Selective Neuromodulation of the Vagus Nerve
Open accessAbstract
Vagus nerve stimulation (VNS) is an effective technique for the treatment of refractory epilepsy and shows potential for the treatment of a range of other serious conditions. However, until now stimulation has generally been supramaximal and non-selective, resulting in a range of side effects. Selective VNS (sVNS) aims to mitigate this by targeting specific fiber types within the nerve to produce functionally specific effects. In recent years, several key paradigms of sVNS have been developed—spatially selective, fiber-selective, anodal block, neural titration, and kilohertz electrical stimulation block—as well as various stimulation pulse parameters and electrode array geometries. sVNS can significantly reduce the severity of side effects, and in some cases increase efficacy of the treatment. While most studies have focused on fiber-selective sVNS, spatially selective sVNS has demonstrated comparable mitigation of side-effects. It has the potential to achieve greater specificity and provide crucial information about vagal nerve physiology. Anodal block achieves strong side-effect mitigation too, but is much less specific than fiber- and spatially selective paradigms. The major hurdle to achieving better selectivity of VNS is a limited knowledge of functional anatomical organization of vagus nerve. It is also crucial to optimize electrode array geometry and pulse shape, as well as expand the applications of sVNS beyond the current focus on cardiovascular disease.
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Non-selective vagus nerve stimulation results in coughs, headaches, throat pain, nausea and apnea.
“For example, non-selective vagus nerve stimulation (VNS) results in coughs, headaches, throat pain, nausea and apnea.”
From Active Neural Interface Circuits and Systems for Selective Control of Peripheral Nerves: A Review (2024) · cites this paper as [3]
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Vagus Nerve Stimulation and Its Cardioprotective Abilities: A Systematic Review
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Closed-loop electrical block of vagus nerve scales from rodent to porcine cardiac models
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Optimal delivery of vagus nerve stimulation
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Targeting the Vagus Nerve to Treat Inflammatory Bowel Disease?
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Vagus Nerve Manipulation and Microglial Plasticity in the Prenatal Brain
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- Authors
- Fitchett, A., Mastitskaya, S., & Aristovich, K.
- Affiliations
- University College London (GB)
- Corresponding author
- Mastitskaya, Svetlana
- Aristovich, Kirill
- Venue
- Frontiers in Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2021-05-24
- Volume
- 15
- Pages
- 685872-685872
- ISSN
- 1662-453X (ISSN-L)
- PMC
- PMC8180849
- OpenAlex
- W3165578688
- Cited by
- 94
- References
- 74
- Citations by year
- 2026: 10 · 2025: 23 · 2024: 19 · 2023: 26 · 2022: 14 · 2021: 2
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Neuroscience (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institutes of Health
- Topics
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- vagus nerve, drug-resistant epilepsy, pulse parameters
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