Selective stimulation of the vagus nerve in a man

Functional Vagotopy in the Cervical Vagus Nerve of the Domestic Pig: Implications for the Study of Vagus Nerve Stimulation

“…These off-target effects have been attributed to activation of somatic fibers within the cervical vagus that eventually become the recurrent laryngeal branch, and potentially by current escaping the open helix electrodes to activate the somatic fibers of the nearby superior laryngeal branch (Tosato et al 2007;Yoo et al 2013). Given the off-target effects of VNS, there is renewed interest in developing novel stimulation strategies and multi-contact electrodes to stimulate selectively specific fibers within the vagus -typically preganglionic efferents or sensory afferents to and from the visceral organs -while avoiding motor efferent fibers coursing within or nearby the cervical vagus trunk (Plachta et al 2014;Rozman and Bunc 2004;Thompson, Mastitskaya, and Holder 2019;Aristovich et al 2019;Pečlin et al 2009).…”

Selective Neuromodulation of the Vagus Nerve

“… Peclin and Rozman (2009) were the first to demonstrate fiber-selective VNS in humans ( Pečlin et al, 2009 ; Peclin and Rozman, 2009 ), following earlier work in a canine model ( Rozman and Peclin, 2008 ). In the dog, they demonstrated selective control of HR and respiration rate by stimulating with sets of three electrodes at different positions around the nerve circumference ( Figures 3F,G ; Rozman and Peclin, 2008 ).…”

“…They then applied the same technique to two human patients, reducing the HR Plachta et al (2013Plachta et al ( , 2014Plachta et al ( , 2016, . while preferentially activating B over A fibers (Pečlin et al, 2009). Their method involves the use of "quasi-trapezoidal" pulses (Figure 2F), which activate A and B fibers during their square cathodal phase, before blocking A fibers during an exponentially decaying anodal phase (Pečlin and Rozman, 2014).…”

“…A number of research groups have demonstrated that it is possible to achieve functionally specific effects from sVNS by selectively targeting and modulating organ function in various animal models and human patients ( Pečlin et al, 2009 ; Plachta et al, 2014 ; Aristovich et al, 2021 ). sVNS results in similar or improved therapeutic effects compared to nsVNS, whereas side effects are reduced ( Plachta et al, 2014 ).…”

Avoiding off-target effects in electrical stimulation of the cervical vagus nerve: Neuroanatomical tracing techniques to study fascicular anatomy of the vagus nerve

“…With a known fascicular organisation of the vagus nerve, selective stimulation could be used to target specific organs or effectors for neuromodulation and avoid adverse off-target effects. Preliminary studies have shown this is possible using cuff electrodes optimised for selective stimulation in sheep, dogs and humans (Aristovich et al, 2019; Pečlin et al, 2009; Rozman and Bunc, 2004). Stimulation through a pair of electrodes in the same radial position on two rings of 14 electrodes in a cylindrical multielectrode nerve cuff array in the sheep allows for selective neuromodulation of cardiac, pulmonary and recurrent laryngeal activity in the vagus nerve; evidence is yet to be obtained to show that function is localised to individual fascicles, but these results already suggest that such function is localised within the nerve (Aristovich et al, 2019).…”