Titel Deelnemers "Korte inhoud" "A novel implantable vagus nerve stimulation system (ADNS-300) for combined stimulation and recording of the vagus nerve" "Riëm el Tahry, Robrecht Raedt, Lies Mollet, Veerle de Herdt, Tine Wyckhuys, Annelies van Dycke, Alfred Meurs, Frank Dewaele, Dirk van Roost, Pascal Doguet, Jean Delbeke, Wytse Wadman, Kristl Vonck, Paul Boon" "Purpose Vagus nerve stimulation (VNS) is an established treatment for refractory epilepsy. The ADNS-300 is a new system for VNS that includes a rechargeable stimulus generator and an electrode for combined stimulation and recording. In this feasibility study, three patients were implanted with ADNS-300 for therapeutic VNS. In addition, compound action potentials (CAPs) were recorded to evaluate activation of the vagus nerve in response to VNS. Methods Three patients were implanted with a cuff-electrode around the left vagus nerve, that was connected to a rechargeable pulse generator under the left clavicula. Two weeks after surgery, therapeutic VNS (0.251.25 mA, 500 μs, 30 s on, 10 min off and 30 Hz) was initiated and stimulus-induced CAPs were recorded. Results The ADNS-300 system was successfully implanted in all three patients and patients were appropriately stimulated during six months of follow-up. A reduction in seizure frequency was demonstrated in two patients (43% and 40% in patients 1 and 3, respectively), while in patient 2 seizure frequency remained unchanged. CAPs could be recorded in patients 1 and 2, proving stimulation-induced activation of the vagus nerve. Conclusion This feasibility study demonstrates that the ADNS-300 system can be used for combined therapeutic stimulation (in 3/3 patients) and recording of CAPs in response to VNS (in 2/3 patients) up to three weeks after surgery. Implantation in a larger number of patients will lead to a better understanding of the electrophysiology of the vagus nerve, which in turn could result in more adequate and individualized VNS parameter choice." "Vagus nerve compound action potentials (CAPs) verify vagus nerve stimulation in rats" "Liesbeth Waterschoot, Tim De Smedt, Tine Wyckhuys, Veerle De Herdt, Jean Delbeke, Wytse Wadman" "Vagus nerve stimulation-induced laryngeal motor evoked potentials : a possible biomarker of effective nerve activation" "Simone Vespa, Lars Stumpp, Charlotte Bouckaert, Jean Delbeke, Hugo Smets, Joaquin Cury, Susana Ferrao Santos, Herbert Rooijakkers, Antoine Nonclercq, Robrecht Raedt, Kristl Vonck, Riëm El Tahry" "Vagus nerve stimulation (VNS) therapy is associated with laryngeal muscle activation and induces voice modifications, well-known side effects of the therapy resulting from co-activation of the recurrent laryngeal nerve. In this study, we describe the non-invasive transcutaneous recording of laryngeal motor evoked potentials (LMEPs), which could serve as a biomarker of effective nerve activation and individual titration in patients with drug-resistant epilepsy. We recruited drug-resistant epileptic patients treated for at least 6 months with a VNS. Trains of 600-1200 VNS pulses were delivered with increasing current outputs. We placed six skin electrodes on the ventral surface of the neck, in order to record LMEPs whenever the laryngeal muscular threshold was reached. We studied the internal consistency and the variability of LMEP recordings, and compared different methods for amplitude calculation. Recruitment curves were built based on the stimulus-response relationship. We also determined the electrical axis of the LMEPs dipole in order to define the optimal electrode placement for LMEPs recording in a clinical setting. LMEPs were successfully recorded in 11/11 patients. The LMEPs threshold ranged from 0.25 to 1 mA (median 0.50 mA), and onset latency was between 5.37 and 8.77 ms. The signal-to-noise ratio was outstanding in 10/11 patients. In these cases, excellent reliability (Intraclass correlation coefficient, ICC > 0.90 across three different amplitude measurements) was achieved with 10 sample averages. Moreover, our recordings showed very good internal consistency (Cronbach's alpha > 0.95 for 10 epochs). Area-under-the-curve and peak-to-peak measurement proved to be complementary methods for amplitude calculation. Finally, we determined that an optimal derivation requires only two recording electrodes, aligned on a horizontal axis around the laryngeal prominence. In conclusion, we describe here an optimal methodology for the recording of VNS-induced motor evoked responses from the larynx. Although further clinical validation is still necessary, LMEPs might be useful as a non-invasive marker of effective nerve activation, and as an aid for the clinician to perform a more rational titration of VNS parameters." "Assessment of nerve cathodal block for the percutaneous auricular vagus nerve stimulation" "Mohammed Samoudi, Tom Van de Steene, Emmeric Tanghe, Luc Martens, Wout Joseph" "Electrical Stimulation of the Abdominal Vagus Nerve Is as Effective as Cervical Nerve Stimulation in Reducing Postoperative Ileus" "Nathalie Stakenborg, Pedro J Gomez Pinilla, Giovanna Farro, Albert Wolthuis, Goele Bosmans, Evelien Labeeuw, Martina Di Giovangiulio, André D'Hoore, Gianluca Matteoli, Guy Boeckxstaens" "Functional electrical stimulation of the left recurrent laryngeal nerve using a vagus nerve stimulator in a normal horse" "Katleen Vanschandevijl, Heidi Nollet, Piet Deprez" "Current directions in the auricular vagus nerve stimulation I - A physiological perspective" "Eugenijus Kaniusas, Stefan Kampusch, Marc Tittgemeyer, Fivos Panetsos, Raquel Fernandez Gines, Michele Papa, Attila Kiss, Bruno Podesser, Antonino Mario Cassara, Emmeric Tanghe, Mohammed Samoudi, Thomas Tarnaud, Wout Joseph, Vaidotas Marozas, Arunas Lukosevicius, Niko