Current Directions in the Auricular Vagus Nerve Stimulation II - an engineering perspective
- 1Institute of Electrodynamics, Microwave and Circuit Engineering, Vienna University of Technology, Austria
- 2Max-Planck-Institute for Metabolism Research, Germany
- 3Faculty of Optics and Optometry, Complutense University of Madrid, Spain
- 4Department of Mental Health, Physical and Preventive Medicine, University of Campania Luigi Vanvitelli, Italy
- 5Ludwig Boltzmann Cluster for Cardiovascular Research, Austria
- 6Foundation for Research on Information Technologies in Society, ETH Zurich, Switzerland
- 7Department of Information Technology, Faculty of Engineering and Architecture, Ghent University, Belgium
- 8Biomedical Engineering Institute, Kaunas University of Technology, Lithuania
- 9Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Croatia
- 10Independent researcher, Austria
- 11Institute of Biocybernetics and Biomedical Engineering (PAN), Poland
- 12Sleep Medicine Centre, Klaipeda University Hospital, Lithuania
- 13Institute of Neuroscience, Lithuanian University of Health Sciences, Lithuania
- 14Department of Surgery, Medical University of Vienna, Austria
Electrical stimulation of the auricular vagus nerve (aVNS) is an emerging electroceutical technology in the field of bioelectronic medicine with applications in therapy. Artificial modulation of the afferent vagus nerve - a powerful entrance to the brain - affects a large number of physiological processes implicating interactions between the brain and body. Engineering aspects of aVNS determine its efficiency in application. The relevant safety and regulatory issues need to be appropriately addressed. In particular, in-silico modelling acts as a tool for aVNS optimization. The evolution of personalized electroceuticals using novel architectures of the closed-loop aVNS paradigms with biofeedback can be expected to optimally meet therapy needs.
For the first time, two international workshops on aVNS have been held in Warsaw and Vienna in 2017 within the scope of EU COST Action “European network for innovative uses of EMFs in biomedical applications (BM1309)”. Both workshops focused critically on the driving physiological mechanisms of aVNS, its experimental and clinical studies in animals and humans, in-silico aVNS studies, technological advancements, and regulatory barriers. The results of the workshops are covered in two reviews, covering physiological and engineering aspects. The present review summarizes on engineering aspects - a discussion of physiological aspects is provided by our accompanying article (Kaniusas et al., 2019). Both reviews build a reasonable bridge from the rationale of aVNS as a therapeutic tool to current research lines, all of them being highly relevant for the promising aVNS technology to reach the patient.
Keywords: Vagus nerve (VN) stimulation, Auricular nerves, Auricular transillumination, Stimulation patterns, Stimulation optimization, in-silico modeling, Personalized Stimulation
Received: 08 Apr 2019;
Accepted: 09 Jul 2019.
Edited by:Reinhold Scherer, University of Essex, United Kingdom
Reviewed by:Vitaly Napadow, Harvard Medical School, United States
Ilknur Ay, Massachusetts General Hospital, Harvard Medical School, United States
Copyright: © 2019 Kaniusas, Kampusch, Tittgemeyer, Panetsos, Gines, Papa, Kiss, Podesser, Cassara, Tanghe, Samoudi, Tarnaud, Joseph, Marozas, Lukosevicius, Ištuk', Lechner, Klonowski, Varoneckas, Szeles and Šarolic. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Prof. Eugenijus Kaniusas, Vienna University of Technology, Institute of Electrodynamics, Microwave and Circuit Engineering, Vienna, Austria, email@example.com