read More

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February 2019

Vagus nerve stimulation for primary headache disorders: An anatomical review to explain a clinical phenomenon.

Cephalalgia 2019 Aug 20;39(9):1180-1194. Epub 2019 Feb 20.

4 Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.

Background: Non-invasive stimulation of the vagus nerve has been proposed as a new neuromodulation therapy to treat primary headache disorders, as the vagus nerve is hypothesized to modulate the headache pain pathways in the brain. Vagus nerve stimulation can be performed by placing an electrode on the ear to stimulate the tragus nerve, which contains about 1% of the vagus fibers. Non-invasive vagus nerve stimulation (nVNS) conventionally refers to stimulation of the cervical branch of the vagus nerve, which is made up entirely of vagal nerve fibers. Read More

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Inter-ictal assay of peripheral circulating inflammatory mediators in migraine patients under adjunctive cervical non-invasive vagus nerve stimulation (nVNS): A proof-of-concept study.

Brain Stimul 2019 May - Jun;12(3):643-651. Epub 2019 Jan 19.

University Hospital Bonn, Rheinische Friedrich-Wilhelms-University of Bonn, Germany; Department of Psychiatry, Germany; Division of Medical Psychology, Germany. Electronic address:

Objective: To assay peripheral inter-ictal cytokine serum levels and possible relations with non-invasive vagus nerve stimulation (nVNS) responsiveness in migraineurs.

Methods: This double-blinded, sham-controlled study enrolled 48 subjects and measured headache severity, frequency [headache days/month, number of total and mild/moderate/severe classified attacks/month], functional state [sleep, mood, body weight, migraine-associated disability] and serum levels of inflammatory markers [inter-ictal] using enzyme-linked immunoassays at baseline and after 2 months of adjunctive nVNS compared to sham stimulation and suitably matched controls.

Results: No significant differences were observed at baseline and after 2 months for headache severity, total attacks/month, headache days/month and functional outcome [sleep, mood, disability] between verum and sham nVNS. Read More

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Vagus nerve stimulation modulates the cranial trigeminal autonomic reflex.

Ann Neurol 2018 12 30;84(6):886-892. Epub 2018 Nov 30.

Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Objective: The trigeminal autonomic reflex plays an important role in primary headache syndromes. Noninvasive vagal nerve stimulation (nVNS) may be an effective modulator of this reflex.

Methods: Twenty-two healthy volunteers underwent kinetic oscillation stimulation (KOS) of the left nostril as a reliable trigger of the trigeminal autonomic reflex. Read More

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December 2018

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

Neuromodulation 2019 Jul 17;22(5):580-585. Epub 2018 Oct 17.

Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.

Objectives: Primary Sjögren's syndrome (pSS) sufferers have rated chronic fatigue as the most important symptom needing improvement. Emerging data suggest that stimulation of the vagus nerve can modulate immunological responses. The gammaCore device (electroCore), developed to stimulate the cervical vagus nerve noninvasively, was used to assess the effects of vagus nerve activation on immune responses and clinical symptoms of pSS. Read More

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Exploration of the Impact of Brief Noninvasive Vagal Nerve Stimulation on EEG and Event-Related Potentials.

Neuromodulation 2019 Jul 4;22(5):564-572. Epub 2018 Oct 4.

electroCore LLC, Basking Ridge, NJ, USA.

Objectives: The primary objective of this study was to explore the impact of noninvasive Vagal Nerve Stimulation (nVNS) on brain electrophysiology, as assessed through spontaneous resting-state EEG and stimulus-driven event-related potentials (ERPs).

Methods: A hand-held transcutaneous stimulator was placed on the neck over the main branch of the left vagus (active condition) or more laterally over neck muscles (sham condition), with two 120-sec long bursts of stimulation applied over a five-minute period. For each of eight neurotypical subjects, prior to stimulation, and then again beginning at 15, 120, and 240 min post-stimulation, ten minutes of background EEG data were collected, along with a series of ERPs-N100 auditory sensory-gating; the N1/P2 loudness dependent auditory evoked responses (LDAER); mismatch negativity; P300a; and P300b. Read More

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Effect of Non-invasive Vagus Nerve Stimulation on Resting-State Electroencephalography and Laser-Evoked Potentials in Migraine Patients: Mechanistic Insights.

