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Rosenthal A, Haslacher D, Garbusow M, Pangratz L, Apfel B, Soekadar S, Romanczuk-Seiferth N, Beck A. Neuromodulation and mindfulness as therapeutic treatment in detoxified patients with alcohol use disorder. BMC Psychiatry 2024; 24:635. [PMID: 39334026 PMCID: PMC11438385 DOI: 10.1186/s12888-024-06085-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) poses a significant global health challenge. Traditional management strategies often face high relapse rates, leading to a need for innovative approaches. Mindfulness-based relapse prevention (MBRP) has emerged as a promising intervention to enhance cognitive control, reduce cue-related craving and improve interoceptive processing. Neuroimaging studies suggest that mindfulness training can modulate brain networks associated with these factors, potentially improving treatment outcomes for AUD. Neuroimaging studies suggest that mindfulness training can modulate brain networks linked to these brain functions, potentially improving treatment outcomes for AUD. However, it is unclear how MBRP links to neurophysiological measures such as frontal midline theta oscillations (FMΘ) and whether the beneficial effects of MBRP can be increased by enhancing FMΘ. Here, we will use two different forms of neuromodulation to target and enhance these oscillations, and evaluate their impact on the effectiveness of MBRP. METHODS This study will employ a four-arm randomized controlled trial to evaluate the synergistic effects of MBRP augmented with transcutaneous vagus nerve stimulation (tVNS) or closed-loop amplitude-modulated transcranial alternating current stimulation (CLAM-tACS) on cognitive control, cue reactivity and interoceptive processing in AUD patients. Participants will undergo six weekly group MBRP sessions and daily individual mindfulness practices. Assessments will include an inhibition task, cue-induced craving task, and heartbeat discrimination task, alongside heart rate variability and 32-channel EEG recordings. Participants will be assessed pre and post treatment, with a three-month follow-up to evaluate long-term effects on abstinence and alcohol consumption. DISCUSSION This study will not only elucidate the causal link between FMΘ and efficacy of MBRP, but contribute to a better understanding of how combined psychological and neuromodulation interventions can improve treatment outcomes for AUD, potentially leading to more effective therapeutic strategies. This study also seeks to explore individual differences in response to treatment, which could inform future approaches to AUD management. TRIAL REGISTRATION This study received approval by the Charité-Universitätsmedizin Berlin Institutional Review Board (EA1/030/23, 10.11.2023). It was registered on ClinicalTrials.gov (NCT06308484).
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Affiliation(s)
- Annika Rosenthal
- Institute for Mental Health and Behavioral Medicine, Department of Psychology, HMU Health and Medical University Potsdam, 14471, Potsdam, Germany.
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany.
| | - D Haslacher
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - M Garbusow
- Department of Psychology, MSB Medical School Berlin, 14197, Berlin, Germany
| | - L Pangratz
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - B Apfel
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - S Soekadar
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | | | - A Beck
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
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dos Reis LD, Pereira Generoso L, Pereira GS, Teixeira Barú JPDS, Candido NL, Maziero Capello MG, de Castro ROM, Cardoso EJR, Scoz RD, Ferreira LMA, da Silva ML, da Silva JRT. Effects of multisession prefrontal cortex tDCS or taVNS on stress, perceived stress and sleep quality: a double-blind, randomized controlled study. Front Psychol 2024; 15:1343413. [PMID: 39346507 PMCID: PMC11427356 DOI: 10.3389/fpsyg.2024.1343413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/18/2024] [Indexed: 10/01/2024] Open
Abstract
Introduction Chronic stress is a condition characterized by prolonged stimulation, leading to mental and physical weakness. It can have detrimental effects on individuals' mental health and cognitive function, potentially causing various health issues. This article explores the potential of non-invasive neuromodulation techniques, specifically transcranial direct current stimulation (tDCS) and transcutaneous auricular vagus nerve stimulation (taVNS), in managing chronic stress and improving sleep quality. Methods The study conducted a randomized, double-blinded, controlled trial with participants experiencing chronic stress. In total, 100 participants were randomly assigned to one of four conditions: the anodal tDCS group (n = 50), the sham tDCS group (n = 50), the taVNS group (n = 50), or the sham taVNS group (n = 50). Within each condition, participants received five sessions of either active treatment or sham treatment, with 20 min of tDCS over the dorsolateral prefrontal cortex (2 mA) for the tDCS groups, or taVNS on the left ear (20 Hz) for the taVNS groups. At baseline, post-intervention, and 4 weeks thereafter, we evaluated stress using the Lipp's Inventory of Stress Symptoms for Adults (LSSI), perceived stress through the Perceived Stress Scale (PSS-10), and sleep quality via the Pittsburgh Sleep Quality Index (PSQI). Results The tDCS and taVNS interventions resulted in reduced stress levels, improved sleep quality, and enhanced perception of stress. Discussion These findings suggest that tDCS and taVNS hold promise as effective treatments for chronic stress, offering a safe and accessible approach to improving individuals' wellbeing and overall quality of life. Clinical trial registration https://ensaiosclinicos.gov.br/rg/RBR-2ww2ts8, identifier UTN: U1111-1296-1810; Brazilian Registry of Clinical Trials (REBEC) RBR-2ww2ts8.
