Histopathology of the stimulated Vagus nerve: primum non nocere.

Heart Failure Reviews
Mark L Cohen, Zhanna Georgievskaya

Abstract

A primary concern in the utilization of implantable neural interfaces for the treatment of medical diseases is to follow the Hippocratic dictum: First, do no harm. If we are to avoid harm to the Vagus nerve in our use of stimulatory electrodes in the treatment of heart failure, we must understand the structural and functional elements that comprise peripheral nerves, their susceptibility to various types of injury that might be expected to occur secondary to functional electrical stimulation and how to separate the various components of the response of peripheral nervous system elements to stresses that may occur in the complex interactions that take place between electrode and nerve. To this end, we review the functional histology of peripheral nerve, followed by a consideration of salient types of nerve injuries, which have been elucidated through the combination of careful observations of human disease and well-constructed experimental models. We then examine the extant literature on stimulation-induced nerve injury in light of recent developments in the understanding of electropermeabilization of biological membranes. Finally, we briefly discuss our experience using the CardioFit™ electrode on the canine Vagus nerve.

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Citations

Dec 31, 2010·Heart Failure Reviews·Paul J Hauptman, Douglas L Mann
Jun 20, 2012·American Heart Journal·Paul J HauptmanDouglas L Mann
Dec 26, 2012·Trends in Cardiovascular Medicine·Christoph LeibZiya Kaya
Aug 25, 2016·Plastic and Reconstructive Surgery·Sahil K KapurSamuel O Poore
Mar 10, 2016·The Journal of Physiology·Guillaume de Lartigue
Feb 27, 2018·Bioelectronics in Medicine·Ranu JungAnil K Thota
May 29, 2014·Oxidative Medicine and Cellular Longevity·Yash B Joshi, Domenico Praticò
May 6, 2011·Journal of Neural Engineering·Tamar Ahilea AnholtJoshua A Goldberg
Jun 10, 2020·Scientific Reports·Umair AhmedStavros Zanos

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