Acute effects of vagus nerve stimulation parameters on gastric motility assessed with magnetic resonance imaging

(Lu, Cao, Phillips, Powley, Liu, 2020. Neurogastroenterology and Motility, e13853)

Vagus nerve stimulation (VNS) is an emerging bioelectronic therapy for regulating food intake and controlling gastric motility. However, the effects of different VNS parameters and polarity on post-prandial gastric motility remain incompletely characterized. We have found that monophasic VNS biased towards the afferent pathway is potentially more effective for facilitating occlusive contractions than that biased towards the efferent pathway.

Gastric stimulation drives fast BOLD responses

(Cao, Lu, Oleson, Phillips, Jaffey, Hendren, Powley, Liu. NeuroImage, 197: 200-211, 2019)

Figure of Gastric stimulation drives fast BOLD responses

Functional magnetic resonance imaging (fMRI) is commonly thought to be too slow to capture any neural dynamics faster than 0.1 Hz. However, recent findings demonstrate the feasibility of detecting fMRI activity at higher frequencies beyond 0.2 Hz, whereas the origin, reliability, and generalizability of fast fMRI responses are under debate and remain to be confirmed through animal experiments with fMRI and invasive electrophysiology. Here, we acquired single-echo and multi-echo fMRI, as well as local field potentials, from anesthetized rat brains given gastric electrical stimulation modulated at 0.2, 0.4 and 0.8 Hz. Such gastric stimuli could drive widespread fMRI responses at corresponding frequencies from the somatosensory and cingulate cortices. Such fast fMRI responses were linearly dependent on echo times and thus indicative of blood oxygenation level dependent nature (BOLD). Local field potentials recorded during the same gastric stimuli revealed transient and phase-locked broadband neural responses, preceding the fMRI responses by as short as 0.5 sec. Taken together, these results suggest that gastric stimulation can drive widespread and rapid fMRI responses of BOLD and neural origin, lending support to the feasibility of using fMRI to detect rapid changes in neural activity up to 0.8 Hz.

Adaptive and wireless recordings of electrophysiological signals during concurrent MRI

(Mandal, Babaria, Cao, Liu. IEEE Trans. Biomed. Engr., 2018)

GIF of Typical MRI image formation

  Strong electromagnetic fields during functional magnetic resonance imaging (fMRI) presents a challenging environment for any concurrent electrophysiological recording. Here, we present a miniaturized, wireless platform – “MR-Link” (Multimodal Recording Link) that provides a hardware solution for simultaneous electrophysiological and fMRI signal acquisition. The device detects changes in the electromagnetic field during fMRI and synchronizes amplification and sampling of electrophysiological signals to minimize effects of gradient and RF artifacts. It wirelessly transmits the recorded data at a frequency detectable by the MR-receiver coil. The transmitted data is readily separable from MRI in the frequency domain. To demonstrate its efficacy, we used this device to record electrocardiograms and somatosensory evoked potential without artifacts from concurrent fMRI scans, or compromising imaging quality. The compact recording device (20 mm dia., 2gms) placed within the MR-bore minimized movement artifacts and achieved microsecond-level synchronization with fMRI data. MR-Link offers an inexpensive system to eliminate the need for amplifiers with high dynamic range or sampling rate, high-power sampling, additional storage or synchronization hardware to connect with the MR-scanner. This device is expected to enable easier and a broader range of applications of simultaneous fMRI and electrophysiology in animals and humans.  

Vagus nerve stimulation promotes gastric emptying

(Lu, Cao, Oleson, Phillips, Ward,  Powley, Liu. Neurogastroenterology and Motility, 2018)

Picture of Vagus nerve stimulation promotes gastric emptying

Background: Vagus nerve stimulation (VNS) is an emerging electroceutical therapy for remedying gastric disorders that are poorly managed by pharmacological treatments and/or dietary changes. Such therapy seems promising since the vagovagal neurocircuitry controlling the enteric nervous system strongly influences gastric functions. Methods: Here, the modulatory effects of left cervical VNS on gastric emptying in rats was quantified using a 1) feeding protocol in which the animal voluntarily consumed a post-fast, gadolinium-labeled meal and 2) newly developed, robust, sensitive and non-invasive imaging strategy to measure antral motility, pyloric activity and gastric emptying based on contrast-enhanced magnetic resonance imaging (MRI) and computer-assisted image processing pipelines. Key Results: VNS significantly accelerated gastric emptying (control vs. VNS: 24.9±3.5% vs. 40.7±3.9% of meal emptied per 4hrs, p<0.05). This effect resulted from a greater relaxation of the pyloric sphincter (control vs. VNS: 1.4±0.2 vs. 2.5±0.5 mm2 cross-sectional area of lumen, p<0.05), without notable changes in antral contraction amplitude (control vs. VNS: 30.6±3.0% vs. 32.5±3.0% occlusion), peristaltic velocity (control vs. VNS: 0.67±0.03 vs. 0.67±0.03 mm/s), or frequency (control vs. VNS: 6.3±0.1 vs. 6.4±0.2 cpm). The degree to which VNS relaxed the pylorus positively correlated with gastric emptying rate (r = 0.5465, p<0.01). Conclusions & Inferences: The MRI protocol employed in this study is expected to enable advanced preclinical studies to understand stomach pathophysiology and its therapeutics. Results from this study suggest an electroceutical treatment approach for gastric emptying disorders using cervical VNS to control the degree of pyloric sphincter relaxation.  

