The Impact of Peripheral Nerve Stimulation on Coronary Blood Flow and Endothelial Function

Lack of blood flow to the brain, i.e., ischemic stroke, results in loss of nerve cells and therefore loss of function in the effected brain regions. There is no effective treatment to improve lost function except restoring blood flow within the first several hours. Rehabilitation strategies are widely used with limited success. The purpose of this study was to examine the effect of electrical stimulation on the impaired upper extremity to improve functional recovery after stroke. We developed a rodent model using an electrode cuff implant onto a single peripheral nerve (median nerve) of the paretic forelimb and applied daily electrical stimulation. The skilled forelimb reaching test was used to evaluate functional outcome after stroke and electrical stimulation. Anterograde axonal tracing from layer V pyramidal neurons with biotinylated dextran amine was done to evaluate the formation of new neuronal connections from the contralesional cortex to the deafferented spinal cord. Rats receiving electrical stimulation on the median nerve showed significant improvement in the skilled forelimb reaching test in comparison with stroke only and stroke with sham stimulation. Rats that received electrical stimulation also exhibited significant improvement in the latency to initiate adhesive removal from the impaired forelimb, indicating better sensory recovery. Furthermore, axonal tracing analysis showed a significant higher midline fiber crossing index in the cervical spinal cord of rats receiving electrical stimulation. Our results indicate that direct peripheral nerve stimulation leads to improved sensorimotor recovery in the stroke-impaired forelimb, and may be a useful approach to improve post-stroke deficits in human patients.

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Enhancing osteoblast survival through pulsed electrical stimulation and implications for osseointegration

Scientific Reports ◽

10.1038/s41598-021-01901-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Emily Pettersen ◽

Furqan A. Shah ◽

Max Ortiz-Catalan

Keyword(s):

Electrical Stimulation ◽

Peripheral Nerve ◽

Cell Survival ◽

Nerve Stimulation ◽

Peripheral Nerve Stimulation ◽

Dependent Manner ◽

Stimulation Parameters ◽

Wide Range ◽

The Impact

AbstractElectrical stimulation has been suggested as a means for promoting the direct structural and functional bonding of bone tissue to an artificial implant, known as osseointegration. Previous work has investigated the impact of electrical stimulation in different models, both in vitro and in vivo, using various electrode configurations for inducing an electric field with a wide range of stimulation parameters. However, there is no consensus on optimal electrode configuration nor stimulation parameters. Here, we investigated a novel approach of delivering electrical stimulation to a titanium implant using parameters clinically tested in a different application, namely peripheral nerve stimulation. We propose an in vitro model comprising of Ti6Al4V implants precultured with MC3T3-E1 preosteoblasts, stimulated for 72 h at two different pulse amplitudes (10 µA and 20 µA) and at two different frequencies (50 Hz and 100 Hz). We found that asymmetric charge-balanced pulsed electrical stimulation improved cell survival and collagen production in a dose-dependent manner. Our findings suggest that pulsed electrical stimulation with characteristics similar to peripheral nerve stimulation has the potential to improve cell survival and may provide a promising approach to improve peri-implant bone healing, particularly to neuromusculoskeletal interfaces in which implanted electrodes are readily available.

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Using Peripheral Stimulation to Reduce the Pain of C2-Mediated Occipital Headaches: A Preliminary Report

January 2018 - Pain Physician ◽

10.36076/ppj.2007/10/453 ◽

2007 ◽

Vol 3;10 (5;3) ◽

pp. 453-460

Author(s):

Eugene A. Melvin, Jr

Keyword(s):

Peripheral Nerve ◽

Nerve Stimulation ◽

Short Form ◽

Medication Use ◽

Peripheral Nerve Stimulation ◽

Mcgill Pain Questionnaire ◽

Before And After ◽

Occipital Headache ◽

Headache Pain ◽

The Impact

Background: Peripheral nerve stimulation (PNS) is an accepted treatment for neuropathic pain. Recent studies have focused on its potential for relieving headache pain. Objectives: To investigate the effectiveness of PNS in reducing occipital headache pain. Design: A prospective, 12-week pilot study involving 11 patients evaluated before and after implantation of PNS systems to treat C2-mediated occipital headaches. Methods: Prior to and at 4 and 12 weeks after implantation, patients completed the Short-Form McGill Pain Questionnaire (SF-MPQ), Visual Analog Scale (VAS), and Present Pain Index (PPI). Patients also answered questionnaires and kept diaries to record stimulator use, medication consumption, and numbers of headaches. Results: A comparison of pre- and post-implantation evaluations showed statistically significant declines in scores on the SF-MPQ (64%; p = 0.0013), VAS (67%; p < 0.0001), and PPI (68%; p = 0.0009). Most patients (91% and 64% respectively) reported reductions in medication use and numbers of headaches. Patients also reported a reduction in headache symptoms and the impact of headaches on activities. Two adverse events were encountered, one due to a loose connection and, the other caused by lead migration. Conclusions: PNS reduced headache pain, headache frequency and medication use. Key words: peripheral nerve stimulation, PNS, peripheral nerve, occipital headache, headache pain