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Affiliation(s)
- Laya Dalila dos Reis
- Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Laura Pereira Generoso
- Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Gabrielly Santos Pereira
- Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - João Paulo da Silva Teixeira Barú
- Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Natalie Lange Candido
- Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Maria Gabriela Maziero Capello
- Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Renato Ortolani Marcondes de Castro
- Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Edvaldo José Rodrigues Cardoso
- Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Robson Dias Scoz
- Neuromodulation and Pain Unit (NeuroPain), Egas Moniz Interdisciplinary Research Center (CiiEM), Almada, Portugal
| | - Luciano Maia Alves Ferreira
- Neuromodulation and Pain Unit (NeuroPain), Egas Moniz Interdisciplinary Research Center (CiiEM), Almada, Portugal
| | - Marcelo Lourenço da Silva
- Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - Josie Resende Torres da Silva
- Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED), Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
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Giraudier M, Ventura-Bort C, Weymar M. Effects of Transcutaneous Auricular Vagus Nerve Stimulation on the P300: Do Stimulation Duration and Stimulation Type Matter? Brain Sci 2024; 14:690. [PMID: 39061430 PMCID: PMC11274684 DOI: 10.3390/brainsci14070690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) has attracted increasing interest as a neurostimulation tool with potential applications in modulating cognitive processes such as attention and memory, possibly through the modulation of the locus-coeruleus noradrenaline system. Studies examining the P300 brain-related component as a correlate of noradrenergic activity, however, have yielded inconsistent findings, possibly due to differences in stimulation parameters, thus necessitating further investigation. In this event-related potential study involving 61 participants, therefore, we examined how changes in taVNS parameters, specifically stimulation type (interval vs. continuous stimulation) and duration, influence P300 amplitudes during a visual novelty oddball task. Although no effects of stimulation were found over the whole cluster and time window of the P300, cluster-based permutation tests revealed a distinct impact of taVNS on the P300 response for a small electrode cluster, characterized by larger amplitudes observed for easy targets (i.e., stimuli that are easily discernible from standards) following taVNS compared to sham stimulation. Notably, our findings suggested that the type of stimulation significantly modulated taVNS effects on the P300, with continuous stimulation showing larger P300 differences (taVNS vs. sham) for hard targets and standards compared to interval stimulation. We observed no interaction effects of stimulation duration on the target-related P300. While our findings align with previous research, further investigation is warranted to fully elucidate the influence of taVNS on the P300 component and its potential utility as a reliable marker for neuromodulation in this field.
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Affiliation(s)
- Manon Giraudier
- Department of Biological Psychology and Affective Science, Faculty of Human Sciences, University of Potsdam, Campus Golm, Karl-Liebknecht-Str. 24/25, 14476 Potsdam, Germany; (C.V.-B.); (M.W.)
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Baumeister-Lingens L, Rothe R, Wolff L, Gerlach AL, Koenig J, Sigrist C. Vagally-mediated heart rate variability and depression in children and adolescents - A meta-analytic update. J Affect Disord 2023; 339:237-255. [PMID: 37437729 DOI: 10.1016/j.jad.2023.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/09/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Depression is one of the most common mental disorders and a leading cause of disability worldwide. In adults, depression is characterized by decreased vagal activity (vagally-mediated heart rate variability; vmHRV), while vmHRV is inversely correlated with depressive symptoms. In children/adolescents, a 2016 synthesis (4 studies, 259 individuals) found similarly decreased vmHRV in clinical depression, but no significant association between depressive symptoms and vmHRV (6 studies, 2625 individuals). Given the small number of studies previously considered for synthesis and the rapidly growing evidence base in this area, a meta-analytic update was warranted. METHOD A previous review was updated by a systematic literature search to identify studies that (a) compared vmHRV in clinically depressed children/adolescents with non-depressed controls and (b) reported associations between vmHRV and depression severity. RESULTS The search update identified 5 additional studies for group comparison (k = 9 studies in total, n = 608 individuals in total) and 15 additional studies for correlational meta-analysis (k = 21 studies in total, n = 4224 individuals in total). Evidence was found for lower resting-state vmHRV in clinically depressed children/adolescents compared to healthy controls (SMD = -0.593, 95 % CI [-1.1760; -0.0101], I2 = 90.92 %) but not for a significant association between vmHRV and depressive symptoms (r = -0.053, 95 % CI [-0.118; 0.012], I2 = 65.77 %). Meta-regression revealed a significant association between depressive symptoms and vmHRV as a function of sex. LIMITATIONS The samples considered are highly heterogeneous. Data on the longitudinal association between vmHRV and depression are currently lacking. CONCLUSION The present findings support the use of vmHRV as a biomarker for clinical depression in children/adolescents.
