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  • 1
    Online Resource
    Online Resource
    New York, NY : Springer US
    Subject(s): Neurosciences. ; Neuroscience.
    In: Springer Nature eBook
    Description / Table of Contents: This volume covers the latest research and development in the areas of Vagus Nerve Stimulation (VNS) as it relates to bioelectronic medicine from neonate to adult. The chapters in this book cover topics such as invasive and non-invasive VNS including methodological considerations (study design, stimulation parameters, and use of heart rate variability metrics); mechanisms of action (automatic regulation and immune plasticity); and disorders where VNS approaches may be therapeutic (migraine and cluster headaches, mood disorders, trauma-related disorders, and language learning). In the Neuromethods series style, chapters include the kind of detail and key advice from the specialists needed to get successful results in your laboratory. Comprehensive and thorough, Vagus Nerve Stimulation is a valuable resource for both novice and expert preclinical and clinical scientists, clinicians, physicians, and scholars who are interested in learning more about this exciting and developing field.
    Type of Medium: Online Resource
    Pages: XXII, 206 p. 26 illus., 19 illus. in color. , online resource.
    Edition: 1st ed. 2024.
    ISBN: 9781071634653
    Series Statement: Neuromethods, 205
    Language: English
    Note: Vagus Nerve Stimulation in Peripheral Targets -- Vagal Nerve Stimulation Through the Lens of the Polyvagal Theory: Recruiting Neurophysiological Mechanisms to Dampen Threat Reactions and Promote Homeostatic Functions -- Heart Rate Variability as a Biomarker for Electrical Vagus Nerve Stimulation -- Vagus Nerve Manipulation and Microglial Plasticity in the Prenatal Brain -- Neonatal Sepsis is Diminished by Cervical Vagus Nerve Stimulation and Tracked Non-Invasively by ECG: A Pilot Report and Dataset in the Piglet Model -- Cognitive Enhancement through Vagus Nerve Stimulation: Methodological Considerations for Behavioral Studies in Rats -- Better Mood through Vagus Nerve Stimulation -- Transcutaneous Vagal Nerve Stimulation in Trauma Spectrum Psychiatric Disorders -- Vagus Nerve Stimulation for Migraine and Cluster Headaches -- Vagus Nerve Stimulation and Language Learning. .
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  • 2
    Publication Date: 2021-09-20
    Description: The autonomic nervous system (ANS) is one of the main biological systems that regulates the body's physiology. Autonomic nervous system regulatory capacity begins before birth as the sympathetic and parasympathetic activity contributes significantly to the fetus' development. In particular, several studies have shown how vagus nerve is involved in many vital processes during fetal, perinatal, and postnatal life: from the regulation of inflammation through the anti-inflammatory cholinergic pathway, which may affect the functioning of each organ, to the production of hormones involved in bioenergetic metabolism. In addition, the vagus nerve has been recognized as the primary afferent pathway capable of transmitting information to the brain from every organ of the body. Therefore, this hypothesis paper aims to review the development of ANS during fetal and perinatal life, focusing particularly on the vagus nerve, to identify possible “critical windows” that could impact its maturation. These “critical windows” could help clinicians know when to monitor fetuses to effectively assess the developmental status of both ANS and specifically the vagus nerve. In addition, this paper will focus on which factors—i.e., fetal characteristics and behaviors, maternal lifestyle and pathologies, placental health and dysfunction, labor, incubator conditions, and drug exposure—may have an impact on the development of the vagus during the above-mentioned “critical window” and how. This analysis could help clinicians and stakeholders define precise guidelines for improving the management of fetuses and newborns, particularly to reduce the potential adverse environmental impacts on ANS development that may lead to persistent long-term consequences. Since the development of ANS and the vagus influence have been shown to be reflected in cardiac variability, this paper will rely in particular on studies using fetal heart rate variability (fHRV) to monitor the continued growth and health of both animal and human fetuses. In fact, fHRV is a non-invasive marker whose changes have been associated with ANS development, vagal modulation, systemic and neurological inflammatory reactions, and even fetal distress during labor.
    Print ISSN: 1662-4548
    Electronic ISSN: 1662-453X
    Topics: Medicine
    Published by Frontiers Media
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  • 3
    Publication Date: 2021-05-05
    Description: Background: When exposed to repetitive umbilical cord occlusions (UCO) with worsening acidemia, fetuses eventually develop cardiovascular decompensation manifesting as pathological hypotensive arterial blood pressure (ABP) responses to fetal heart rate (FHR) decelerations. Failure to maintain cardiac output during labor is a key event leading up to brain injury. We reported that the timing of the event when a fetus begins to exhibit this cardiovascular phenotype is highly individual and was impossible to predict.Objective: We hypothesized that this phenotype would be reflected in the individual behavior of heart rate variability (HRV) as measured by root mean square of successive differences of R-R intervals (RMSSD), a measure of vagal modulation of HRV, which is known to increase with worsening acidemia. This is clinically relevant because HRV can be computed in real-time intrapartum. Consequently, we aimed to predict the individual timing of the event when a hypotensive ABP pattern would emerge in a fetus from a series of continuous RMSSD data.Study Design: Fourteen near-term fetal sheep were chronically instrumented with vascular catheters to record fetal arterial blood pressure, umbilical cord occluder to mimic uterine contractions occurring during human labor and ECG electrodes to compute the ECG-derived HRV measure RMSSD. All animals were studied over a ~6 h period. After a 1–2 h baseline control period, the animals underwent mild, moderate, and severe series of repetitive UCO. We applied the recently developed machine learning algorithm to detect physiologically meaningful changes in RMSSD dynamics with worsening acidemia and hypotensive responses to FHR decelerations. To mimic clinical scenarios using an ultrasound-based 4 Hz FHR sampling rate, we recomputed RMSSD from FHR sampled at 4 Hz and compared the performance of our algorithm under both conditions (1,000 Hz vs. 4 Hz).Results: The RMSSD values were highly non-stationary, with four different regimes and three regime changes, corresponding to a baseline period followed by mild, moderate, and severe UCO series. Each time series was characterized by seemingly randomly occurring (in terms of timing of the individual onset) increase in RMSSD values at different time points during the moderate UCO series and at the start of the severe UCO series. This event manifested as an increasing trend in RMSSD values, which counter-intuitively emerged as a period of relative stationarity for the time series. Our algorithm identified these change points as the individual time points of cardiovascular decompensation with 92% sensitivity, 86% accuracy and 92% precision which corresponded to 14 ± 21 min before the visual identification. In the 4 Hz RMSSD time series, the algorithm detected the event with 3 times earlier detection times than at 1,000 Hz, i.e., producing false positive alarms with 50% sensitivity, 21% accuracy, and 27% precision. We identified the overestimation of baseline FHR variability by RMSSD at a 4 Hz sampling rate to be the cause of this phenomenon.Conclusions: The key finding is demonstration of FHR monitoring to detect fetal cardiovascular decompensation during labor. This validates the hypothesis that our HRV-based algorithm identifies individual time points of ABP responses to UCO with worsening acidemia by extracting change point information from the physiologically related fluctuations in the RMSSD signal. This performance depends on the acquisition accuracy of beat to beat fluctuations achieved in trans-abdominal ECG devices and fails at the sampling rate used clinically in ultrasound-based systems. This has implications for implementing such an approach in clinical practice.
    Electronic ISSN: 2296-2360
    Topics: Medicine
    Published by Frontiers Media
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