scholarly journals Non-Invasive Transcutaneous Vagus Nerve Stimulation for the Treatment of Fibromyalgia Symptoms: A Study Protocol

2022 ◽  
Vol 12 (1) ◽  
pp. 95
Author(s):  
Andrés Molero-Chamizo ◽  
Michael A. Nitsche ◽  
Armin Bolz ◽  
Rafael Tomás Andújar Barroso ◽  
José R. Alameda Bailén ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vagus Nerve ◽  
Pain Intensity ◽  
Vagus Nerve Stimulation ◽  
Vagal Stimulation ◽  
Immune Systems ◽  
Non Invasive ◽  
Transcutaneous Vagus Nerve Stimulation ◽  
Stimulation Of

Stimulation of the vagus nerve, a parasympathetic nerve that controls the neuro-digestive, vascular, and immune systems, induces pain relief, particularly in clinical conditions such as headache and rheumatoid arthritis. Transmission through vagal afferents towards the nucleus of the solitary tract (NST), the central relay nucleus of the vagus nerve, has been proposed as the main physiological mechanism that reduces pain intensity after vagal stimulation. Chronic pain symptoms of fibromyalgia patients might benefit from stimulation of the vagus nerve via normalization of altered autonomic and immune systems causing their respective symptoms. However, multi-session non-invasive vagal stimulation effects on fibromyalgia have not been evaluated in randomized clinical trials. We propose a parallel group, sham-controlled, randomized study to modulate the sympathetic–vagal balance and pain intensity in fibromyalgia patients by application of non-invasive transcutaneous vagus nerve stimulation (tVNS) over the vagal auricular and cervical branches. We will recruit 136 fibromyalgia patients with chronic moderate to high pain intensity. The primary outcome measure will be pain intensity, and secondary measures will be fatigue, health-related quality of life, sleep disorders, and depression. Heart rate variability and pro-inflammatory cytokine levels will be obtained as secondary physiological measures. We hypothesize that multiple tVNS sessions (five per week, for 4 weeks) will reduce pain intensity and improve quality of life as a result of normalization of the vagal control of nociception and immune–autonomic functions. Since both vagal branches project to the NST, we do not predict significantly different results between the two stimulation protocols.

Non-invasive vagus nerve stimulation significantly improves quality of life in patients with persistent postural-perceptual dizziness

2018 ◽  
Vol 265 (S1) ◽  
pp. 63-69 ◽  
Author(s):  
Ozan E. Eren ◽  
Filipp Filippopulos ◽  
Kristina Sönmez ◽  
Ken Möhwald ◽  
Andreas Straube ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Non Invasive

A literature review on the neurophysiological underpinnings and cognitive effects of transcutaneous vagus nerve stimulation: challenges and future directions

2020 ◽  
Vol 123 (5) ◽  
pp. 1739-1755
Author(s):  
Lorenza Colzato ◽  
Christian Beste
Keyword(s):  
Literature Review ◽  
Vagus Nerve ◽  
Brain Stimulation ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Cognitive Effects ◽  
Future Directions ◽  
Transcutaneous Vagus Nerve Stimulation ◽  
Stimulation Technique ◽  
Stimulation Of

Brain stimulation approaches are important to gain causal mechanistic insights into the relevance of functional brain regions and/or neurophysiological systems for human cognitive functions. In recent years, transcutaneous vagus nerve stimulation (tVNS) has attracted considerable popularity. It is a noninvasive brain stimulation technique based on the stimulation of the vagus nerve. The stimulation of this nerve activates subcortical nuclei, such as the locus coeruleus and the nucleus of the solitary tract, and from there, the activation propagates to the cortex. Since tVNS is a novel stimulation technique, this literature review outlines a brief historical background of tVNS, before detailing underlying neurophysiological mechanisms of action, stimulation parameters, cognitive effects of tVNS on healthy humans, and, lastly, current challenges and future directions of tVNS research in cognitive functions. Although more research is needed, we conclude that tVNS, by increasing norepineprine (NE) and gamma-aminobutyric acid (GABA) levels, affects NE- and GABA-related cognitive performance. The review provides detailed background information how to use tVNS as a neuromodulatory tool in cognitive neuroscience and outlines important future leads of research on tVNS.

scholarly journals Health Technology Assessment Report on Vagus Nerve Stimulation in Drug-Resistant Epilepsy