Istuk, Antonio Sarolic, Sarah Lechner, Wlodzimierz Klonowski, Giedrius Varoneckas, Jozsef Constantin Szeles" "Electrical stimulation of the auricular vagus nerve (aVNS) is an emerging technology in the field of bioelectronic medicine with applications in therapy. Modulation of the afferent vagus nerve affects a large number of physiological processes and bodily states associated with information transfer between the brain and body. These include disease mitigating effects and sustainable therapeutic applications ranging from chronic pain diseases, neurodegenerative and metabolic ailments to inflammatory and cardiovascular diseases. Given the current evidence from experimental research in animal and clinical studies we discuss basic aVNS mechanisms and their potential clinical effects. Collectively, we provide a focused review on the physiological role of the vagus nerve and formulate a biology-driven rationale for aVNS. For the first time, two international workshops on aVNS have been held in Warsaw and Vienna in 2017 within the framework of EU COST Action ""European network for innovative uses of EMFs in biomedical applications (BM1309)."" Both workshops focused critically on the driving physiological mechanisms of aVNS, its experimental and clinical studies in animals and humans, in silico aVNS studies, technological advancements, and regulatory barriers. The results of the workshops are covered in two reviews, covering physiological and engineering aspects. The present review summarizes on physiological aspects - a discussion of engineering aspects is provided by our accompanying article (Kaniusas et al., 2019). Both reviews build a reasonable bridge from the rationale of aVNS as a therapeutic tool to current research lines, all of them being highly relevant for the promising aVNS technology to reach the patient." "Effects of short and prolonged transcutaneous vagus nerve stimulation on heart rate variability in healthy subjects" "Marijke De Couck, Renata Cserjesi, Ralf Caers, W P Zijlstra, D Widjaja, Nicole I Wolf, O. Luminet, J Ellrich, Yori Gidron" "The vagus nerve is strategically located in the body, and has multiple homeostatic and health-promoting effects. Low vagal activity predicts onset and progression of diseases. These are the reasons to activate this nerve. This study examined the effects of transcutaneous vagus nerve stimulation (t-VNS) on a main index of vagal activity, namely heart rate variability (HRV). In Study 1, we compared short (10min) left versus right ear t-VNS versus sham (no stimulation) in a within-subjects experimental design. Results revealed significant increases in only one HRV parameter (standard deviation of the RR intervals (SDNN)) following right-ear t-VNS. Study 2 examined the prolonged effects of t-VNS (1h) in the right ear. Compared to baseline, right-t-VNS significantly increased the LF and LF/HF components of HRV, and SDNN in women, but not in men. These results show limited effects of t-VNS on HRV, and are discussed in light of neuroanatomical and statistical considerations and future directions are proposed." "Reduced distractor interference during vagus nerve stimulation" "Marlies E van Bochove, Leen De Taeye, Robrecht Raedt, Kristl Vonck, Alfred Meurs, Paul Boon, Ine Dauwe, Wim Notebaert, Geen naam beschikbaar" "Suppressing irrelevant information in decision making is an essential everyday skill. We studied whether this ability could be improved in epileptic patients during vagus nerve stimulation (VNS). VNS is known to increase norepinephrine (NE) in the brain. NE is thought to improve several aspects of cognitive control, including the suppression of irrelevant information. Nineteen epileptic VNS patients executed the Eriksen flanker task twice, both during on and off stimulation. Distractor interference was indexed by the congruency effect, a standard empirical marker of cognitive control. We found a reduced congruency effect during stimulation, which indicates an improved ability to suppress distractor interference. This effect was only found in patients that are clinically determined VNS-responders (n = 10). As VNS increases NE in VNS-responders, our finding suggests a beneficial role of NE in cognitive control. At the same time, it suggests that VNS does not only reduce seizure frequency in epileptic patients, but also improves cognitive control." "Ambiguous effect of signals transmitted by the vagus nerve on fibrosarcoma incidence and survival of tumor-bearing rats" "Lucia Mikova, Lubica Horvathova, Katarina Ondicova, Andrej Tillinger, Luca E Vannucci, Jozef Bizik, Yori Gidron, Boris Mravec" "While the parasympathetic nervous system appears to be involved in the regulation of tumor progression, its exact role is still unclear. Therefore, using a rat BP6-TU2 fibrosarcoma tumor model, we investigated the effect of (1) reduction of vagal activity produced by subdiaphragmatic vagotomy; and (2) enhancement of vagal activity produced by continuous delivery of electric impulses to the cervical part of the vagus nerve on tumor development and survival of tumor-bearing rats. We also evaluated the expression of cholinergic receptors within in vitro cultivated BP6-TU2 cells. Interestingly, we found that both, vagal stimulation and subdiaphragmatic vagotomy slightly reduced tumor incidence. However, survival of tumor-bearing rats was not affected by any of the experimental approaches. Additionally, we detected mRNA expression of the α1, α2, α5, α7, and α10 subunits of nicotinic receptors and the M1, M3, M4, and M5 subtypes of muscarinic receptors within in vitro cultivated BP6-TU2 cells. Our data indicate that the role of the vagus nerve in modulation of fibrosarcoma development is ambiguous and uncertain and requires further investigation."