Journal ArticleDOI
Optimization of Transcutaneous Vagus Nerve Stimulation Using Functional MRI.
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TLDR
In this article, the authors used functional magnetic resonance imaging (fMRI) to determine the most effective location for tVNS, and they found that stimulation at the ear canal resulted in the weakest activation of the solitary tract (NTS), the recipient of most afferent vagal projections, and a brainstem nucleus that receives direct input from the NTS.Abstract:
Objective/Hypothesis
Vagus nerve stimulation (VNS) is an established therapy for drug-resistant epilepsy, depression, and a number of other disorders. Transcutaneous stimulation of the auricular branch of the vagus nerve (tVNS) has been considered as a non-invasive alternative. Several functional magnetic resonance imaging (fMRI) studies on the effects of tVNS used different stimulation parameters and locations in the ear, which makes it difficult to determine the optimal tVNS methodology. The present study used fMRI to determine the most effective location for tVNS.
Materials and Methods
Four stimulation locations in the ear were compared: the inner tragus, inferoposterior wall of the ear canal, cymba conchae, and earlobe (sham). Thirty-seven healthy subjects underwent two 6-min tVNS stimulation runs per electrode location (monophasic rectangular 500 μs pulses, 25 Hz). General linear model was performed using SPM; region-of-interest analyses were performed for the brainstem areas.
Results
Stimulation at the ear canal resulted in the weakest activation of the nucleus of solitary tract (NTS), the recipient of most afferent vagal projections, and of the locus coeruleus (LC), a brainstem nucleus that receives direct input from the NTS. Stimulation of the inner tragus and cymba conchae activated these two nuclei as compared to sham. However, ROI analysis showed that only stimulation of the cymba conchae produced a significantly stronger activation in both the NTS and LC than did the sham stimulation.
Conclusions
These findings suggest that tVNS at the cymba conchae properly activates the vagal pathway and results in its strongest activation, and thus may be the optimal location for tVNS therapies applied to the auricle.read more
Citations
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Journal ArticleDOI
The anatomical basis for transcutaneous auricular vagus nerve stimulation.
TL;DR: The neuroanatomy of the ABVN is explored with reference to clinical surveys examining Arnold’s reflex, cadaveric studies, fMRI studies, electrophysiological studies, acupuncture studies, retrograde tracing studies, and studies measuring changes in autonomic parameters in response to auricular tVNS.
Journal ArticleDOI
Neurophysiologic effects of transcutaneous auricular vagus nerve stimulation (taVNS) via electrical stimulation of the tragus: A concurrent taVNS/fMRI study and review.
Bashar W. Badran,Logan T. Dowdle,Oliver J. Mithoefer,Nicholas T. LaBate,James Coatsworth,Joshua C. Brown,William H. DeVries,Christopher W. Austelle,Lisa M. McTeague,Mark S. George +9 more
TL;DR: Stimulation of the tragus activates the cerebral afferents of the vagal pathway and combined with the review of the literature suggest that taVNS is a promising form of VNS.
Journal ArticleDOI
Current directions in the auricular vagus nerve stimulation I - A physiological perspective
Eugenijus Kaniusas,Stefan Kampusch,Marc Tittgemeyer,Marc Tittgemeyer,Fivos Panetsos,Raquel Fernandez Gines,Michele Papa,Attila Kiss,Bruno K. Podesser,Antonino M. Cassarà,Emmeric Tanghe,Amine M. Samoudi,Thomas Tarnaud,Wout Joseph,Vaidotas Marozas,Arunas Lukosevicius,Niko Istuk,Antonio Sarolic,Sarah Lechner,Wlodzimierz Klonowski,Giedrius Varoneckas,Giedrius Varoneckas,Jozsef Constantin Szeles +22 more
TL;DR: Two reviews build a reasonable bridge from the rationale of aVNS as a therapeutic tool to current research lines, all of them being highly relevant for the promising aV NS technology to reach the patient.
Journal ArticleDOI
Vagal Nerve Stimulation for Treatment-Resistant Depression.
TL;DR: VNS affects many of the same brain areas, neurotransmitters and signal transduction mechanisms as those found with traditional antidepressants, Nevertheless, the mechanisms by which VNS benefits patients nonresponsive to conventional antidepressants is unclear, with further research needed to clarify this.
Journal ArticleDOI
Treating Depression with Transcutaneous Auricular Vagus Nerve Stimulation: State of the Art and Future Perspectives
TL;DR: It is found that transcutaneous auricular vagus nerve stimulation can significantly reduce multiple symptoms of depression patients, including anxiety, psychomotor retardation, sleep disturbance, and hopelessness.
References
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Geun Hee Seol,Jokubas Ziburkus,Jokubas Ziburkus,Shiyong Huang,Lihua Song,In Tae Kim,Kogo Takamiya,Richard L. Huganir,Hey Kyoung Lee,Alfredo Kirkwood +9 more
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Thomas R. Henry,Roy A.E. Bakay,John R. Votaw,Page B. Pennell,Charles M. Epstein,Tracy L. Faber,Scott T. Grafton,John M. Hoffman +7 more
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Duvernoy's Atlas of the Human Brain Stem and Cerebellum
Thomas P. Naidich,Henri M. Duvernoy,Bradley N. Delman,A G Sorensen,Spyros S. Kollias,E M Haacke +5 more
TL;DR: This atlas gives radiologists and other professionals who research brain physiology a sophisticated knowledge of anatomy by correlating thin-section brain anatomy with clinical practice.
Journal ArticleDOI
Effect of Vagus Nerve Stimulation on Serotonergic and Noradrenergic Transmission
Adrienne E. Dorr,Guy Debonnel +1 more
TL;DR: VNS appears to have a novel mechanism of antidepressant action, enabling its effectiveness in treatment-resistant depression, and the responses of autoreceptors to the acute administration of their respective agonists were assessed.
Journal ArticleDOI
VNS therapy in treatment-resistant depression: clinical evidence and putative neurobiological mechanisms.
Charles B. Nemeroff,Helen S. Mayberg,Scott E. Krahl,James O. McNamara,Alan Frazer,Thomas R. Henry,Mark S. George,Dennis S. Charney,Stephen K. Brannan +8 more
TL;DR: Evidence from neuroimaging and other studies suggests that VNS therapy acts via innervation of the nucleus tractus solitarius, with secondary projections to limbic and cortical structures that are involved in mood regulation, including brainstem regions that contain serotonergic and noradrenergic regions that project to the forebrain.