Personalization and Optimization of Auricular Vagus Nerve Stimulation

Yıl 2021, Cilt: 1 Sayı: 3, 6 - 10, 26.12.2021

Ali Veysel Özden , Onur Yusuf Çınar Tolga Çorbacı Duru Berfin Su Kıvanç Uzer Hasan Kerem Alptekin

Öz

Vagus nerve stimulation (VSU) is a treatment approved by the US Food and Drug Administration, which has been used for the treatment of diseases such as epilepsy and depression for nearly 20 years. It is known that the vagus nerve plays a role in maintaining homeostasis, controlling stress and regulating the immune system. VSU can be done electrically invasively from the neck, non-invasively from the neck or ear. Due to the variable character of autonomic nervous system activity, the application of personalized current parameters appears to be more important in VSU compared to other neuromodulation methods. In order to increase the effectiveness of the treatment and reduce the possible side effects, the stimulation parameters (frequency, duration, pulse width, etc.) can be shaped by online closed-loop stimulation according to the data collected from the person. Measurements such as electroencephalography, functional magnetic resonance imaging, heart rate variability, pulse, blood pressure, evoked potential can be continuously collected from the individual to create personalized stimulation parameters. Thanks to the monitoring of the effects on the individual as a result of stimulation, the stimulation parameters can be determined more clearly. It can be stated that a closed-loop VSU method, in which optimal stimulation parameters are determined with artificial intelligence, will be more effective and safe. By VagustimⓇ company, which develops IoT and machine learning-based medical technological devices in the field of auricular VSU; A device that can stimulate both ears at the same time and perform optimal and personalized stimulation as stated above has been produced. The device, which can be controlled with the mobile application interface, will also allow the user to be followed remotely, as in telemedicine applications.

Anahtar Kelimeler

Vagus nerve stimulation, artificial intelligence, autonomic nervous system, machine learning, personalized medicine

Auriküler Vagus Sinir Uyarımının Kişiselleştirilmesi ve Optimizasyonu

Öz

Vagus sinir uyarımı (VSU), yaklaşık 20 yıldır epilepsi ve depresyon gibi hastalıkların tedavisinde kullanılan ve Amerikan Gıda ve İlaç Dairesi tarafından onaylanmış bir tedavidir. Vagus sinirinin homeostazın sağlanmasında, stresin kontrolünde ve bağışıklık sisteminin düzenlenmesinde rol oynadığı bilinmektedir. VSU elektriksel olarak invazif şekilde boyundan, non-invazif şekilde yine boyundan veya kulaktan yapılabilmektedir. Otonom sinir sistemi aktivitesinin değişken karakterinden dolayı, kişiselleştirilmiş akım parametrelerinin uygulanmasının diğer nöromodülasyon yöntemlerine kıyasla VSU'da daha önemli olduğu görülmektedir. Tedavinin etkinliğini arttırmak ve olası yan etkileri azaltmak amacıyla stimülasyon parametreleri (frekans, süre, atım genişliği vb.) kişiden toplanan verilere göre çevrimiçi olarak kapalı döngü uyarım ile şekillendirilebilir. Kişiye özel stimülasyon parametreleri oluşturmak için bireyden elektroensefalografi, fonksiyonel manyetik rezonans görüntüleme, kalp hızı değişkenliği, nabız, kan basıncı, uyarılmış potansiyel gibi ölçümler sürekli olarak toplanabilir. Uyarım sonucunda bireyde oluşan etkilerin takip edilmesi sayesinde uyarım parametreleri daha net belirlenebilir. Yapay zeka ile optimal stimülasyon parametrelerinin belirlendiği kapalı döngüsel bir VSU yönteminin daha etkili ve güvenli olacağı belirtilebilir. Auriküler VSU alanında loT ve makine öğrenmesi tabanlı medikal teknolojik cihazlar geliştiren VagustimⓇ firması tarafından; her iki kulaktan aynı anda uyarım yapabilen, yukarıda belirtildiği şekilde optimal ve kişiselleştirilmiş stimülasyonu gerçekleştirebilecek bir cihaz üretilmiştir. Mobil uygulama arayüzü ile kontrol edilebilecek olan cihaz, teletıp uygulamalarında olduğu gibi kullanıcının uzaktan takip edilmesine de olanak sağlayacaktır.

Anahtar Kelimeler

Vagus sinir uyarımı, yapay zeka, otonom sinir sistemi, makine öğrenmesi, kişiselleştirilmiş tıp

Kaynakça

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