Research Reports - Is there a role for vagus nerve stimulation therapy as a treatment of traumatic brain injury?
Br J Neurosurg. 2012 Jun;26(3):316-20
Kumaria A, Tolias CM.
Abstract This paper aims to review the current literature on vagus nerve
stimulation (VNS) use in animal models of traumatic brain injury (TBI) and
explore its potential role in treatment of human TBI. A MEDLINE search yielded
four primary papers from the same group that demonstrated VNS mediated
improvement following fluid percussion models of TBI in rats, seen as motor and
cognitive improvements, reduction of cortical oedema and neuroprotective effects.
The underlying mechanisms are elusive and authors attribute these to attenuation
of post traumatic seizures, a noradrenergic mechanism and as yet undetermined
mechanisms. Reviewing and elaborating on these ideas, we speculate other
potential mechanisms including attenuation of peri-infarct depolarisations,
attenuation of glutamate mediated excitotoxicity, stabilisation of intracranial
pressure, enhancement of synaptic plasticity, upregulation of endogenous
neurogenesis and anti-inflammatory effects may have a role. Although this data
unequivocally shows that VNS improves outcome from TBI in animal models, it
remains to be determined if these findings translate clinically. Further studies