Bioelectronic therapies modulating the vagus nerve are promising for cardiovascular, inflammatory, and mental disorders. Clinical applications are however limited by side-effects such as breathing obstruction and headache caused by non-specific stimulation. To design selective and functional stimulation, we engineered VaStim, a realistic and efficient in-silico model. We developed a protocol to personalize VaStim in-vivo using simple muscle responses, successfully reproducing experimental observations, by combining models with trials conducted on five pigs. Through optimized algorithms, VaStim simulated the complete fiber population in minutes, including often omitted unmyelinated fibers which constitute 80% of the nerve. The model suggested that all Aα-fibers across the nerve affect laryngeal muscle, while heart rate changes were caused by B-efferents in specific fascicles. It predicted that tripolar paradigms could reduce laryngeal activity by 70% compared to typically used protocols. VaStim may serve as a model for developing neuromodulation therapies by maximizing efficacy and specificity, reducing animal experimentation.

调节迷走神经的生物电子疗法有望治疗心血管、炎症和精神疾病。然而，临床应用受到非特异性刺激引起的呼吸阻塞和头痛等副作用的限制。为了设计选择性和功能性刺激，我们设计了 VaStim，这是一种逼真且高效的计算机模型。我们开发了一种协议，使用简单的肌肉反应在体内个性化 VaStim，通过将模型与对五头猪进行的试验相结合，成功地再现了实验观察结果。通过优化的算法，VaStim 在几分钟内模拟了完整的纤维群，包括经常被忽略的无髓鞘纤维，它们构成了神经的 80%。该模型表明，穿过神经的所有 Aα 纤维都会影响喉部肌肉，而心率变化是由特定束中的 B 传出引起的。据预测，与通常使用的方案相比，三极范例可以将喉部活动减少 70%。 VaStim 可以作为开发神经调节疗法的模型，最大限度地提高功效和特异性，减少动物实验。