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Affiliation(s)
- Luise Baumeister-Lingens
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Roxana Rothe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Lena Wolff
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Alexander L Gerlach
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Christine Sigrist
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany.
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D'Agostini M, Burger AM, Jelinčić V, von Leupoldt A, Van Diest I. Effects of transcutaneous auricular vagus nerve stimulation on P300 magnitudes and salivary alpha-amylase during an auditory oddball task. Biol Psychol 2023; 182:108646. [PMID: 37481230 DOI: 10.1016/j.biopsycho.2023.108646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neurostimulation technique that is thought to modulate noradrenergic activity. Previous studies have demonstrated inconsistent effects of taVNS on noradrenergic activity, which is possibly due to insufficient statistical power, suboptimal stimulation parameter settings, and data collection procedures. In this preregistered within-subject experiment, 44 healthy participants received taVNS and sham (earlobe) stimulation during two separate experimental sessions. Stimulation intensity was individually calibrated to the maximum level below pain. During each session, participants received the stimulation continuously ten minutes before an auditory novelty oddball task till the end of the experimental session. The P3b component of the event-related potential served as a marker of phasic noradrenergic activity, whereas P3a magnitude was explored as an index of dopaminergic activity. Salivary alpha-amylase (sAA) was measured as an index of tonic noradrenergic activity before and at the end of the stimulation. The taVNS and sham conditions did not differ in P3a or P3b magnitudes, nor sAA secretion. These findings call into question whether taVNS, administered continuously at high, nonpainful stimulation intensities, reliably augments noradrenergic activity via the vagus nerve.
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Affiliation(s)
- Martina D'Agostini
- Health Psychology Research Group, KU Leuven, Tiensestraat 102/3726, Leuven 3000, Belgium.
| | - Andreas M Burger
- Health Psychology Research Group, KU Leuven, Tiensestraat 102/3726, Leuven 3000, Belgium
| | - Valentina Jelinčić
- Health Psychology Research Group, KU Leuven, Tiensestraat 102/3726, Leuven 3000, Belgium
| | - Andreas von Leupoldt
- Health Psychology Research Group, KU Leuven, Tiensestraat 102/3726, Leuven 3000, Belgium
| | - Ilse Van Diest
- Health Psychology Research Group, KU Leuven, Tiensestraat 102/3726, Leuven 3000, Belgium
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Dolphin H, Dyer AH, Dukelow T, Finucane C, Commins S, Kennelly SP. Safety and feasibility of transcutaneous vagus nerve stimulation in mild cognitive impairment: VINCI-AD study protocol. BMC Neurol 2023; 23:289. [PMID: 37532979 PMCID: PMC10394887 DOI: 10.1186/s12883-023-03320-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Over 55 million adults are living with dementia globally, which is projected to reach 157 million by 2050. Mild cognitive impairment (MCI), a syndrome of memory impairment with intact activities of daily living, may precede dementia by several years. Around 5-15% of individuals with MCI convert to dementia annually. Novel treatments which delay progression of MCI to dementia are urgently needed. Transcutaneous vagal nerve stimulation (tVNS) is a non-invasive neuromodulation technique that targets the vagus nerve. Importantly, tVNS has been shown to improve cognition in healthy volunteers, but has not been extensively examined as a potential therapeutic approach in MCI. VINCI-AD will examine the safety and feasibility of tVNS in older adults with MCI. DESIGN VINCI-AD is an investigator-led, single-site, single-blind, sham-controlled crossover pilot study which aims to assess the safety and feasibility of tVNS in 40 participants with amnestic MCI. All participants will attend for three consecutive study visits during which they will be randomised to receive no stimulation (baseline), active tVNS stimulation (stimulation at cymba conchae of left ear) or sham tVNS stimulation (at earlobe). Safety will be primarily assessed by ascertainment of adverse events. Further safety assessment will examine the impact of acute tVNS on subjective (orthostatic symptoms), peripheral (finometry-based blood pressure) and central (assessed via Near Infrared Spectroscopy [NIRS]) haemodynamic responses to active stand. Feasibility will be determined using a custom-designed occupational assessment of device usability. Exploratory secondary analysis in VINCI-AD will examine the potential impact of acute tVNS on associative memory, spatial memory and inhibitory control to inform sample size estimates for future trials of tVNS in older adults with MCI. DISCUSSION VINCI-AD will report on the safety (adverse events/haemodynamic responses to active stand) and feasibility of tVNS as a potential therapeutic option in MCI. Detailed reporting of study eligibility and completion rates will be reported. Exploratory analysis will examine the potential cognitive benefits of acute tVNS on cognitive function in MCI to report potential effect sizes that may inform future clinical trials in this cohort. TRIAL REGISTRATION https://clinicaltrials.gov/ct2/show/NCT05514756 . Trial Registration Number NCT05514756 (24th August 2022 for this protocol, version 1.0.).
