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Effect of Electrical Vagus Nerve Stimulation on Cerebral Blood Flow and Neurological Outcome in Asphyxial Cardiac Arrest Model of Rats

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Abstract

Background

Vagus nerve stimulation (VNS) during post-resuscitation may increase recovery of cerebral blood flow (CBF) and reduce neurological injury.

Objective

This study was designed to investigate the effect of electrical VNS on neurological outcomes following cardiac arrest (CA).

Methods

Male Sprague–Dawley rats (n = 48) were subjected to the asphyxial CA model and blindly allocated to the VN isolation (CA + VN isolation) or VNS group (CA + VNS group). Cardiopulmonary resuscitation was initiated 450 s after pulseless electrical arrest, and the left cervical vagus nerve was electrically stimulated (0.05 mA, 1 Hz) for 3 h in the CA + VNS group. The neurological deficit score (NDS) and overall performance category (OPC) were assessed at 24 h after resuscitation, and histological injury of the hippocampus was evaluated. Independent experiments were performed to evaluate the effect of VNS on global cortical CBF after resuscitation using laser speckle Doppler imaging through a thinned skull window from pre-arrest to 6 h after resuscitation.

Results

The baseline characteristics were not significantly different between the two groups. The NDS was significantly higher, and the OPC was substantially lower in the CA + VNS group (p = 0.022 and p = 0.049, respectively) supported by decrease in histological injury of the hippocampal CA1 region. CBF in the early period of post-return of spontaneous circulation (ROSC) was significantly higher in the CA + VNS group (p < 0.05 at post-ROSC 2 h and 4 h), and 4-hydroxynonenal was significantly lower in the CA + VNS group (p = 0.026).

Conclusions

VNS improved cerebral perfusion and neurological outcomes at 24 h after ROSC in an asphyxial CA model of rats.

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Acknowledgements

We acknowledge the technical assistance of animal care provided by pre-clinical experimental center in SNUBH.

Funding

This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2017R1D1A1B03034360).

Author information

Author notes

  1. Byunghyun Kim and Inwon Park have equally contributed as the first author.

Authors and Affiliations

  1. Department of Emergency Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea

    Byunghyun Kim, Inwon Park, Jae Hyuk Lee, Seonghye Kim, Min Ji Lee & You Hwan Jo

Authors
  1. Byunghyun Kim
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  2. Inwon Park
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  3. Jae Hyuk Lee
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  4. Seonghye Kim
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  6. You Hwan Jo
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Contributions

JHL and YHJ designed the study and prepared the protocol. BK, IP, SK, MJL, and JHL performed experiments. All authors participated in interpretation of data. BK, IP, and JHL drafted and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jae Hyuk Lee.

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Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

The Institutional Animal Care and Use Committee of Seoul National University Bundang Hospital (protocol no. BA1705-223/042-01) approved this study.

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Kim, B., Park, I., Lee, J.H. et al. Effect of Electrical Vagus Nerve Stimulation on Cerebral Blood Flow and Neurological Outcome in Asphyxial Cardiac Arrest Model of Rats. Neurocrit Care 30, 572–580 (2019). https://doi.org/10.1007/s12028-018-0640-7

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  • DOI: https://doi.org/10.1007/s12028-018-0640-7

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