Human Vagus Nerve Branching in the Cervical Region
نویسندگان
چکیده
BACKGROUND Vagus nerve stimulation is increasingly applied to treat epilepsy, psychiatric conditions and potentially chronic heart failure. After implanting vagus nerve electrodes to the cervical vagus nerve, side effects such as voice alterations and dyspnea or missing therapeutic effects are observed at different frequencies. Cervical vagus nerve branching might partly be responsible for these effects. However, vagus nerve branching has not yet been described in the context of vagus nerve stimulation. MATERIALS AND METHODS Branching of the cervical vagus nerve was investigated macroscopically in 35 body donors (66 cervical sides) in the carotid sheath. After X-ray imaging for determining the vertebral levels of cervical vagus nerve branching, samples were removed to confirm histologically the nerve and to calculate cervical vagus nerve diameters and cross-sections. RESULTS Cervical vagus nerve branching was observed in 29% of all cases (26% unilaterally, 3% bilaterally) and proven histologically in all cases. Right-sided branching (22%) was more common than left-sided branching (12%) and occurred on the level of the fourth and fifth vertebra on the left and on the level of the second to fifth vertebra on the right side. Vagus nerves without branching were significantly larger than vagus nerves with branches, concerning their diameters (4.79 mm vs. 3.78 mm) and cross-sections (7.24 mm2 vs. 5.28 mm2). DISCUSSION Cervical vagus nerve branching is considerably more frequent than described previously. The side-dependent differences of vagus nerve branching may be linked to the asymmetric effects of the vagus nerve. Cervical vagus nerve branching should be taken into account when identifying main trunk of the vagus nerve for implanting electrodes to minimize potential side effects or lacking therapeutic benefits of vagus nerve stimulation.
منابع مشابه
Protective effects of an interaction between vagus nerve and melatonin on gastric ischemia/reperfusion: the role of oxidative stress
Objectives:Vagal pathways in gastrointestinal tract are the most important pathways that regulate ischemia/reperfusion (I/R). Gastrointestinal tract is one of the important sources of melatonin production. The aim of this study was to investigate probable protective effect of the interaction between vagus nerve and melatonin after I/R. Materials and methods:This study was performed in male rat...
متن کاملVagus nerve stimulation in the treatment of nervous system disease: a review article
The vagus nerve (VN), the longest cranial nerve and an essential part of the parasympathetic system, connects the central nervous system to respiratory, cardiovascular, immune, gastrointestinal, and endocrine systems and is involved in the maintenance of homeostasis by controlling these systems. Vagus nerve stimulation (VNS) is related to any method that would stimulate the vagal nerve via elec...
متن کاملEvaluation of the effect of dendritic branching on signal processing in hippocampus pyramidal cells
Since branching region of an active nerve fiber is an abrupt widening of the structure, two concepts emerge: first, the stimulating current must be sufficient to raise the outgrowing fibers above the thresh¬old, and secondly, the stimulating current will be divided in proportion to the characteristic admittance of the branches. On the other hand, blocking of the nerve impulse in this region is ...
متن کاملEvaluation of the effect of dendritic branching on signal processing in hippocampus pyramidal cells
Since branching region of an active nerve fiber is an abrupt widening of the structure, two concepts emerge: first, the stimulating current must be sufficient to raise the outgrowing fibers above the thresh¬old, and secondly, the stimulating current will be divided in proportion to the characteristic admittance of the branches. On the other hand, blocking of the nerve impulse in this region is ...
متن کاملMorphological relationship between the superior cervical ganglion and cervical nerves in Japanese cadaver donors
INTRODUCTION There are various communications between the superior cervical ganglion (SCG) and the vagus and glossopharyngeal nerves. However, little information exists concerning the origin of these sympathetic ganglion branches at the superior, middle, and inferior regions of the human SCG. The aim of this study was to describe the human SCG in a morphometric manner with the communication wit...
متن کامل