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Affiliation(s)
- Helena Dolphin
- Department of Medical Gerontology, Trinity College, Dublin 2, Dublin, Ireland.
- Institute of Memory and Cognition, Tallaght University Hospital, Dublin 24, Tallaght, Ireland.
- Age-Related Healthcare Department, Tallaght University Hospital, Tallaght, Ireland.
| | - Adam H Dyer
- Department of Medical Gerontology, Trinity College, Dublin 2, Dublin, Ireland
- Institute of Memory and Cognition, Tallaght University Hospital, Dublin 24, Tallaght, Ireland
| | - Tim Dukelow
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
| | - Ciaran Finucane
- Department of Medical Gerontology, Trinity College, Dublin 2, Dublin, Ireland
- Department of Medical Physics, St James's Hospital, Dublin, Ireland
| | - Sean Commins
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Sean P Kennelly
- Department of Medical Gerontology, Trinity College, Dublin 2, Dublin, Ireland
- Institute of Memory and Cognition, Tallaght University Hospital, Dublin 24, Tallaght, Ireland
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Wang C, Zeng L, Cao X, Dai J, Liu Y, Gao Z, Qin Y, Yang L, Wang H, Wen Z. Synergistic effects of transcutaneous vagus nerve stimulation and inhibitory control training on electrophysiological performance in healthy adults. Front Neurosci 2023; 17:1123860. [PMID: 36968500 PMCID: PMC10033592 DOI: 10.3389/fnins.2023.1123860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/23/2023] [Indexed: 03/11/2023] Open
Abstract
Transcutaneous vagal nerve stimulation (tVNS) is a non-invasive nerve stimulation technique that exerts a positive “exogenous” online neuromodulatory effect on inhibitory control (IC). Additionally, IC training (ICT) is an effective approach for enhancing IC via the “endogenous” activation of brain regions implicated in this process. The aim of the present study was to examine the synergistic effects of tVNS and ICT on IC enhancement. For this, we measured the changes in neural activity in frontal, fronto-central, and central regions in the time domain of the N2 component and the frequency domain of alpha power during the stop signal task. A total of 58 participants were randomly divided into four groups that received five sessions of either ICT or sham ICT with either online tVNS or sham tVNS. No differences in N2 amplitude were detected after any of the interventions. However, N2 latency shortened after tVNS + ICT in frontal, fronto-central, and central regions. N2 latency shortened after the intervention of sham tVNS + ICT in frontal region. Moreover, alpha power after tVNS + ICT intervention was larger than those of the other interventions in frontal, fronto-central, and central regions. The obtained electrophysiological data suggested that combining tVNS with ICT has synergistic ameliorative effects on IC, and provide evidence supporting the IC-enhancing potential of tVNS combined with ICT.
