Vagus nerve stimulation: a potential new treatment for ischaemic stroke

Meij, Anne van der; Wermer, Marieke J.H.

doi:10.1016/s0140-6736(21)00667-x

Cited by 11 publications

(7 citation statements)

References 12 publications

(10 reference statements)

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“…The brain in ammatory response after CI / RI runs throughout the development of CI / RI pathology,in ammatory factor IL-1β and TNF-α promote the occurrence of in ammatory reaction and has the effect of cascade ampli cation, which can cause delayed neuronal necrosis and aggravate brain injury (23).Previous studies have found that the protective effects of Met treatment on CI/RI mainly focus on anti-in ammatory, antioxidant stress and anti apoptosis,Nrf2 is a key factor in the cellular oxidative stress response,the NF-B pathway is a key factor of the in ammatory response, has an interaction with the Nrf2 pathway.NF-κ B is negatively correlated with Nrf2, and the increase of Nrf2 leads to NF-κ B expression decreased, thereby weakening the in ammatory response.HO-1, as an important antiin ammatory and antioxidant factor downstream of Nrf2, is positively correlated with Nrf2 and is an important neuroprotective factor found at present.HO-1 and its metabolites have a certain inhibitory effect on the in ammatory response mediated by neutrophils, macrophages and lymphocytes (23,24,25).…”

Section: Discussionmentioning

confidence: 99%

Neuroprotective of Metformin on ischemic brain injury in rats

Ruan

Yan

et al. 2022

Preprint

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Ischemic brain injury is a disease with high incidence rate, high disability rate and high mortality rate. The insufficiency of cerebral blood supply makes cerebral ischemia and hypoxia, leading to severe oxidative stress, severe inflammatory reaction and ultimately irreversible brain tissue damage or apoptosis.Metformin(Met,Abdominal inject,20 mg/kg,28days)is a guanidine derivative extracted from goats and is the first choice for first-line treatment of type 2 diabetes.In this study, the rat model of middle cerebral artery occlusion(MCAO) reperfusion injury and the hippocampal HT22 cell oxygen glucose privatization / reoxygenation (OGD/R) cell model were used to observe the effects of Met on the morphology of hippocampus, Nrf2, apoptosis factors, oxidative stress factors and inflammatory factors after CI/RI in rats ,it was further revealed that Met by using LY294002 antagonist, a specific kinase (phosphoinositide-3 kinase,PI3K) phosphoinositol-3 kinase, regulates the PI3K/Akt/Nrf2 signaling pathway in role in CI/RI.

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Section: Discussionmentioning

confidence: 99%

Neuroprotective of Metformin on ischemic brain injury in rats

Ruan

Yan

et al. 2022

Preprint

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“…In addition, VNS has been indicated to regulate immune cells and reduce proinflammatory cytokines through cholinergic anti‐inflammatory pathway, thus exerting neuroimmunomodulatory effects in a spectrum of brain disorders 130 . Recent studies have indicated that VNS paired with rehabilitation is a promising treatment option for people with moderate‐to‐severe neurological impairment after stroke 131–134 . The US Food and Drug Administration (FDA) then approved the use of VNS paired with upper limb rehabilitation for the treatment of moderate‐to‐severe upper extremity motor deficits associated with chronic ischemic stroke in 2021 131,135 .…”

Section: Treatment Strategiesmentioning

confidence: 99%

“… 130 Recent studies have indicated that VNS paired with rehabilitation is a promising treatment option for people with moderate‐to‐severe neurological impairment after stroke. 131 , 132 , 133 , 134 The US Food and Drug Administration (FDA) then approved the use of VNS paired with upper limb rehabilitation for the treatment of moderate‐to‐severe upper extremity motor deficits associated with chronic ischemic stroke in 2021. 131 , 135 It has also been indicated that VNS during rehabilitative training improved functional recovery after ICH in rats models.…”

