Vagal nerve stimulation improves cerebellar tremor and dysphagia in multiple sclerosis

Abstract

Vagus nerve stimulation (VNS), an adjunctive approach for the treatment of epilepsy, was performed in three multiple sclerosis (MS) patients displaying postural cerebellar tremor (PCT) and dysphagia. Following VNS, improvement of PCT and dysphagia was manifested over a period of two and three months, respectively. In view of the involvement of the main brainstem visceral component of the vagus, the nucleus tractus solitarius (NTS), in modulating central pattern generators (CPGs) linked to both olive complex pathway and swallowing, improvement is likely to be VNS related. The results obtained suggest an additional therapeutic application for VNS and may represent a novel form of treatment in patients with severe MS. Multiple Sclerosis 2007; 13: 1200—1202. http://msj.sagepub.com

Keywords

Central Pattern Generators (CPGs)dysphagia multiple sclerosis postural cerebellar tremor vagus nerve stimulation (VNS)

Get full access to this article

View all access options for this article.

References

Grillner S. , Markram H. , De Schutter E. , Silberberg G. , LeBeau FE Microcircuits in action—from CPGs to neocortex. Trends Neurosci 2005; 28: 525—33.

Arshavsky YI , Deliagina TG , Orlovsky GN Pattern generation. Curr Opin Neurobiol 1997; 7: 781—89.

DeLong MR Possible involvement of central pacemakers in clinical disorders of movement . Fed Proc 1978; 37: 2171—75.

Ertekin C. , Aydogdu I. Neurophysiology of swallowing. Clin Neurophysiol 2003; 114: 2226—44.

Krahl SE , Martin FC , Handforth A. Vagus nerve stimulation inhibits harmaline-induced tremor. Brain Res 2004; 1011: 135—38.

Marrosu F. , Maleci A. , Cocco E. , Puligheddu M. , Marrosu MG Vagal nerve stimulation effects on cerebellar tremor in multiple sclerosis . Neurology 2005; 65: 490.

Klockgether T. , Ludtke R. , Kramer B. , Abele M. , Burk K. , Schols L. et al. The natural history of degenerative ataxia: a retrospective study in 466 patients. Brain 1998; 121: 589—600.

Nathadwarawala KM , Nicklin J. , Wiles CM A timed test of swallowing capacity for neurological patients. J Neurol Neurosurg Psychiatry 1992 ; 55: 822—25.

Marrosu F. , Serra A. , Maleci A. , Puligheddu M. , Biggio G. , Piga M. Correlation between GABA(A) receptor density and vagus nerve stimulation in individuals with drug-resistant partial epilepsy. Epilepsy Res 2003; 55: 59—70.

10.

Kobelt G. , Berg J. , Lindgren P. , Fredrikson S. , Jonsson B. Costs and quality of life in multiple sclerosis in Europe. J Neurol Neurosurg Psychiatry 2006; 77: 918—26.