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Affiliation(s)
- Chunchen Wang
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Lingwei Zeng
- Department of Medical Psychology, Air Force Medical University, Xi’an, China
| | - Xinsheng Cao
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Jing Dai
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Yang Liu
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Zhijun Gao
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Yilong Qin
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Lin Yang
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
- Lin Yang,
| | - Hang Wang
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
- Hang Wang,
| | - Zhihong Wen
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
- *Correspondence: Zhihong Wen,
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De Smet S, Ottaviani C, Verkuil B, Kappen M, Baeken C, Vanderhasselt MA. Effects of non-invasive vagus nerve stimulation on cognitive and autonomic correlates of perseverative cognition. Psychophysiology 2023; 60:e14250. [PMID: 36683127 DOI: 10.1111/psyp.14250] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/03/2023] [Accepted: 01/03/2023] [Indexed: 01/24/2023]
Abstract
Perseverative cognitions can provoke psychophysiological stress in the absence of an actual stressor and are considered important transdiagnostic vulnerability factors for several (mental) health issues. These stress-related cognitive processes are reflected by both cognitive (assessed by self-reports) and autonomic inflexibility (assessed by heart rate variability; HRV), with a key role attributed to the vagus nerve. Interestingly, modulation of the afferent branches of the vagus can be achieved with transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive technique that employs a low-intensity electrical current applied to the ear. In a sample of healthy individuals, we investigated the effects of taVNS of the left concha, compared to sham (earlobe) stimulation, on the cognitive and autonomic correlates of perseverative cognition following a psychosocial stress task. Interestingly, taVNS significantly reduced cognitive rigidity, reflected by reduced subjective perseverative thinking after psychosocial stress. Although there were no direct effects on autonomic correlates of perseverative cognition, individual differences in perseverative thinking after the stressor significantly affected the effects of taVNS on HRV. Specifically, more autonomic inflexibility during the stress task (i.e., reduced HRV) was associated with increases in perseverative thinking afterward for the sham condition, but not the active taVNS condition. Additional exploratory analyses revealed no significant moderation of stimulation intensity. Overall, the study findings endorse the association between perseverative cognitions and vagus nerve functioning.
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Affiliation(s)
- Stefanie De Smet
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Santa Lucia Foundation, Rome, Italy
| | - Bart Verkuil
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands
| | - Mitchel Kappen
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Chris Baeken
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Psychiatry, Brussels University Hospital, Brussels, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Gholamrezaei A, Jafari H. How to approach baseline imbalance in cross-randomised studies? Auton Neurosci 2023; 244:103020. [PMID: 36495838 DOI: 10.1016/j.autneu.2022.103020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/31/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Ali Gholamrezaei
- Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia.
| | - Hassan Jafari
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
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Koenig J, Kaess M. By trying different approaches (and transparent reporting)! Response to: How to approach baseline imbalance in cross-randomised studies? Auton Neurosci 2023; 244:103055. [PMID: 36495837 DOI: 10.1016/j.autneu.2022.103055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany.
| | - Michael Kaess
- University of Bern, University Hospital of Child and Adolescent Psychiatry and Psychotherapy, Bern, Switzerland; University Hospital Heidelberg, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Heidelberg, Germany
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Jang SH, Cho MJ. Transcutaneous auricular vagus nerve stimulation in disorders of consciousness: A mini-narrative review. Medicine (Baltimore) 2022; 101:e31808. [PMID: 36550876 PMCID: PMC9771208 DOI: 10.1097/md.0000000000031808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
In this mini review, 6 studies that investigated the effects of transcutaneous auricular vagus nerve stimulation (taVNS) in patients with disorders of consciousness (DOC) were reviewed. Generally, the application of taVNS in patients with DOC appears to be effective (positive results in 5 of 6 studies) and safe. Furthermore, 4 studies that evaluated changes in the brain following taVNS reported positive results (2 studies, functional magnetic resonance imaging and 2 studies, electroencephalography). Based on our review of the 6 studies, we believe that research and clinical application of taVNS in DOC are in the initial stages and have the following limitations. First, there is a shortage of studies on this topic, with only 6 studies, 2 of which were case reports. Second, 5 studies were performed without control or sham groups. Third, there was no standardization of treatment schedules and electrical stimulation parameters. Therefore, further studies to overcome the above limitations should be encouraged; further original studies involving a larger number of patients in the control or sham groups are needed. However, studies on the optimal conditions (treatment schedule and electrical stimulation parameters) for taVNS in patients with DOC are necessary. Furthermore, neuroimaging studies should be undertaken to elucidate the neurological mechanisms for the recovery of impaired consciousness in DOC and the lasting effects of taVNS on the brain.
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Affiliation(s)
- Sung Ho Jang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea
| | - Min Jye Cho
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea
- * Correspondence: Min Jye Cho, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyung dong, Namgu, Daegu 705-717, Republic of Korea (e-mail: )
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