Functional seizure therapy via transauricular vagus nerve stimulation

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses Pub Date : 2024-08-21 DOI:10.1016/j.mehy.2024.111462

Abhijit Das , Anirban Dutta

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Abstract

This article explores the potential of transauricular Vagus nerve stimulation (taVNS) in treating Functional Seizures (FS), a condition that significantly burdens healthcare systems. Traditional seizure treatments are ineffective for FS due to its unique pathophysiology, highlighting the urgent need for alternative therapeutic strategies. While invasive VNS has shown promise in improving autonomic balance, its invasive nature poses limitations in FS treatment. taVNS, a non-invasive alternative, enhances parasympathetic tone and reduces sympathetic activity. Additionally, it is hypothesized to modulate interoceptive processing by influencing Heart Rate Evoked Potential and normalizing interoceptive signals. This hypothesis article examines taVNS from a closed-loop perspective, focusing on the controllability and observability of its effects using wearable physiological sensors. It postulates regulating desired therapeutic states through physiological sensor feedback, suggesting the potential for customized, adaptive stimulation in FS treatment. However, rigorous testing of its controller and observer functions will be necessary for optimal clinical translation of adaptive taVNS.

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通过经耳迷走神经刺激进行功能性癫痫治疗

这篇文章探讨了经耳迷走神经刺激（taVNS）在治疗功能性癫痫发作（FS）方面的潜力，功能性癫痫发作给医疗系统造成了沉重负担。由于其独特的病理生理学，传统的癫痫发作治疗对 FS 无效，这凸显了对替代治疗策略的迫切需求。虽然侵入性 VNS 在改善自律神经平衡方面已显示出前景，但其侵入性对 FS 的治疗造成了限制。此外，假设它还能通过影响心率诱发电位和使感知间信号正常化来调节感知间处理。这篇假设性文章从闭环角度对 taVNS 进行了研究，重点是利用可穿戴生理传感器对其效果进行可控性和可观测性研究。它假设通过生理传感器反馈调节所需的治疗状态，表明在 FS 治疗中定制化、自适应刺激的潜力。不过，要将自适应 taVNS 最佳地应用于临床，还需要对其控制器和观察器功能进行严格测试。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical hypotheses 医学-医学：研究与实验

CiteScore

10.60

自引率

2.10%

发文量

167

审稿时长

60 days

期刊介绍： Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. The Aims and Scope of Medical Hypotheses are no different now from what was proposed by the founder of the journal, the late Dr David Horrobin. In his introduction to the first issue of the Journal, he asks ''what sorts of papers will be published in Medical Hypotheses? and goes on to answer ''Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary''. (Horrobin DF, 1975 Ideas in Biomedical Science: Reasons for the foundation of Medical Hypotheses. Medical Hypotheses Volume 1, Issue 1, January-February 1975, Pages 1-2.). Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations.