Abstract

BackgroundInvestigations into the benefits of vagus nerve stimulation (VNS) through pre-clinical and clinical research have led to promising findings for treating several disorders. Despite proven effectiveness of VNS on conditions such as epilepsy and depression, understanding of off-target effects and contributing factors such as sex differences can be beneficial to optimize therapy design.New MethodsIn this article, we assessed longitudinal effects of VNS on cardiovascular and immune systems, and studied potential sex differences using a rat model of long-term VNS. Rats were implanted with cuff electrodes around the left cervical vagus nerve for VNS, and wireless physiological monitoring devices for continuous monitoring of cardiovascular system using electrocardiogram (ECG) signals. ECG morphology and heart rate variability (HRV) features were extracted to assess cardiovascular changes resulting from VNS in short-term and long-term timescales. We also assessed VNS effects on expression of inflammatory cytokines in blood during the course of the experiment. Statistical analysis was performed to compare results between Treatment and Sham groups, and between male and female animals from Treatment and Sham groups.ResultsConsiderable differences between male and female rats in cardiovascular effects of VNS were observed in multiple cardiovascular features. However, the effects seemed to be transient with approximately 1-h recovery after VNS. While short-term cardiovascular effects were mainly observed in male rats, females in general showed more significant long-term effects even after VNS stopped. We did not observe notable changes or sex differences in systemic cytokine levels resulting from VNS.Comparison With Existing MethodsCompared to existing methods, our study design incorporated wireless physiological monitoring and systemic blood cytokine level analysis, along with long-term VNS experiments in unanesthetized rats to study sex differences.ConclusionThe contribution of sex differences for long-term VNS off-target effects on cardiovascular and immune systems was assessed using awake behaving rats. Although VNS did not change the concentration of inflammatory biomarkers in systemic circulation for male and female rats, we observed significant differences in cardiovascular effects of VNS characterized using ECG morphology and HRV analyses.

Highlights

  • The vagus nerve innervates multiple organs and plays a critical role in a number hemostatic and health-promoting physiologic pathways (Groves and Brown, 2005)

  • ECG signals recorded from 16 rats (n = 8 in Treatment and n = 8 in Sham group) were analyzed for total duration of the experiment to characterize cardiovascular effects of vagus nerve stimulation (VNS) and potential sex differences

  • To overcome technical challenges related to the implementation of long-term VNS experiments in awake behaving rodents, we developed a robust animal model using rats (Yaghouby et al, 2019)

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Summary

Introduction

The vagus nerve innervates multiple organs and plays a critical role in a number hemostatic and health-promoting physiologic pathways (Groves and Brown, 2005). The immunomodulatory function of the vagus nerve through the cholinergic antiinflammatory pathway (CAP) has been first demonstrated in VNS studies using animal models (Pavlov and Tracey, 2005). Through this pathway, afferent and efferent nerve fibers can activate or inhibit the release of pro-inflammatory cytokines, respectively (Pavlov and Tracey, 2005). VNS has been shown to regulate pro-inflammatory cytokine release by activating the descending cholinergic efferent pathway to potentially treat inflammatory diseases (Tracey, 2002; Hoover, 2017). Despite proven effectiveness of VNS on conditions such as epilepsy and depression, understanding of off-target effects and contributing factors such as sex differences can be beneficial to optimize therapy design

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