Front Hum Neurosci 2018 13;12:366. Epub 2018 Sep 13.

Applied Neurophysiology and Pain Unit, SMBNOS Department, Polyclinic General Hospital, Bari Aldo Moro University, Bari, Italy.

A recent multicenter trial provided Class I evidence that for patients with an episodic migraine, non-invasive vagus nerve stimulation (nVNS) significantly increases the probability of having mild pain or being pain-free 2 h post-stimulation. Here we aimed to investigate the potential effect of nVNS in the modulation of spontaneous and pain related bioelectrical activity in a subgroup of migraine patients enrolled in the PRESTO trial by using resting-state electroencephalography and trigeminal laser-evoked potentials (LEPs). LEPs were recorded for 27 migraine patients who received active or sham nVNS over the cervical vagus nerve. Read More

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September 2018

Spotlight on cervical vagus nerve stimulation for the treatment of primary headache disorders: a review.

J Pain Res 2018 27;11:1613-1625. Epub 2018 Aug 27.

Department of Psychiatry, Rheinische Friedrich-Wilhelms University, Bonn, Germany,

Objectives: Cervical noninvasive vagus nerve stimulation (nVNS) emerged as an adjunctive neuromodulation approach for primary headache disorders with limited responsiveness to pharmacologic and behavioral treatment. This narrative review evaluates the safety and efficacy of invasive and noninvasive peripheral nerve stimulation of the cervical branch of the vagal nerve (afferent properties) for primary headache disorders (episodic/chronic migraine [EM/CM] and cluster headache [ECH/CCH]) and provides a brief summary of the preclinical data on the possible mechanism of action of cervical vagus nerve stimulation (VNS) and trigemino-nociceptive head pain transmission.

Materials And Methods: A systematic search of published data was performed in PubMed for randomized controlled trials (RCTs) and prospective cohort clinical studies assessing the efficacy/safety and cost-effectiveness of cervical VNS in primary headache disorders and related preclinical studies. Read More

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Non-invasive vagus nerve stimulation reduces blood-brain barrier disruption in a rat model of ischemic stroke.

Brain Stimul 2018 Jul - Aug;11(4):689-698. Epub 2018 Feb 15.

Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA. Electronic address:

Background: Vagus nerve stimulation (VNS) significantly reduces infarct volume in rat models of cerebral ischemia, but the mechanism of this protective effect remains open.

Hypothesis: This study tested the hypothesis that non-invasive VNS (nVNS), during transient middle cerebral artery occlusion (MCAO), protects the blood-brain barrier (BBB), leading to reduced infarct size in ischemic brain.

Methods: Spontaneous hypertensive rats (SHRs) were subjected to a 90 min MCAO. Read More

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February 2019

Vagus nerve stimulation inhibits trigeminal nociception in a rodent model of episodic migraine.

Pain Rep 2017 Nov 17;2(6):e628. Epub 2017 Oct 17.

Missouri State University, Springfield, MO, USA.

Introduction: Although neck muscle tension is considered a risk factor for migraine, pungent odors can act as a trigger to initiate an attack in sensitized individuals. Although noninvasive vagus nerve stimulation (nVNS) is now an approved treatment for chronic migraine, how it functions to inhibit trigeminal nociception in an episodic migraine model is not known.

Objectives: The objectives of this study were to determine if nVNS could inhibit trigeminal nociception in a novel model of episodic migraine and investigate changes in the expression of proteins implicated in peripheral and central sensitization. Read More

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November 2017

Mechanism of action of non-invasive cervical vagus nerve stimulation for the treatment of primary headaches.

Am J Manag Care 2017 Nov;23(17 Suppl):S312-S316

Stimulation of the cervical vagus nerve with implanted vagus nerve stimulation (iVNS) has been used clinically for more than 20 years to treat patients with epilepsy. More recently, a non-invasive cervical vagus nerve stimulation (nVNS), gammaCore, was developed, which has been purported to also stimulate the vagus nerve without the cost and morbidity associated with an iVNS system. gammaCore has been used to acutely treat various types of primary headaches, including migraine and cluster headaches (CH), and for the prevention of episodic, chronic, and menstrual migraines and CH. Read More

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November 2017

High-Resolution Multi-Scale Computational Model for Non-Invasive Cervical Vagus Nerve Stimulation.

Neuromodulation 2018 Apr 27;21(3):261-268. Epub 2017 Oct 27.

Department of Biomedical Engineering, The City College of New York, City University of New York, New York, NY, USA.

Objectives: To develop the first high-resolution, multi-scale model of cervical non-invasive vagus nerve stimulation (nVNS) and to predict vagus fiber type activation, given clinically relevant rheobase thresholds.

Methods: An MRI-derived Finite Element Method (FEM) model was developed to accurately simulate key macroscopic (e.g. Read More

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Proof of concept: short-term non-invasive cervical vagus nerve stimulation in patients with drug-refractory gastroparesis.

Frontline Gastroenterol 2017 Oct 24;8(4):325-330. Epub 2017 May 24.

Royal Free London NHS Foundation Trust, London, UK.

Background: Gastric electric stimulation (GES) is a treatment approach to refractory gastroparesis, possibly acting centrally via afferent vagus nerve stimulation (VNS). Non-invasive VNS (nVNS) is a potential alternative to GES that could eliminate the safety risks of or identify likely responders to implantable neurostimulators.

Objective: This open-label proof-of-concept study assessed the effects of nVNS in patients with severe drug-refractory gastroparesis. Read More

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October 2017

Evidence of activation of vagal afferents by non-invasive vagus nerve stimulation: An electrophysiological study in healthy volunteers.

Cephalalgia 2017 Nov 26;37(13):1285-1293. Epub 2017 Jun 26.

Headache Research Unit, University Department of Neurology CHR, Liège, Belgium.

Background Benefits of cervical non-invasive vagus nerve stimulation (nVNS) devices have been shown in episodic cluster headache and preliminarily suggested in migraine, but direct evidence of vagus nerve activation using such devices is lacking. Vagal somatosensory evoked potentials (vSEPs) associated with vagal afferent activation have been reported for invasive vagus nerve stimulation (iVNS) and non-invasive auricular vagal stimulation. Here, we aimed to show and characterise vSEPs for cervical nVNS. Read More

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November 2017

Access to Vagal Projections via Cutaneous Electrical Stimulation of the Neck: fMRI Evidence in Healthy Humans.

Brain Stimul 2017 Jan - Feb;10(1):19-27. Epub 2016 Oct 20.

Department of Psychology, Rutgers University, 101 Warren St, Newark, NJ 07102, USA.

Background: Stimulation of the vagus nerve via implanted electrodes is currently used to treat refractory epilepsy and depression. Recently, a non-invasive approach to vagal stimulation has demonstrated similar beneficial effects, but it remains unclear whether these effects are mediated via activation of afferent vagal fibers.

Objective: The present study was designed to ascertain whether afferent vagal projections can be accessed non-invasively by transcutaneous electrical stimulation of the antero-lateral surface of the neck, which overlies the course of the vagus nerve. Read More

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September 2017

Transcutaneous Cervical Vagus Nerve Stimulation Ameliorates Acute Ischemic Injury in Rats.

Brain Stimul 2016 Mar-Apr;9(2):166-73. Epub 2015 Dec 1.

MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Stroke Service, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background: Direct stimulation of the vagus nerve in the neck via surgically implanted electrodes is protective in animal models of stroke. We sought to determine the safety and efficacy of a non-invasive cervical VNS (nVNS) method using surface electrodes applied to the skin overlying the vagus nerve in the neck in a model of middle cerebral artery occlusion (MCAO).

Methods: nVNS was initiated variable times after MCAO in rats (n = 33). Read More

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February 2017