1
|
Gerges ANH, Graetz L, Hillier S, Uy J, Hamilton T, Opie G, Vallence AM, Braithwaite FA, Chamberlain S, Hordacre B. Transcutaneous auricular vagus nerve stimulation modifies cortical excitability in middle-aged and older adults. Psychophysiology 2024:e14584. [PMID: 38602055 DOI: 10.1111/psyp.14584] [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: 11/27/2023] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/12/2024]
Abstract
There is a growing interest in the clinical application of transcutaneous auricular vagus nerve stimulation (taVNS). However, its effect on cortical excitability, and whether this is modulated by stimulation duration, remains unclear. We evaluated whether taVNS can modify excitability in the primary motor cortex (M1) in middle-aged and older adults and whether the stimulation duration moderates this effect. In addition, we evaluated the blinding efficacy of a commonly reported sham method. In a double-blinded randomized cross-over sham-controlled study, 23 healthy adults (mean age 59.91 ± 6.87 years) received three conditions: active taVNS for 30 and 60 min and sham for 30 min. Single and paired-pulse transcranial magnetic stimulation was delivered over the right M1 to evaluate motor-evoked potentials. Adverse events, heart rate and blood pressure measures were evaluated. Participant blinding effectiveness was assessed via guesses about group allocation. There was an increase in short-interval intracortical inhibition (F = 7.006, p = .002) and a decrease in short-interval intracortical facilitation (F = 4.602, p = .014) after 60 min of taVNS, but not 30 min, compared to sham. taVNS was tolerable and safe. Heart rate and blood pressure were not modified by taVNS (p > .05). Overall, 96% of participants detected active stimulation and 22% detected sham stimulation. taVNS modifies cortical excitability in M1 and its effect depends on stimulation duration in middle-aged and older adults. taVNS increased GABAAergic inhibition and decreased glutamatergic activity. Sham taVNS protocol is credible but there is an imbalance in beliefs about group allocation.
Collapse
Affiliation(s)
- Ashraf N H Gerges
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Lynton Graetz
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Susan Hillier
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Jeric Uy
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Taya Hamilton
- Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, Western Australia, Australia
| | - George Opie
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ann-Maree Vallence
- School of Psychology, College of Health and Education, Murdoch University, Perth, Western Australia, Australia
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, Western Australia, Australia
| | - Felicity A Braithwaite
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Saran Chamberlain
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Brenton Hordacre
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Wang L, Gao F, Wang Z, Liang F, Dai Y, Wang M, Wu J, Chen Y, Yan Q, Wang L. Transcutaneous auricular vagus nerve stimulation in the treatment of disorders of consciousness: mechanisms and applications. Front Neurosci 2023; 17:1286267. [PMID: 37920298 PMCID: PMC10618368 DOI: 10.3389/fnins.2023.1286267] [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: 08/31/2023] [Accepted: 10/05/2023] [Indexed: 11/04/2023] Open
Abstract
This review provides an in-depth exploration of the mechanisms and applications of transcutaneous auricular vagus nerve stimulation (taVNS) in treating disorders of consciousness (DOC). Beginning with an exploration of the vagus nerve's role in modulating brain function and consciousness, we then delve into the neuroprotective potential of taVNS demonstrated in animal models. The subsequent sections assess the therapeutic impact of taVNS on human DOC, discussing the safety, tolerability, and various factors influencing the treatment response. Finally, the review identifies the current challenges in taVNS research and outlines future directions, emphasizing the need for large-scale trials, optimization of treatment parameters, and comprehensive investigation of taVNS's long-term effects and underlying mechanisms. This comprehensive overview positions taVNS as a promising and safe modality for DOC treatment, with a focus on understanding its intricate neurophysiological influence and optimizing its application in clinical settings.
Collapse
Affiliation(s)
- Likai Wang
- Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Fei Gao
- Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Zhan Wang
- Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Feng Liang
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Yongli Dai
- Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Mengchun Wang
- Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Jingyi Wu
- Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Yaning Chen
- Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Qinjie Yan
- Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Litong Wang
- Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| |
Collapse
|
4
|
Konjusha A, Colzato L, Ghin F, Stock A, Beste C. Auricular transcutaneous vagus nerve stimulation for alcohol use disorder: A chance to improve treatment? Addict Biol 2022; 27:e13202. [DOI: 10.1111/adb.13202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/21/2022] [Accepted: 06/09/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Anyla Konjusha
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine TU Dresden Dresden Germany
- University Neuropsychology Center, Faculty of Medicine TU Dresden Dresden Germany
| | - Lorenza Colzato
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine TU Dresden Dresden Germany
- University Neuropsychology Center, Faculty of Medicine TU Dresden Dresden Germany
| | - Filippo Ghin
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine TU Dresden Dresden Germany
- University Neuropsychology Center, Faculty of Medicine TU Dresden Dresden Germany
| | - Ann‐Kathrin Stock
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine TU Dresden Dresden Germany
- University Neuropsychology Center, Faculty of Medicine TU Dresden Dresden Germany
- Biopsychology, Faculty of Psychology TU Dresden Dresden Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine TU Dresden Dresden Germany
- University Neuropsychology Center, Faculty of Medicine TU Dresden Dresden Germany
| |
Collapse
|
5
|
Keller BN, Hajnal A, Browning KN, Arnold AC, Silberman Y. Involvement of the Dorsal Vagal Complex in Alcohol-Related Behaviors. Front Behav Neurosci 2022; 16:801825. [PMID: 35330845 PMCID: PMC8940294 DOI: 10.3389/fnbeh.2022.801825] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/19/2022] [Indexed: 12/20/2022] Open
Abstract
The neurobiological mechanisms that regulate the development and maintenance of alcohol use disorder (AUD) are complex and involve a wide variety of within and between systems neuroadaptations. While classic reward, preoccupation, and withdrawal neurocircuits have been heavily studied in terms of AUD, viable treatment targets from this established literature have not proven clinically effective as of yet. Therefore, examination of additional neurocircuitries not classically studied in the context of AUD may provide novel therapeutic targets. Recent studies demonstrate that various neuropeptides systems are important modulators of alcohol reward, seeking, and intake behaviors. This includes neurocircuitry within the dorsal vagal complex (DVC), which is involved in the control of the autonomic nervous system, control of intake of natural rewards like food, and acts as a relay of interoceptive sensory information via interactions of numerous gut-brain peptides and neurotransmitter systems with DVC projections to central and peripheral targets. DVC neuron subtypes produce a variety of neuropeptides and transmitters and project to target brain regions critical for reward such as the mesolimbic dopamine system as well as other limbic areas important for the negative reinforcing and aversive properties of alcohol withdrawal such as the extended amygdala. This suggests the DVC may play a role in the modulation of various aspects of AUD. This review summarizes the current literature on neurotransmitters and neuropeptides systems in the DVC (e.g., norepinephrine, glucagon-like peptide 1, neurotensin, cholecystokinin, thyrotropin-releasing hormone), and their potential relevance to alcohol-related behaviors in humans and rodent models for AUD research. A better understanding of the role of the DVC in modulating alcohol related behaviors may lead to the elucidation of novel therapeutic targets for drug development in AUD.
Collapse
|