Vagus nerve stimulation in ischemic stroke: old wine in a new bottle

Authors

Peter Y. Cai, Department of Neurology, University of Florida , Gainesville, FL , USA ; Department of Anesthesiology, University of Florida , Gainesville, FL , USA.
Aakash Bodhit, Department of Neurology, University of Florida , Gainesville, FL , USA.
Roselle Derequito, Department of Neurology, University of Florida , Gainesville, FL , USA.
Saeed Ansari, Department of Neurology, University of Florida , Gainesville, FL , USA ; Department of Anesthesiology, University of Florida , Gainesville, FL , USA ; Department of Surgery, University of Florida , Gainesville, FL , USA.
Fawzi Abukhalil, Department of Neurology, University of Florida , Gainesville, FL , USA.
Spandana Thenkabail, Department of Neurology, University of Florida , Gainesville, FL , USA.
Sarah Ganji, Department of Neurology, University of Florida , Gainesville, FL , USA.
Pradeepan Saravanapavan, Department of Neurology, University of Florida , Gainesville, FL , USA.
Chandana C. Shekar, Department of Neurology, University of Florida , Gainesville, FL , USA.
Sharatchandra Bidari, Department of Radiology, University of Florida , Gainesville, FL , USA.
Michael F. Waters, Department of Neurology, University of Florida , Gainesville, FL , USA ; Department of Neuroscience, University of Florida , Gainesville, FL , USA.
Vishnumurthy Shushrutha Hedna, Department of Neurology, University of Florida , Gainesville, FL , USA.

Document Type

Article

Abstract

Vagus nerve stimulation (VNS) is currently Food and Drug Administration-approved for treatment of both medically refractory partial-onset seizures and severe, recurrent refractory depression, which has failed to respond to medical interventions. Because of its ability to regulate mechanisms well-studied in neuroscience, such as norepinephrine and serotonin release, the vagus nerve may play an important role in regulating cerebral blood flow, edema, inflammation, glutamate excitotoxicity, and neurotrophic processes. There is strong evidence that these same processes are important in stroke pathophysiology. We reviewed the literature for the role of VNS in improving ischemic stroke outcomes by performing a systematic search for publications in Medline (1966-2014) with keywords "VNS AND stroke" in subject headings and key words with no language restrictions. Of the 73 publications retrieved, we identified 7 studies from 3 different research groups that met our final inclusion criteria of research studies addressing the role of VNS in ischemic stroke. Results from these studies suggest that VNS has promising efficacy in reducing stroke volume and attenuating neurological deficits in ischemic stroke models. Given the lack of success in Phase III trials for stroke neuroprotection, it is important to develop new therapies targeting different neuroprotective pathways. Further studies of the possible role of VNS, through normally physiologically active mechanisms, in ischemic stroke therapeutics should be conducted in both animal models and clinical studies. In addition, recent advent of a non-invasive, transcutaneous VNS could provide the potential for easier clinical translation.

Keywords

cerebral blood flow, glutamate excitotoxicity, middle cerebral artery occlusion, neuroinflammation, stroke

Publication Date

1-1-2014

Publication Title

Frontiers in neurology

ISSN

1664-2295

Volume

5

First Page

107

PubMed ID

25009531

Digital Object Identifier (DOI)

10.3389/fneur.2014.00107

Recommended Citation

Cai, Peter Y.; Bodhit, Aakash; Derequito, Roselle; Ansari, Saeed; Abukhalil, Fawzi; Thenkabail, Spandana; Ganji, Sarah; Saravanapavan, Pradeepan; Shekar, Chandana C.; Bidari, Sharatchandra; Waters, Michael F.; and Hedna, Vishnumurthy Shushrutha, "Vagus nerve stimulation in ischemic stroke: old wine in a new bottle" (2014). Translational Neuroscience. 1349.
https://scholar.barrowneuro.org/neurobiology/1349