2020 ◽  
Vol 17 (17) ◽  
pp. 6150
Author(s):  
Carlo Efisio Marras ◽  
Gabriella Colicchio ◽  
Luca De Palma ◽  
Alessandro De Benedictis ◽  
Giancarlo Di Gennaro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Technology Assessment ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Technology Assessment ◽  
Vagus Nerve Stimulation ◽  
Palliative Treatment ◽  
Health Technology ◽  
Drug Resistant

Background: Vagus nerve stimulation (VNS) is a palliative treatment for medical intractable epileptic syndromes not eligible for resective surgery. Health technology assessment (HTA) represents a modern approach to the analysis of technologies used for healthcare. The purpose of this study is to assess the clinical, organizational, financial, and economic impact of VNS therapy in drug-resistant epilepsies and to establish the congruity between costs incurred and health service reimbursement. Methods: The present study used an HTA approach. It is based on an extensive detailed bibliographic search on databases (Medline, Pubmed, Embase and Cochrane, sites of scientific societies and institutional sites). The HTA study includes the following issues: (a) social impact and costs of the disease; (b) VNS eligibility and clinical results; (c) quality of life (QoL) after VNS therapy; (d) economic impact and productivity regained after VNS; and (e) costs of VNS. Results: Literature data indicate VNS as an effective treatment with a potential positive impact on social aspects and on quality of life. The diagnosis-related group (DRG) financing, both on national and regional levels, does not cover the cost of the medical device. There was an evident insufficient coverage of the DRG compared to the full cost of implanting the device. Conclusions: VNS is a palliative treatment for reducing seizure frequency and intensity. Despite its economic cost, VNS should improve patients’ quality of life and reduce care needs.

scholarly journals Modulation of memory performance and brain activity by non-invasive auricular transcutaneous vagus nerve stimulation in a mouse model of intellectual disability disorder

2021 ◽  
Vol 14 (6) ◽  
pp. 1593-1594
Author(s):  
Cecilia Brambilla Pisoni ◽  
Emma Muñoz Moreno ◽  
Anna Vázquez Oliver ◽  
Rafael Maldonado Lopez ◽  
Antoni Ivorra Cano ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Mouse Model ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Brain Activity ◽  
Memory Performance ◽  
Non Invasive ◽  
Transcutaneous Vagus Nerve Stimulation

Transcutaneous vagus nerve stimulation for refractory epilepsy: a randomized controlled trial

2014 ◽  
Author(s):  
Peijing Rong ◽  
Aihua Liu ◽  
Jianguo Zhang ◽  
Yuping Wang ◽  
Wei He ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Seizure Frequency ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Refractory Epilepsy ◽  
Controlled Trial ◽  
Control Group ◽  
Transcutaneous Vagus Nerve Stimulation ◽  
Significant Difference

Abstract This trial was designed to test the safety and effectiveness of transcutaneous auricular vagus nerve stimulation (ta-VNS) for patients with refractory epilepsy. Pre-trial：144 patients were randomly assigned to ta-VNS group (n=98) or transcutaneous auricular non-vagus nerve stimulation (tn-VNS) control group (n=46). Treatment was conducted twice per day for 24 weeks. After 8, 16 and 24 weeks of treatment，the patients were evaluated according to the Modified Engel Scale (four classes). After 8 weeks，according to the medical ethic design, patients in tn-VNS group were switched into ta-VNS group uniquely. After 8 weeks’ treatment 41.0% and 27.5% of patients from ta-VNS and tn-VNS groups, respectively, experienced reduction in seizure frequency that reached I, II and III levels according to the standards of the Modified Engel Scale compared with the baselines, indicating significant difference in seizure reduction between the two groups. After 24 weeks of treatment, ta-VNS patients had a 47.7% reduction, and tn-VNS, with an additional 16 weeks of treatment, reached 47.5% in reduction. After 8 weeks’ treatment, the percentages of average seizure frequency in ta-VNS and tn-VNS were reduced by 42.6% and 11.5% respectively, providing a statistically significant difference in the results between the two groups (P<0.05). In addition, there were significant improvements in electroencephalograph (EEG) and the quality of daily life of the patients after treatment. The results show that this ta-VNS treatment can effectively reduce the frequency of seizures and improve the patient's quality of life. This may be an effective treatment for refractory epilepsy. At the same time，it is also safe，economic, and widely applicable.

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