Section: Treatment Strategiesmentioning

confidence: 99%

Autonomic dysfunction and treatment strategies in intracerebral hemorrhage

Kang,

Shi,

Liu

et al. 2024

CNS Neurosci Ther

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AimsAutonomic dysfunction with central autonomic network (CAN) damage occurs frequently after intracerebral hemorrhage (ICH) and contributes to a series of adverse outcomes. This review aims to provide insight and convenience for future clinical practice and research on autonomic dysfunction in ICH patients.DiscussionWe summarize the autonomic dysfunction in ICH from the aspects of potential mechanisms, clinical significance, assessment, and treatment strategies. The CAN structures mainly include insular cortex, anterior cingulate cortex, amygdala, hypothalamus, nucleus of the solitary tract, ventrolateral medulla, dorsal motor nucleus of the vagus, nucleus ambiguus, parabrachial nucleus, and periaqueductal gray. Autonomic dysfunction after ICH is closely associated with neurological functional outcomes, cardiac complications, blood pressure fluctuation, immunosuppression and infection, thermoregulatory dysfunction, hyperglycemia, digestive dysfunction, and urogenital disturbances. Heart rate variability, baroreflex sensitivity, skin sympathetic nerve activity, sympathetic skin response, and plasma catecholamine concentration can be used to assess the autonomic functional activities after ICH. Risk stratification of patients according to autonomic functional activities, and development of intervention approaches based on the restoration of sympathetic‐parasympathetic balance, would potentially improve clinical outcomes in ICH patients.ConclusionThe review systematically summarizes the evidence of autonomic dysfunction and its association with clinical outcomes in ICH patients, proposing that targeting autonomic dysfunction could be potentially investigated to improve the clinical outcomes.

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“…Among these therapies are: constraint-induced movement (10), mirror therapy (11), and resistance training (12), however, these interventions have a low level of adherence (13) and the evidence supporting their effects is still weak (10)(11)(12). Recently, Vagus Nerve Stimulation (VNS) has been proposed as an intervention that could have beneficial effects in the recovery of motor function in these patients, since it contributes to the generation of adaptive neuroplasticity and the activation of neuromodulators that reduce brain inflammation (14,15).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Vagus Nerve Stimulation on Upper Limb Motor Recovery After Stroke. A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundUpper limb motor impairment is one of the main complications of stroke, affecting quality of life both for the patient and their family. The aim of this systematic review was to summarize the scientific evidence on the safety and efficacy of Vagus Nerve Stimulation (VNS) on upper limb motor recovery after stroke.MethodsA systematic review and meta-analysis of studies that have evaluated the efficacy or safety of VNS in stroke patients was performed. The primary outcome was upper limb motor recovery. A search of articles published on MEDLINE, CENTRAL, EBSCO and LILACS up to December 2021 was performed, and a meta-analysis was developed to calculate the overall effects.ResultsEight studies evaluating VNS effects on motor function in stroke patients were included, of which 4 used implanted and 4 transcutaneous VNS. It was demonstrated that VNS, together with physical rehabilitation, increased upper limb motor function on average 7.06 points (95%CI 4.96; 9.16) as assessed by the Fugl-Meyer scale. Likewise, this improvement was significantly greater when compared to a control intervention (mean difference 2.48, 95%CI 0.98; 3.98). No deaths or serious adverse events related to the intervention were reported. The most frequent adverse events were dysphonia, dysphagia, nausea, skin redness, dysgeusia and pain related to device implantation.ConclusionVNS, together with physical rehabilitation, improves upper limb motor function in stroke patients. Additionally, VNS is a safe intervention.

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Vagus nerve stimulation: a potential new treatment for ischaemic stroke

Cited by 11 publications

References 12 publications

Neuroprotective of Metformin on ischemic brain injury in rats

Neuroprotective of Metformin on ischemic brain injury in rats

Autonomic dysfunction and treatment strategies in intracerebral hemorrhage

Efficacy and Safety of Vagus Nerve Stimulation on Upper Limb Motor Recovery After Stroke. A Systematic Review and Meta-Analysis

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