{"title":"通过经耳迷走神经刺激进行功能性癫痫治疗","authors":"Abhijit Das , Anirban Dutta","doi":"10.1016/j.mehy.2024.111462","DOIUrl":null,"url":null,"abstract":"<div><p>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.</p></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"191 ","pages":"Article 111462"},"PeriodicalIF":2.1000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0306987724002056/pdfft?md5=c86eb29eb533207c19258a99cd037a8f&pid=1-s2.0-S0306987724002056-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Functional seizure therapy via transauricular vagus nerve stimulation\",\"authors\":\"Abhijit Das , Anirban Dutta\",\"doi\":\"10.1016/j.mehy.2024.111462\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>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.</p></div>\",\"PeriodicalId\":18425,\"journal\":{\"name\":\"Medical hypotheses\",\"volume\":\"191 \",\"pages\":\"Article 111462\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-08-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0306987724002056/pdfft?md5=c86eb29eb533207c19258a99cd037a8f&pid=1-s2.0-S0306987724002056-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medical hypotheses\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0306987724002056\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical hypotheses","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0306987724002056","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Functional seizure therapy via transauricular vagus nerve stimulation
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.
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.
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