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Verma N, Knudsen B, Gholston A, Skubal A, Blanz S, Settell M, Frank J, Trevathan J, Ludwig K. Microneurography as a minimally invasive method to assess target engagement during neuromodulation. J Neural Eng 2023; 20:10.1088/1741-2552/acc35c. [PMID: 36898148 PMCID: PMC10587909 DOI: 10.1088/1741-2552/acc35c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/10/2023] [Indexed: 03/12/2023]
Abstract
Objective.Peripheral neural signals recorded during neuromodulation therapies provide insights into local neural target engagement and serve as a sensitive biomarker of physiological effect. Although these applications make peripheral recordings important for furthering neuromodulation therapies, the invasive nature of conventional nerve cuffs and longitudinal intrafascicular electrodes (LIFEs) limit their clinical utility. Furthermore, cuff electrodes typically record clear asynchronous neural activity in small animal models but not in large animal models. Microneurography, a minimally invasive technique, is already used routinely in humans to record asynchronous neural activity in the periphery. However, the relative performance of microneurography microelectrodes compared to cuff and LIFE electrodes in measuring neural signals relevant to neuromodulation therapies is not well understood.Approach.To address this gap, we recorded cervical vagus nerve electrically evoked compound action potentials (ECAPs) and spontaneous activity in a human-scaled large animal model-the pig. Additionally, we recorded sensory evoked activity and both invasively and non-invasively evoked CAPs from the great auricular nerve. In aggregate, this study assesses the potential of microneurography electrodes to measure neural activity during neuromodulation therapies with statistically powered and pre-registered outcomes (https://osf.io/y9k6j).Main results.The cuff recorded the largest ECAP signal (p< 0.01) and had the lowest noise floor amongst the evaluated electrodes. Despite the lower signal to noise ratio, microneurography electrodes were able to detect the threshold for neural activation with similar sensitivity to cuff and LIFE electrodes once a dose-response curve was constructed. Furthermore, the microneurography electrodes recorded distinct sensory evoked neural activity.Significance.The results show that microneurography electrodes can measure neural signals relevant to neuromodulation therapies. Microneurography could further neuromodulation therapies by providing a real-time biomarker to guide electrode placement and stimulation parameter selection to optimize local neural fiber engagement and study mechanisms of action.
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Affiliation(s)
- Nishant Verma
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Bruce Knudsen
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Aaron Gholston
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Aaron Skubal
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Stephan Blanz
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Megan Settell
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Jennifer Frank
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
| | - James Trevathan
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Kip Ludwig
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
- Department of Neurosurgery, University of Wisconsin-Madison, Madison, WI, United States of America
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Smets H, Stumpp L, Chavez J, Cury J, Vande Perre L, Doguet P, Vanhoestenberghe A, Delbeke J, El Tahry R, Nonclercq A. Chronic recording of the vagus nerve to analyze modulations by the light-dark cycle. J Neural Eng 2022; 19. [PMID: 35764074 DOI: 10.1088/1741-2552/ac7c8f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 06/28/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The vagus nerve is considered to play a key role in the circadian rhythm. Chronic continuous analysis of the vagus nerve activity could contribute to a better understanding of the role of the vagus nerve in light-dark modulations. This paper presents a continuous analysis of spontaneous vagus nerve activity performed in four rats. APPROACH We analyzed the vagus electroneurogram (VENG) and electroencephalogram (EEG) over a recording period of 28 days. Spike activity and heart rate estimation were derived from the VENG, and slow-wave activity was derived from the EEG. The presence of repetitive patterns was investigated with periodograms, cosinor fitting, autocorrelation, and statistical tests. The light-dark variations derived from the VENG spikes were compared with EEG slow waves, an established metric in circadian studies. RESULTS Our results demonstrate that light-dark variations can be detected in long-term vagus nerve activity monitoring. A recording period of about seven days is required to characterize accurately the VENG light-dark variations. SIGNIFICANCE As a major outcome of this study, vagus nerve recordings hold the promise to help understand circadian regulation.
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Affiliation(s)
- Hugo Smets
- BEAMS, Université Libre de Bruxelles Faculté des sciences appliquées/Ecole polytechnique, Avenue Franklin Roosevelt, 50, CP 165/56, Bruxelles, 1050, BELGIUM
| | - Lars Stumpp
- IONS, Université catholique de Louvain, Avenue Mounier 53/B1.53.05, Brussels, 1200, BELGIUM
| | - Javier Chavez
- BEAMS, Université Libre de Bruxelles Faculté des sciences appliquées/Ecole polytechnique, Avenue Franklin Roosevelt, 50, CP 165/56, Bruxelles, 1050, BELGIUM
| | - Joaquin Cury
- BEAMS, Université Libre de Bruxelles Faculté des sciences appliquées/Ecole polytechnique, Avenue Franklin Roosevelt, 50, CP 165/56, Bruxelles, 1050, BELGIUM
| | - Louis Vande Perre
- BEAMS, Université Libre de Bruxelles Faculté des sciences appliquées/Ecole polytechnique, Avenue Franklin Roosevelt, 50, CP 165/56, Bruxelles, 1050, BELGIUM
| | - Pascal Doguet
- Synergia Medical SA, Rue Emile Francqui 6, Mont-Saint-Guibert, 1435, BELGIUM
| | - Anne Vanhoestenberghe
- Aspire Centre for Rehabilitation Engineering and Assistive Technology, University College London, Brockley Hill, Aspire Create - IOMS BUilding, RNOH campus, London, HA74LP, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Jean Delbeke
- Private Address - Belgium, Seringenstraat 27, Kraainem, B-1950, BELGIUM
| | - Riëm El Tahry
- IONS, Université catholique de Louvain, Avenue Mounier 53/B1.53.05, Brussels, 1200, BELGIUM
| | - Antoine Nonclercq
- BEAMS, Université Libre de Bruxelles Faculté des sciences appliquées/Ecole polytechnique, Avenue Franklin Roosevelt, 50, CP 165/56, Bruxelles, 1050, BELGIUM
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Sevcencu C. Single-interface bioelectronic medicines - concept, clinical applications and preclinical data. J Neural Eng 2022; 19. [PMID: 35533654 DOI: 10.1088/1741-2552/ac6e08] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/08/2022] [Indexed: 11/12/2022]
Abstract
Presently, large groups of patients with various diseases are either intolerant, or irresponsive to drug therapies and also intractable by surgery. For several diseases, one option which is available for such patients is the implantable neurostimulation therapy. However, lacking closed-loop control and selective stimulation capabilities, the present neurostimulation therapies are not optimal and are therefore used as only "third" therapeutic options when a disease cannot be treated by drugs or surgery. Addressing those limitations, a next generation class of closed-loop controlled and selective neurostimulators generically named bioelectronic medicines seems within reach. A sub-class of such devices is meant to monitor and treat impaired functions by intercepting, analyzing and modulating neural signals involved in the regulation of such functions using just one neural interface for those purposes. The primary objective of this review is to provide a first broad perspective on this type of single-interface devices for bioelectronic therapies. For this purpose, the concept, clinical applications and preclinical studies for further developments with such devices are here analyzed in a narrative manner.
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Affiliation(s)
- Cristian Sevcencu
- National Institute for Research and Development of Isotopic and Molecular Technologies, 67-103 Donat Street, Cluj-Napoca, 400293, ROMANIA
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Stumpp L, Smets H, Vespa S, Cury J, Doguet P, Delbeke J, Nonclercq A, El Tahry R. Vagus Nerve Electroneurogram-Based Detection of Acute Pentylenetetrazol Induced Seizures in Rats. Int J Neural Syst 2021; 31:2150024. [PMID: 34030610 DOI: 10.1142/s0129065721500246] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
On-demand stimulation improves the efficacy of vagus nerve stimulation (VNS) in refractory epilepsy. The vagus nerve is the main peripheral parasympathetic connection and seizures are known to exhibit autonomic symptoms. Therefore, we hypothesized that seizure detection is possible through vagus nerve electroneurogram (VENG) recording. We developed a metric able to measure abrupt changes in amplitude and frequency of spontaneous vagus nerve action potentials. A classifier was trained using a "leave-one-out" method on a set of 6 seizures and 3 control recordings to utilize the VENG spike feature-based metric for seizure detection. We were able to detect pentylenetetrazol (PTZ) induced acute seizures in 6/6 animals during different stages of the seizure with no false detection. The classifier detected the seizure during an early stage in 3/6 animals and at the onset of tonic clonic stage of the seizure in 3/6 animals. EMG and motion artefacts often accompany epileptic activity. We showed the "epileptic" neural signal to be independent from EMG and motion artefacts. We confirmed the existence of seizure related signals in the VENG recording and proved their applicability for seizure detection. This detection might be a promising tool to improve efficacy of VNS treatment by developing new responsive stimulation systems.
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Affiliation(s)
- Lars Stumpp
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Hugo Smets
- BEAMS Department, Université libre de Bruxelles, Brussels, Belgium
| | - Simone Vespa
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Joaquin Cury
- BEAMS Department, Université libre de Bruxelles, Brussels, Belgium
| | | | - Jean Delbeke
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | | | - Riem El Tahry
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.,Cliniques Universitaires Saint Luc, Center for Refractory Epilepsy, Brussels, Belgium
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