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Application of Vagus Nerve Stimulation in Spinal Cord Injury Rehabilitation Publisher Pubmed



Fallahi MS1, 2 ; Azadnajafabad S1, 3 ; Maroufi SF1, 4 ; Pourrashidi A1, 5 ; Khorasanizadeh M6 ; Sattari SA7 ; Faramarzi S8 ; Slavin KV9
Authors
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Authors Affiliations
  1. 1. Neurosurgical Research Network (NRN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  2. 2. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Neurosurgery, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Neurosurgery, Mount Sinai Hospital, Icahn School of Medicine, New York, NY, United States
  7. 7. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
  8. 8. School of Biological Sciences, University of California, Irvine, Irvine, CA, United States
  9. 9. Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, United States

Source: World Neurosurgery Published:2023


Abstract

Spinal cord injury (SCI) is a prevalent devastating condition causing significant morbidity and mortality, especially in developing countries. The pathophysiology of SCI involves ischemia, neuroinflammation, cell death, and scar formation. Due to the lack of definitive therapy for SCI, interventions mainly focus on rehabilitation to reduce deterioration and improve the patient's quality of life. Currently, rehabilitative exercises and neuromodulation methods such as functional electrical stimulation, epidural electrical stimulation, and transcutaneous electrical nerve stimulation are being tested in patients with SCI. Other spinal stimulation techniques are being developed and tested in animal models. However, often these methods require complex surgical procedures and solely focus on motor function. Vagus nerve stimulation (VNS) is currently used in patients with epilepsy, depression, and migraine and is being investigated for its application in other disorders. In animal models of SCI, VNS significantly improved locomotor function by ameliorating inflammation and improving plasticity, suggesting its use in human subjects. SCI patients also suffer from nonmotor complications, including pain, gastrointestinal dysfunction, cardiovascular disorders, and chronic conditions such as obesity and diabetes. VNS has shown promising results in alleviating these conditions in non-SCI patients, which makes it a possible therapeutic option in SCI patients. © 2023 Elsevier Inc.