Design and validation of a closed-loop, motor-activated auricular vagus nerve stimulation (MAAVNS) system for neurorehabilitation

Brain Stimul. 2020 May-Jun;13(3):800-803. doi: 10.1016/j.brs.2020.02.028. Epub 2020 Feb 27.

Abstract

Background: Studies have found that pairing vagus nerve stimulation (VNS) with motor activity accelerates cortical reorganization. This synchronous pairing may enhance motor recovery.

Objective: To develop and validate a motor-activated auricular vagus nerve stimulation (MAAVNS) system as a potential neurorehabilitation tool.

Methods: We created MAAVNS and validated its function as part of an ongoing clinical trial investigating whether taVNS-paired rehabilitation enhances oromotor learning. We compared 3 different MAAVNS EMG electrode configurations in 3 neonates. The active lead was placed over the buccinator muscle. Reference lead placements were orbital, temporal or frontal.

Results: The frontal reference lead produced the highest sensitivity (0.87 ± 0.07 (n = 8)) and specificity (0.64 ± 0.13 (n = 8)). Oral sucking reliably triggers MAAVNS stimulation with high confidence.

Conclusion: EMG electrodes placed on target orofacial muscles can effectively trigger taVNS stimuli in infants in a closed loop fashion.

Keywords: Closed-loop neuromodulation; MAAVNS; Motor rehabilitation; Oral feeding; Pediatrics; VNS; taVNS.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Electromyography / methods
  • Electromyography / standards
  • Female
  • Humans
  • Infant, Newborn
  • Motor Activity / physiology*
  • Neurological Rehabilitation / methods*
  • Neurological Rehabilitation / standards*
  • Reproducibility of Results
  • Stroke Rehabilitation / methods
  • Stroke Rehabilitation / standards
  • Vagus Nerve / physiology
  • Vagus Nerve Stimulation / methods*
  • Vagus Nerve Stimulation / standards*