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Cardiovascular autonomic effects of vagus nerve stimulation

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Abstract

The vagus nerve is responsible for the parasympathetic innervation of the major thoracic and abdominal organs. It also carries sensory afferent fibres from these viscera and reaches different brain structures. These connections have proven useful in the treatment of different diseases. Afferent stimulation of the left vagus nerve is used to treat epilepsy and major depression, and stimulation of the right vagus nerve is being tried for the treatment of heart failure. The device used for the therapy delivers intermittent stimuli. It is indicated worldwide for the treatment of drug-resistant epilepsy in patients who are not appropriate candidates for respective surgery. It has also received approval for the treatment of major depression, obesity and episodic cluster headache by the Food and Drug Administration. Randomised controlled trials and prospective studies have confirmed the efficacy and safety of this therapy in epilepsy. Nevertheless, sporadic cases of ventricular asystole have been reported. To evaluate the effect of vagus nerve stimulation therapy on the autonomic nervous system, different studies that assess heart function and blood pressure changes have been conducted, although the methods employed were not homogeneous. These studies have found subtle or no significant changes in heart rate variability and blood pressure in epileptic patients. Moreover, this therapy may reduce the risk of one of the most lethal conditions in epilepsy—sudden unexpected death.

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Acknowledgements

We would like to acknowledge the contributions of Dr Iñigo Gabilondo (PhD) of the Biocruces Health Research Institute and Dr Lara Galbarriatu of the Neurosurgery Department of the Cruces University Hospital.

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Authors and Affiliations

  1. Epilepsy Unit, Biocruces Research Institute, Barakaldo, Bizkaia, Spain

    Iñigo Garamendi-Ruiz

  2. Autonomic and Movement Disorders Unit, Biocruces Research Institute, Barakaldo, Bizkaia, Spain

    Juan Carlos Gómez-Esteban

  3. Department of Neurosciences, University of the Basque Country, Leioa, Spain

    Juan Carlos Gómez-Esteban

Authors
  1. Iñigo Garamendi-Ruiz
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  2. Juan Carlos Gómez-Esteban
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Correspondence to Iñigo Garamendi-Ruiz.

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This study did not receive specific grants from any funding agencies in the public, commercial or non-profit sectors. None of the authors have any conflict of interest to disclose.

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Garamendi-Ruiz, I., Gómez-Esteban, J.C. Cardiovascular autonomic effects of vagus nerve stimulation. Clin Auton Res 29, 183–194 (2019). https://doi.org/10.1007/s10286-017-0477-8

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  • DOI: https://doi.org/10.1007/s10286-017-0477-8

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