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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Journal ArticleDOI
Mossy fiber projections from the cuneate nucleus to the cochlear nucleus in the rat.
Debora D. Wright,David K. Ryugo +1 more
TL;DR: It is determined that the axonal projections from the cuneate region gave rise to mossy fiber terminals in the granule cell regions of the ipsilateral cochlear nucleus, indicating that somatosensory cues are intimately involved with information processing at this early stage of the auditory system.
Journal ArticleDOI
Recordings from the rat locus coeruleus during acute vagal nerve stimulation in the anaesthetised rat.
TL;DR: The results of this study indicate that neuronal activity of the locus coeruleus is modulated by VNS, which may be significant for mediating the clinical effects of VNS.
Journal ArticleDOI
A pilot study of vagus nerve stimulation (VNS) for treatment-resistant anxiety disorders.
Mark S. George,Herbert E. Ward,Philip T. Ninan,Mark H. Pollack,Ziad Nahas,Berry Anderson,Samet Kose,Robert H Howland,Wayne K. Goodman,James C. Ballenger +9 more
TL;DR: These patients with treatment-resistant anxiety disorders generally tolerated VNS treatment, and there was evidence of acute and long-term improvement in some patients, suggesting that further double-blind studies assessing the VNS role in treating anxiety disorders, particularly OCD, may be warranted.
Journal ArticleDOI
Vagus nerve stimulation (VNS) synchronized BOLD fMRI suggests that VNS in depressed adults has frequency/dose dependent effects.
Mikhail Lomarev,Stewart Denslow,Ziad Nahas,Jeong-Ho Chae,Jeong-Ho Chae,Mark S. George,Daryl E. Bohning +6 more
TL;DR: It is suggested further that VNS at different frequencies likely has frequency or dose dependent modulatory effects on other brain activities (e.g. hearing a tone) and in depressed adults, left cervical VNS causes regional brain activity changes that depend on the frequency of stimulation or total dose, or both.
Journal ArticleDOI
Feasibility of vagus nerve stimulation-synchronized blood oxygenation level-dependent functional MRI
Daryl E. Bohning,Mikhail Lomarev,Stewart Denslow,Ziad Nahas,Ananda Shastri,Mark S. George,Mark S. George +6 more
TL;DR: Vagus nerve stimulation pulses from an NCP system can be detected externally to determine its firing pattern, thus allowing V NS-fMRI studies of VNS-induced brain activity, and the blood oxygenation level–dependent response to VNS was shown in brain regions regulated by the vagus nerve.