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Cited by 88Vagus Nerve Stimulation ResearchNeuroscience and Neural EngineeringThyroid and Parathyroid Surgery

Human vagus nerve branching in the cervical region.

Open access
Hammer, Niels, Glätzner, Juliane, Feja, Christine, Kühne, Christian, Meixensberger, Jürgen, Planitzer, Uwe, Schleifenbaum, Stefan, Tillmann, Bernhard N. +1 more·2015·PLOS ONE
DOI 10.1371/journal.pone.0118006PMC PMC4332499
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Abstract

BACKGROUND: Vagus nerve stimulation is increasingly applied to treat epilepsy, psychiatric conditions and potentially chronic heart failure. After implanting vagus nerve electrodes to the cervical vagus nerve, side effects such as voice alterations and dyspnea or missing therapeutic effects are observed at different frequencies. Cervical vagus nerve branching might partly be responsible for these effects. However, vagus nerve branching has not yet been described in the context of vagus nerve stimulation. MATERIALS AND METHODS: Branching of the cervical vagus nerve was investigated macroscopically in 35 body donors (66 cervical sides) in the carotid sheath. After X-ray imaging for determining the vertebral levels of cervical vagus nerve branching, samples were removed to confirm histologically the nerve and to calculate cervical vagus nerve diameters and cross-sections. RESULTS: Cervical vagus nerve branching was observed in 29% of all cases (26% unilaterally, 3% bilaterally) and proven histologically in all cases. Right-sided branching (22%) was more common than left-sided branching (12%) and occurred on the level of the fourth and fifth vertebra on the left and on the level of the second to fifth vertebra on the right side. Vagus nerves without branching were significantly larger than vagus nerves with branches, concerning their diameters (4.79 mm vs. 3.78 mm) and cross-sections (7.24 mm2 vs. 5.28 mm2). DISCUSSION: Cervical vagus nerve branching is considerably more frequent than described previously. The side-dependent differences of vagus nerve branching may be linked to the asymmetric effects of the vagus nerve. Cervical vagus nerve branching should be taken into account when identifying main trunk of the vagus nerve for implanting electrodes to minimize potential side effects or lacking therapeutic benefits of vagus nerve stimulation.

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Crossref · 10.1371/journal.pone.0118006

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  • Anatomically, the NV may interconnect the stress responses in stress, breathing, and speech by means of its nerve branches.

    “Anatomically, the NV may thus interconnect the stress responses in both, stress, breathing and speech by means of its nerve branches (e.g., Yoshida et al., 1992; Câmara and Griessenauer, 2015; Hammer et al., 2015).”

    From Voice Stress Analysis: A New Framework for Voice and Effort in Human Performance (2018) · cites this paper as Hammer et al., 2015

    The Discussion (page not provided) describes vagus-nerve branches and connections to the cervical sympathetic trunk and recurrent laryngeal nerve. The Introduction (page not provided) reports voice alterations and dyspnea associated with vagus-nerve stimulation. These passages support the anatomical and breathing/speech aspects, but the paper does not establish that the branches interconnect stress responses across stress, breathing, and speech. (LLM, conf=0.82)

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  • It has not yet been completely clarified in what way the NV may influence speech and its stress reactivity.

    “Although it has not yet completely been clarified in what way the NV may be of influence on speech (Yoshida et al., 1992; Hammer et al., 2015) and thus its stress reactivity, the missing link between both may be found in breathing parameters.”

    From Voice Stress Analysis: A New Framework for Voice and Effort in Human Performance (2018) · cites this paper as Hammer et al., 2015

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Research works printed but not linked: 5

  1. [14]Wachsmuth W, Lang J, Lanz Tv, Jensen H-P, Schröder F (1985) Übergeordnete Systeme; Lang J, editor. Berlin [u.a.]: Springer XXII, 720 pp.
  2. [15]Rauber A, Leonhardt H (1987) Anatomie des Menschen: Lehrbuch u Atlas 3 Nervensystem, Sinnesorgane. Stuttgart [u.a.]: Thieme XII, 678 pp.
  3. [17]Weiand G, Mangold G (2004) [ Variations in the course of the inferior laryngeal nerve. Surgical anatomy, classification, diagnosis]. Chirurg 75: 187– 195. 14991182
  4. [28]Hafferl A, Thiel W (1969) Lehrbuch der topographischen Anatomie mit den Pariser und Jenaer Nomina anatomica Berlin [u.a.]: Springer XVI, 971 pp.
  5. [40]Lang J, Nachbaur S, Fischer K, Vogel E (1987) [ The superior laryngeal nerve and the superior laryngeal artery]. Acta Anat (Basel) 130: 309– 318. 3434183

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Authors
Hammer, N., Glätzner, J., Feja, C., Kühne, C., Meixensberger, J., Planitzer, U., Schleifenbaum, S., Tillmann, B. N., & Winkler, D.
Affiliations
  • Leipzig University (DE)
  • University Hospital Leipzig (DE)
  • Christian-Albrechts-Universität zu Kiel (DE)
Corresponding author
Hammer, Niels
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2015-02-13
Volume
10
Issue
2
Pages
e0118006
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0118006
PMC
PMC4332499
OpenAlex
W2100123523
Cited by
88
References
63
Citations by year
2026: 3 · 2025: 8 · 2024: 6 · 2023: 12 · 2022: 13 · 2021: 12 · 2020: 11 · 2019: 9 · 2018: 7 · 2017: 5 · 2016: 2
FWCI
2.49
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
Topics
  • Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
cervical vagus nerve, vagus nerve stimulation, carotid sheath, electrode implantation, epilepsy treatment
MeSH terms
Aged, Aged, 80 and over, Female, Humans, Male, Neck, Tissue Donors, Vagus Nerve

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