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State dependent vagus nerve stimulation for targeted plasticity therapy: challenges and considerations

Authors :
Bharadwaj Nandakumar
Ramanamurthy V. Mylavarapu
Rivaldo Harris
Eric R. Albuquerque
Zihan Yan
Cameron Herter
David W. McMillan
Vivek V. Kanumuri
Patrick D. Ganzer
Source :
Frontiers in Control Engineering, Vol 5 (2024)
Publication Year :
2024
Publisher :
Frontiers Media S.A., 2024.

Abstract

Targeted plasticity therapy (TPT) utilizes vagus nerve stimulation (VNS) to promote improvements in function following neurological injury and disease. During TPT, a brief burst of VNS induces neuromodulator release, which when paired with relevant behavioral events can influence functionally relevant neuroplasticity. Functional improvements following TPT are therefore in part mediated by neuromodulator signaling. Unfortunately, comorbidities associated with neurological disease often result in altered cognitive states that can influence neuromodulator signaling, potentially impeding neuroplasticity induced by TPT. Aside from altered cognitive states, cardiorespiratory rhythms also affect neuromodulator signaling, due to the vagus nerve’s role in relaying visceral sensory information from the cardiovascular and respiratory systems. Moreover, precise VNS delivery during specific periods of the cardiorespiratory rhythms may further improve TPT. Ultimately, understanding the impact of patient-specific states on neuromodulator signaling may likely facilitate optimized VNS delivery, paving the way for personalized neuromodulation during TPT. Overall, this review explores challenges and considerations for developing advanced TPT paradigms, focusing on altered cognitive states and cardiorespiratory rhythms. We specifically discuss the possible impact of these cognitive states and autonomic rhythms on neuromodulator signaling and subsequent neuroplasticity. Altered cognitive states (arousal deficits or pain) could affect VNS intensity, while cardiorespiratory rhythms may further inform optimized timing of VNS. We propose that understanding these interactions will lead to the development of personalized state dependent VNS paradigms for TPT.

Details

Language :
English
ISSN :
26736268
Volume :
5
Database :
Directory of Open Access Journals
Journal :
Frontiers in Control Engineering
Publication Type :
Academic Journal
Accession number :
edsdoj.9e93d5d0cfd5479f81eea76c24df3af3
Document Type :
article
Full Text :
https://doi.org/10.3389/fcteg.2024.1452442