The effect of vagus nerve stimulation on cardiorespiratory parameters during rest and exercise

Mulders, Dounia; Vos, Cecilia Cecilia Clementine de; Vosman, I.; Putten, Michel Johannes Antonius Maria van

doi:10.1016/j.seizure.2015.10.004

Cited by 20 publications

(27 citation statements)

References 19 publications

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“…On the other hand, afferent vagal, A-type and C-type, sensory fibers innervate lung stretch receptors and nociceptors, respectively, and, when stimulated, elicit various changes in breathing rate and pattern 30,45 . Similar changes in cardiac and pulmonary functional parameters in response to cervical VNS have been reported in experimental animals 27,46 and in humans 47 , but this is the first time, to our knowledge, that these responses have been evaluated in the context of vagotomies, providing direct functional evidence for 2 easily obtainable, in experimental animals and in humans, markers of activation by VNS of efferent and afferent vagal fibers, respectively 47 .…”

Section: Discussionsupporting

confidence: 72%

Anodal block permits directional vagus nerve stimulation

Ahmed

Chang

Cracchiolo

et al. 2020

Sci Rep

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Section: Discussionsupporting

confidence: 72%

Anodal block permits directional vagus nerve stimulation

Ahmed

Chang

Cracchiolo

et al. 2020

Sci Rep

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“…Epilepsy type 27,30 , epilepsy duration 27 , seizure type 27 and Vagus Nerve Stimulator (VNS) implant side effects 49 were not considered to be associated with performance. Increased age 27 , lower BMI 27 and being female 40 were associated with improved performance, as measured by physical competence 27 and METs 40 .…”

Section: Exercise/fitness Testsmentioning

confidence: 99%

“…28 Matched controls were used in 11 studies. 27,30,34,35,40,41,43,61,62,64,66 Fourteen studies 26,28,[33][34][35][37][38][39]42,56,57,60,64,65 exclusively used questionnaires, five studies 30,32,36,49,66 exclusively used exercise/fitness tests, and seven studies 40,41,43,44,61,62,67 used both methods of data collection. One study 27 used questionnaires, an exercise/fitness test, and a pedometer.…”

Section: Pa In Pwe Compared To Controlsmentioning

confidence: 99%

Physical activity in people with epilepsy: A systematic review

2020

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This study aimed to systematically review studies focussing on levels of physical activity (PA) in people with epilepsy (PWE) compared with non-epilepsy controls, and identify factors associated with PA in PWE. Intervention studies were also reviewed to consider the effects of psychological interventions on levels of PA, and the effects of PA-based interventions on seizure activity, psychiatric comorbidity and health related quality of life (HRQoL). PRISMA guidelines were followed. Searches were conducted using PubMed, Cochrane Controlled Register of Trials, PsychINFO and EMBASE. Forty-six studies met inclusion criteria including case-control, cross-sectional and intervention studies. Assessment measures included questionnaires, activity trackers and measures of physiological fitness. Twelve of 22 (54.5%) case-control studies utilising self-report questionnaire measures reported that PWE were performing lower levels of PA, less likely to be engaging in PA or less likely to meet PA guidelines than controls. The remaining studies did not find a difference between PWE and controls. Eight of 12 (67%) case-control studies utilising exercise/fitness tests reported that PWE performed significantly poorer than controls, whilst in two studies PWE performed better than controls. One of three studies investigating the relationship between PA and seizure frequency found that increased self-reported PA was associated with having fewer seizures, whilst two did not find a significant relationship. All seven cross-sectional studies which included measures of HRQoL and depression/anxiety found a positive relationship between levels of PA and HRQoL/reduced levels of depression and anxiety. All four studies that used PA-based interventions demonstrated improvements in levels of PA and increased HRQoL.Study quality was almost universally low. In conclusion, there is some evidence that PWE engage in less PA than peers, and that interventions can improve PA levels and HRQoL.

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“…In fact, VNS may even increase the risk of SUDEP (Annegers et al 1998). VNS has been shown to regulate sympathetic activation of the sinoatrial node (Zhou et al 2016) and reduce resting HR (Mulders et al 2015) and is believed to enhance parasympathetic activity (Kampusch et al 2015). Additionally, VNS is hypothesized to worsen sleepbreathing disorders via altered laryngeal motility (Zambrelli et al 2016) and has been shown to trigger obstructive sleep apnea, a condition often coupled with an overexpression of parasympathetic activity (Ebben et al 2008;Parhizgar et al 2011;Vollono et al 2015).…”

Section: Possible Physiological Mechanismsmentioning

confidence: 99%

Decreased heart rate and enhanced sinus arrhythmia during interictal sleep demonstrate autonomic imbalance in generalized epilepsy

Sivakumar

Namath

Tuxhorn

et al. 2016

Journal of Neurophysiology

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Sivakumar SS, Namath AG, Tuxhorn IE, Lewis SJ, Galán RF. Decreased heart rate and enhanced sinus arrhythmia during interictal sleep demonstrate autonomic imbalance in generalized epilepsy. J Neurophysiol 115: 1988 -1999. First published February 17, 2016 doi:10.1152/jn.01120.2015.-We hypothesized that epilepsy affects the activity of the autonomic nervous system even in the absence of seizures, which should manifest as differences in heart rate variability (HRV) and cardiac cycle. To test this hypothesis, we investigated ECG traces of 91 children and adolescents with generalized epilepsy and 25 neurologically normal controls during 30 min of stage 2 sleep with interictal or normal EEG. Mean heart rate (HR) and high-frequency HRV corresponding to respiratory sinus arrhythmia (RSA) were quantified and compared. Blood pressure (BP) measurements from physical exams of all subjects were also collected and analyzed. RSA was on average significantly stronger in patients with epilepsy, whereas their mean HR was significantly lower after adjusting for age, body mass index, and sex, consistent with increased parasympathetic tone in these patients. In contrast, diastolic (and systolic) BP at rest was not significantly different, indicating that the sympathetic tone is similar. Remarkably, five additional subjects, initially diagnosed as neurologically normal but with enhanced RSA and lower HR, eventually developed epilepsy, suggesting that increased parasympathetic tone precedes the onset of epilepsy in children. ECG waveforms in epilepsy also displayed significantly longer TP intervals (ventricular diastole) relative to the RR interval. The relative TP interval correlated positively with RSA and negatively with HR, suggesting that these parameters are linked through a common mechanism, which we discuss. Altogether, our results provide evidence for imbalanced autonomic function in generalized epilepsy, which may be a key contributing factor to sudden unexpected death in epilepsy.SUDEP; heart rate variability; cardiac cycle; parasympathetic tone; children EPILEPTIC SEIZURES ARE KNOWN to have profound effects on autonomic function (Wyllie 2015). To quantify these effects, many studies have focused on heart rate (HR) (Behbahani et al.

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The effect of vagus nerve stimulation on cardiorespiratory parameters during rest and exercise

Abstract: This pilot study shows that VNS causes an increase in breathing frequency and a decrease in tidal volume and heart rate in the majority of patients, during both rest and exercise.

Cited by 20 publications

References 19 publications

Anodal block permits directional vagus nerve stimulation

Anodal block permits directional vagus nerve stimulation

Physical activity in people with epilepsy: A systematic review

Decreased heart rate and enhanced sinus arrhythmia during interictal sleep demonstrate autonomic imbalance in generalized epilepsy

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