AUTHOR=Kaniusas Eugenijus , Kampusch Stefan , Tittgemeyer Marc , Panetsos Fivos , Gines Raquel Fernandez , Papa Michele , Kiss Attila , Podesser Bruno , Cassara Antonino Mario , Tanghe Emmeric , Samoudi Amine Mohammed , Tarnaud Thomas , Joseph Wout , Marozas Vaidotas , Lukosevicius Arunas , Ištuk Niko , Lechner Sarah , Klonowski Wlodzimierz , Varoneckas Giedrius , Széles Jozsef Constantin , Šarolić Antonio TITLE=Current Directions in the Auricular Vagus Nerve Stimulation II – An Engineering Perspective JOURNAL=Frontiers in Neuroscience VOLUME=13 YEAR=2019 URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2019.00772 DOI=10.3389/fnins.2019.00772 ISSN=1662-453X ABSTRACT=

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 modeling 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.