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Responses of EEG, cerebral oxygen consumption and blood flow to peripheral nerve stimulation during thiopentone anaesthesia in the dog

Canadian Anaesthetists Society journal / Journal de la Société canadienne des anesthésistes ◽

10.1007/bf03010798 ◽

1985 ◽

Vol 32 (5) ◽

pp. 491-498 ◽

Cited By ~ 12

Author(s):

Yoshitoyo Miyauchi ◽

Takefumi Sakabe ◽

Tsuyoshi Maekawa ◽

Toshizoh Ishikawa ◽

Hiroshi Takeshita

Keyword(s):

Blood Flow ◽

Oxygen Consumption ◽

Peripheral Nerve ◽

Nerve Stimulation ◽

Peripheral Nerve Stimulation ◽

Cerebral Oxygen ◽

Cerebral Oxygen Consumption

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Effects of Peripheral Nerve Stimulation on the Blood Flow of the Spinal Cord and the Nerve Root

Spine ◽

10.1097/00007632-198811000-00013 ◽

1988 ◽

Vol 13 (11) ◽

pp. 1278-1283 ◽

Cited By ~ 23

Author(s):

KEISUKE TAKAHASHI ◽

SUSUMU NOMURA ◽

KATSURO TOMITA ◽

TADAMI MATSUMOTO

Keyword(s):

Spinal Cord ◽

Blood Flow ◽

Peripheral Nerve ◽

Nerve Stimulation ◽

Nerve Root ◽

Peripheral Nerve Stimulation

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Abstract 13292: A Novel Reproducible Noninvasive Imaging Approach to Quantify Nitric Oxide-mediated Coronary Endothelial Function in Humans

Circulation ◽

10.1161/circ.130.suppl_2.13292 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Micaela Iantorno ◽

Allison G Hays ◽

Sahar Soleimanifard ◽

Angela Steinberg ◽

Michael Schar ◽

...

Keyword(s):

Nitric Oxide ◽

Blood Flow ◽

Endothelial Function ◽

Coronary Blood Flow ◽

Repeated Measures ◽

Healthy Subjects ◽

Cine Mri ◽

Isometric Handgrip ◽

Coronary Endothelial Function ◽

The Impact

Endothelial release of nitric oxide (NO) is a defining characteristic of non-diseased vascular tissue. Healthy coronary arteries respond to endothelial-dependent stressors with vasodilatation but those with endothelial dysfunction respond with paradoxical vasoconstriction. The combination of new non-invasive 3T coronary MRI methods and isometric handgrip exercise (IHE), has been suggested as a means to noninvasively quantify coronary endothelial function (CEF). However, IHE may trigger neural, neuro-hormonal and other vasoreactive responses; thus, it is unknown whether the IHE-induced coronary response is, in fact, primarily mediated by NO. Furthermore, it is not known whether the MRI-IHE test is reproducible over time.To test the hypothesis that the IHE-induced coronary response is NO-mediated, we performed MRI-IHE studies before and during the infusion of monomethyl-L-arginine (L-NMMA, 0.3mg/kg/min), a NO synthase inhibitor in 8 healthy subjects. To study reproducibility we performed 2 MRI-IHE studies ~8 weeks apart in 8 coronary artery disease (CAD) patients and 9 healthy subjects. Changes from rest to IHE in coronary cross-sectional area (%CSA) and coronary blood flow (%CBF) were measured with cine MRI. L-NMMA completely blocked coronary vasodilation during IHE (%CSA change 15.4%±2.8% with placebo vs -1.6%±1.3% with L-NMMA; p<0.0001) and the normal increase in coronary blood flow (%CBF change 50.2%±6.7% with placebo vs -2.1%±6.7% with L-NMMA; p< 0.0001). Moreover, there was a strong correlation between repeated measures for %CSA change with IHE at the two exams (R=0.91, p<0.0001) and %CBF change with IHE (R=0.80; p<0.001). Bland-Altman analysis and intra-class correlation coefficients for %CSA and %CBF change with IHE (0.90 and 0.80, respectively) indicated good agreement and little variability between repeated measures. In summary the coronary response to IHE is largely mediated by endothelial-derived NO and is reproducible over several weeks. Thus MRI-IHE is a noninvasive, reproducible tool to assess CEF, arguably the first to noninvasively measure macro- and micro-vascular NO-mediated coronary responses. This noninvasive tool may be useful in future studies of the impact of interventions on CAD pathogenesis.

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