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Gerges ANH, Williams EER, Hillier S, Uy J, Hamilton T, Chamberlain S, Hordacre B. Clinical application of transcutaneous auricular vagus nerve stimulation: a scoping review. Disabil Rehabil 2024:1-31. [PMID: 38362860 DOI: 10.1080/09638288.2024.2313123] [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: 04/25/2023] [Accepted: 01/27/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE Transcutaneous auricular vagus nerve stimulation (taVNS) is an emerging non-invasive neuromodulation therapy. This study aimed to explore the therapeutic use of taVNS, optimal stimulation parameters, effective sham protocols, and safety. METHODS A scoping review was conducted. Five databases and grey literature were searched. The data extracted included stimulation parameters, adverse events (AEs), and therapeutic effects on clinical outcomes. RESULTS 109 studies were included. taVNS was used across 21 different clinical populations, most commonly in psychiatric, cardiac, and neurological disorders. Overall, 2,214 adults received active taVNS and 1,017 received sham taVNS. Reporting of stimulation parameters was limited and inconsistent. taVNS appeared to have a favourable therapeutic effect across a wide range of clinical populations with varied parameters. Three sham protocols were reported but their effectiveness was documented in only two of the 54 sham-controlled studies. Most reported adverse events were localised to stimulation site. CONCLUSION There is growing evidence for taVNS therapeutic effect. taVNS appears safe and tolerable. Sham protocols need evaluation. Standardised and comprehensive reporting of both stimulation parameters and adverse events is required. Two different questionnaires have been proposed to evaluate adverse events and the effectiveness of sham methods in blinding participants.
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Affiliation(s)
- Ashraf N H Gerges
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Ellen E R Williams
- School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Susan Hillier
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Jeric Uy
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Taya Hamilton
- Perron Institute for Neurological and Translational Science, Perth, Australia
- Fourier Intelligence International Pte Ltd., Global Headquarters, Singapore, Singapore
| | - Saran Chamberlain
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Brenton Hordacre
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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Yu Y, Chen T, Zheng Z, Jia F, Liao Y, Ren Y, Liu X, Liu Y. The role of the autonomic nervous system in polycystic ovary syndrome. Front Endocrinol (Lausanne) 2024; 14:1295061. [PMID: 38313837 PMCID: PMC10834786 DOI: 10.3389/fendo.2023.1295061] [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] [Received: 09/15/2023] [Accepted: 12/27/2023] [Indexed: 02/06/2024] Open
Abstract
This article reviewed the relationship between the autonomic nervous system and the development of polycystic ovary syndrome (PCOS). PCOS is the most common reproductive endocrine disorder among women of reproductive age. Its primary characteristics include persistent anovulation, hyperandrogenism, and polycystic ovarian morphology, often accompanied by disturbances in glucose and lipid metabolism. The body's functions are regulated by the autonomic nervous system, which consists mainly of the sympathetic and parasympathetic nervous systems. The autonomic nervous system helps maintain homeostasis in the body. Research indicates that ovarian function in mammals is under autonomic neural control. The ovaries receive central nervous system information through the ovarian plexus nerves and the superior ovarian nerves. Neurotransmitters mediate neural function, with acetylcholine and norepinephrine being the predominant autonomic neurotransmitters. They influence the secretion of ovarian steroids and follicular development. In animal experiments, estrogen, androgens, and stress-induced rat models have been used to explore the relationship between PCOS and the autonomic nervous system. Results have shown that the activation of the autonomic nervous system contributes to the development of PCOS in rat. In clinical practice, assessments of autonomic nervous system function in PCOS patients have been gradually employed. These assessments include heart rate variability testing, measurement of muscle sympathetic nerve activity, skin sympathetic response testing, and post-exercise heart rate recovery evaluation. PCOS patients exhibit autonomic nervous system dysfunction, characterized by increased sympathetic nervous system activity and decreased vagal nerve activity. Abnormal metabolic indicators in PCOS women can also impact autonomic nervous system activity. Clinical studies have shown that various effective methods for managing PCOS regulate patients' autonomic nervous system activity during the treatment process. This suggests that improving autonomic nervous system activity may be an effective approach in treating PCOS.
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Affiliation(s)
- Yue Yu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tong Chen
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zheng Zheng
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fan Jia
- Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, China
| | - Yan Liao
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuehan Ren
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinmin Liu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ying Liu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Sun J, Ma Y, Du Z, Wang Z, Guo C, Luo Y, Chen L, Gao D, Li X, Xu K, Hong Y, Xu F, Yu X, Xiao X, Fang J, Hou X. Immediate Modulation of Transcutaneous Auricular Vagus Nerve Stimulation in Patients With Treatment-Resistant Depression: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2022; 13:923783. [PMID: 35845466 PMCID: PMC9284008 DOI: 10.3389/fpsyt.2022.923783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies found that transcutaneous auricular vagus nerve stimulation (taVNS) was clinically effective in treating a case of treatment-resistant depression (TRD). However, the brain neural mechanisms underlying the immediate effects of taVNS treatment for TRD have not been elucidated. MATERIALS AND METHODS Differences in the amplitude of low-frequency fluctuations (ALFF) between TRD and healthy control (HC) groups were observed. The TRD group was treated with taVNS for 30 min, and changes in ALFF in the TRD group before and after immediate treatment were observed. The ALFF brain regions altered by taVNS induction were used as regions of interest to analyze whole-brain functional connectivity (FC) changes in the TRD group. RESULTS A total of 44 TRD patients and 44 HCs completed the study and were included in the data analysis. Compared with the HC group, the TRD group had increased ALFF in the left orbital area of the middle frontal gyrus. After taVNS treatment, ALFF in the left orbital area of the middle frontal gyrus and right middle frontal gyrus decreased in the TRD group, while ALFF in the right orbital area of the superior frontal gyrus increased. The FC in the left orbital area of the middle frontal gyrus with left middle frontal gyrus and the right inferior occipital gyrus was significantly increased. CONCLUSION Transcutaneous auricular vagus nerve stimulation demonstrates immediate modulation of functional activity in the emotional network, cognitive control network, and visual processing cortex, and may be a potential brain imaging biomarker for the treatment of TRD.
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Affiliation(s)
- Jifei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunlei Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Limei Chen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Deqiang Gao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaojiao Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ke Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Hong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fengquan Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Jiliang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaobing Hou
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
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