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de Faria GM, Lopes EG, Tobaldini E, Montano N, Cunha TS, Casali KR, de Amorim HA. Advances in Non-Invasive Neuromodulation: Designing Closed-Loop Devices for Respiratory-Controlled Transcutaneous Vagus Nerve Stimulation. Healthcare (Basel) 2023; 12:31. [PMID: 38200937 PMCID: PMC10778699 DOI: 10.3390/healthcare12010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
Studies suggest non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) as a potential therapeutic option for various pathological conditions, such as epilepsy and depression. Exhalation-controlled taVNS, which synchronizes stimulation with internal body rhythms, holds promise for enhanced neuromodulation, but there is no closed-loop system in the literature capable of performing such integration in real time. In this context, the objective was to develop real-time signal processing techniques and an integrated closed-loop device with sensors to acquire physiological data. After a conditioning stage, the signal is processed and delivers synchronized electrical stimulation during the patient's expiratory phase. Additional modules were designed for processing, software-controlled selectors, remote and autonomous operation, improved analysis, and graphical visualization. The signal processing method effectively extracted respiratory cycles and successfully attenuated signal noise. Heart rate variability was assessed in real time, using linear statistical evaluation. The prototype feedback stimulator device was physically constructed. Respiratory peak detection achieved an accuracy of 90%, and the real-time processing resulted in a small delay of up to 150 ms in the detection of the expiratory phase. Thus, preliminary results show promising accuracy, indicating the need for additional tests to optimize real-time processing and the application of the prototype in clinical studies.
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Affiliation(s)
- Gabriella Maria de Faria
- Institute of Science and Technology, Universidade Federal de São Paulo, São José dos Campos 12231-280, Brazil; (G.M.d.F.); (E.G.L.); (T.S.C.); (H.A.d.A.)
| | - Eugênia Gonzales Lopes
- Institute of Science and Technology, Universidade Federal de São Paulo, São José dos Campos 12231-280, Brazil; (G.M.d.F.); (E.G.L.); (T.S.C.); (H.A.d.A.)
| | - Eleonora Tobaldini
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy; (E.T.); (N.M.)
| | - Nicola Montano
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy; (E.T.); (N.M.)
| | - Tatiana Sousa Cunha
- Institute of Science and Technology, Universidade Federal de São Paulo, São José dos Campos 12231-280, Brazil; (G.M.d.F.); (E.G.L.); (T.S.C.); (H.A.d.A.)
| | - Karina Rabello Casali
- Institute of Science and Technology, Universidade Federal de São Paulo, São José dos Campos 12231-280, Brazil; (G.M.d.F.); (E.G.L.); (T.S.C.); (H.A.d.A.)
| | - Henrique Alves de Amorim
- Institute of Science and Technology, Universidade Federal de São Paulo, São José dos Campos 12231-280, Brazil; (G.M.d.F.); (E.G.L.); (T.S.C.); (H.A.d.A.)
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Shi X, Zhao J, Xu S, Ren M, Wu Y, Chen X, Zhou Z, Chen S, Huang Y, Li Y, Shan C. Clinical Research Progress of the Post-Stroke Upper Limb Motor Function Improvement via Transcutaneous Auricular Vagus Nerve Stimulation. Neural Plast 2023; 2023:9532713. [PMID: 37789954 PMCID: PMC10545466 DOI: 10.1155/2023/9532713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 06/24/2023] [Accepted: 08/22/2023] [Indexed: 10/05/2023] Open
Abstract
Stroke is a disease with high morbidity and disability, and motor impairment is a common sequela of stroke. Transcutaneous auricular vagus nerve stimulation (taVNS) is a type of non-invasive stimulation, which can effectively improve post-stroke motor dysfunction. This review discusses stimulation parameters, intervention timing, and the development of innovative devices for taVNS. We further summarize the application of taVNS in improving post-stroke upper limb motor function to further promote the clinical research and application of taVNS in the rehabilitation of post-stroke upper limb motor dysfunction.
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Affiliation(s)
- Xiaolong Shi
- Department of Rehabilitation Medicine, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, 200336, Shanghai, China
- Institute of Rehabilitation, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 201203, Shanghai, China
| | - Jingjun Zhao
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 201203, Shanghai, China
| | - Shutian Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 201203, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, 201203, Shanghai, China
| | - Meng Ren
- Institute of Rehabilitation, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 201203, Shanghai, China
| | - Yuwei Wu
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 200437, Shanghai, China
| | - Xixi Chen
- Institute of Rehabilitation, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 201203, Shanghai, China
| | - Zhiqing Zhou
- Institute of Rehabilitation, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 201203, Shanghai, China
| | - Songmei Chen
- Shanghai No.3 Rehabilitation Hospital, 200436, Shanghai, China
| | - Yu Huang
- Institute of Rehabilitation, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 201203, Shanghai, China
| | - Yuanli Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 201203, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, 201203, Shanghai, China
| | - Chunlei Shan
- Department of Rehabilitation Medicine, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, 200336, Shanghai, China
- Institute of Rehabilitation, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, 201203, Shanghai, China
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 200437, Shanghai, China
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