实时神经记录和刺激系统及其在血压调节中的潜在应用。

Frontiers in Medical Technology Pub Date : 2022-08-10 eCollection Date: 2022-01-01 DOI:10.3389/fmedt.2022.941686
Anruo Shen, Runhuan Li, Yiran Li, Jinyao Guo, Jiguang Wang, Xiaohong Sui
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摘要

高血压是最普遍的慢性疾病之一,影响着全世界20%以上的成年人,但幸运的是,大多数人的血压可以通过药物治疗得到有效控制。然而,临床上仍有5-30%的患者对常规药物治疗效果不佳,而现有的非药物治疗存在神经损伤不可逆、副作用大、甚至无效等重大缺陷。本研究基于血压的生理调节机制和最先进的神经调节技术,结合迷走神经刺激方案,开发并探索神经实时记录和刺激系统是否以及如何提供血压的自适应调节,以期在顽固性高血压的闭环治疗中开辟一条新途径。与传统的神经调节设备不同,在同一设备上添加了额外的信号记录和实时无线传输功能,以实现动态监测和调制器的功能。该系统在体外和体内进行了测试,显示出良好的8 kHz采样率和灵活的刺激输出,足以满足我们操纵感兴趣的神经活动的需要。观察到刺激导致的血压相对稳定下降,迷走神经信号中与血压有关的特定模式也可以初步确定。这为最终实现抗高血压治疗闭环自动调节的进一步研究奠定了坚实的基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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A system of real-time neural recording and stimulation and its potential application in blood pressure modulation.

Hypertension is one of the most prevalent chronic diseases that affects more than 20% of the adult population worldwide, but fortunately, most of their blood pressure can be effectively controlled via drug treatment. However, there still remains 5-30% of patients clinically who do not respond well to conventional medication, while the non-drug treatments currently existing are struggling with major drawbacks like irreversible nerve damage, huge side effects, and even non-effectiveness. In this study, based on the physiological regulation mechanism of blood pressure and state-of-the-art neuromodulation technique, we worked along with the vagus nerve stimulation scheme, developed, and explored whether and how a real-time neural recording and stimulation system could provide an insight into self-adaptive modulation in the blood pressure, in the hope to crack a crevice in the closed-loop treatment for resistant hypertension. Unlike traditional neuromodulation devices, additional signal recording and real-time wireless transmission functions are added to the same device to realize the features of a dynamic monitor and modulator. The system is tested both in vitro and in vivo, showing decent electrical performance of 8 kHz sampling rate and flexible stimulation outputs which sufficiently covers our needs in manipulating neural activities of interest. A relatively stable drop in the blood pressure resulting from stimulation was observed and specific patterns in the vagus nerve signals relating to blood pressure could also be primarily identified. This laid a solid foundation for further studies on the final realization of closed-loop automatic adjustment for resistive hypertension treatment.

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