Vagal nerve stimulation triggers widespread responses and alters large-scale functional connectivity in the rat brain

(Cao, Lu, Powley, Liu. 2017. PLoS ONE, 12(2): e0189518)

Pictures and graphs of Vagal nerve stimulation triggers widespread responses and alters large-scale functional connectivity in the rat brain

Vagus nerve stimulation (VNS) is a therapy for epilepsy and depression. However, its efficacy varies and its mechanism remains unclear. Prior studies have used functional magnetic resonance imaging (fMRI) to map brain activations with VNS in human brains, but have reported inconsistent findings. The source of inconsistency is likely attributable to the complex temporal characteristics of VNS-evoked fMRI responses that cannot be fully explained by simplified response models in the conventional model-based analysis for activation mapping. To address this issue, we acquired 7-Tesla blood oxygenation level dependent fMRI data from anesthetized Sprague-Dawley rats receiving electrical stimulation at the left cervical vagus nerve. Using spatially independent component analysis, we identified 20 functional brain networks and detected the network-wise activations with VNS in a data-driven manner. Our results showed that VNS activated 15 out of 20 brain networks, and the activated regions covered >76% of the brain volume. The time course of the evoked response was complex and distinct across regions and networks. In addition, VNS altered the strengths and patterns of correlations among brain networks relative to those in the resting state. The most notable changes in network-network interactions were related to the limbic system. Together, such profound and widespread effects of VNS may underlie its unique potential for a wide range of therapeutics to relieve central or peripheral conditions.  

Contrast enhanced MRI of gastric emptying and motility in rats

(Lu, Cao, Oleson, Powley, Liu. 2017. IEEE Trans. Biomed. Engr. 64(11): 2546-2554)

Pictures of Contrast enhanced MRI of gastric emptying and motility in rats

The assessment of gastric emptying and motility in humans and animals typically requires radioactive imaging or invasive measurements. Here, we developed a robust strategy to image and characterize gastric emptying and motility in rats based on contrast-enhanced magnetic resonance imaging (MRI) and computer-assisted image processing. The animals were trained to naturally consume a gadolinium-labeled dietgel while bypassing any need for oral gavage. Following this test meal, the animals were scanned under low-dose anesthesia for high-resolution T1-weighted MRI in 7-Tesla, visualizing the time-varying distribution of the meal with greatly enhanced contrast against non-GI tissues. Such contrast-enhanced images not only depicted the gastric anatomy, but also captured and quantified stomach emptying, intestinal filling, antral contraction, and intestinal absorption with fully-automated image processing. Over four post-ingestion hours, the stomach emptied by 27%, largely attributed to the emptying of the forestomach rather than the corpus and the antrum, and most notable during the first 30 minutes. Stomach emptying was accompanied by intestinal filling for the first 2 hours, while afterwards intestinal absorption was observable as cumulative contrast enhancement in the renal medulla. The antral contraction was captured as a peristaltic wave propagating from the proximal to distal antrum. The frequency, velocity, and amplitude of the antral contraction were on average 6.340.07 contractions per minute, 0.670.01 mm/s and 30.581.03%, respectively. These results demonstrate an optimized MRI-based strategy to assess gastric emptying and motility in healthy rats, paving the way for using this technique to understand GI diseases, or test new therapeutics in rat models.  

Neural and physiological responses to vagus nerve stimulation in rats

(Cao, Lu, Ward, Powley, Liu. 2017. ISMRM. Magna Cum Laude Award)

Pictures of Neural responses to VNS

Here, we report a part of intrinsic central autonomic network in the rat brain that was modulated by the left cervical vagus nerve. VNS impacts the BOLD response in the brain in two different ways: 1) It directly triggers specific and neuronal activations at the central autonomic network and 2) it modulates cardiac and respiratory rates and in turn alters the global BOLD signal as a non-neuronal physiological effect. We demonstrate that the neuronal and non-neuronal effects are separable, offering a unique way to image and characterize the brain-activation profile of VNS applied to different locations and with variable parameters  

Mapping systemic inflammation with manganese-enhanced MRI

(Lu, Cao, Marussich, Hu, Liu. 2017. ISMRM, Magna Cum Laude Award)

Systemmic Inflamation graphs

We used in vivo manganese-enhanced MRI (MEMRI) to image and assess the increase in calcium influx into immune cells so as to report the cellular responses to systemically LPS-induced inflammation throughout the abdomen. We found that: (1) The contrast enhancement was dose- and time-dependent with variation across organs. (2) An increase in Mn2+ uptake was observed in the liver and the kidney, but not in the spleen or the muscle given inflammation. (3) The inflammation-induced enhancement was dependent on the time after the initial exposure to LPS.