Background and aim: Not enough is known about the effects of vagal nerve stimulation
(VNS) on the many functions of the central autonomic nervous system. Our aim was to
quantify the changes in central parasympathetic activity during VNS. Methods: Heart
rate (HR), mean arterial pressure (MAP), cardiac vagal tone (CVT) and cardiac sensitivity
to baroreflex (CSB) were monitored continuously in seven patients who had vagal nerve
stimulators implanted for treatment of epilepsy. Results: Vagal nerve stimulation
increased CSB from the onset of the stimulus while HR, MAP and CVT increased gradually
during the stimulation period. Conclusion: All aspects of brainstem activity studied
were affected by VNS. Cardiac parasympathetic activity was most affected among the
cardiovascular parameters we measured. Increased central parasympathetic tone may
play a major role in the therapeutic mechanism of VNS and this can now be monitored
non-invasively in real-time. Our results suggest that post-stimulus brainstem plasticity
during VNS may have key therapeutic role.
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© 2015 Published by Elsevier Inc.
