Neuro-cardiac coupling predicts transcutaneous auricular vagus nerve stimulation effects. 2021

Marius Keute, and Kathrin Machetanz, and Levan Berelidze, and Robert Guggenberger, and Alireza Gharabaghi
Institute for Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, And Tuebingen NeuroCampus, University of Tuebingen, Tuebingen, Germany. Electronic address: marius.keute@uni-tuebingen.de.

Transcutaneous auricular Vagus Nerve Stimulation (taVNS) is a non-invasive neuromodulation technique that may constitute an effective treatment for a wide range of neurological, psychiatric, and medical conditions. One key challenge in taVNS research is the high interindividual response variability. To gain an understanding of this variability, reliable biomarkers for taVNS responsiveness would be highly desirable. In this study, we investigated physiological candidate biomarkers while systematically varying stimulation conditions and observing physiological state characteristics. Forty-four healthy young adults received taVNS and sham-stimulation. Subjects were pseudo-randomly assigned to stimulation of the left or right ear. Each subject underwent six blocks of stimulation. Across blocks, respiration-locking (inhalation-locked taVNS vs. exhalation-locked taVNS vs. sham) and the electrode location (tragus vs. cymba conchae) were varied. We analyzed heart rate (HR), various heart rate variability (HRV) scores, and neuro-cardiac coupling (NCC), indexed by the relationship between electroencephalographic delta power and heartbeat length. We observed an effect of taVNS on HR and HRV scores during, but not after stimulation. The direction of the effects was consistent with parasympathetic activation. We did not observe any systematic influence of the stimulation conditions that we varied. However, we found baseline NCC scores to be significant predictors for the individual effect of taVNS on HRV scores. Cardiac effects of taVNS indicate parasympathetic activation. These effects were short lived, which might explain that some previous studies were unable to detect them. We propose NCC as a novel candidate biomarker for responsiveness to taVNS.

UI MeSH Term Description Entries
D004561 Transcutaneous Electric Nerve Stimulation The use of specifically placed small electrodes to deliver electrical impulses across the SKIN to relieve PAIN. It is used less frequently to produce ANESTHESIA. Analgesic Cutaneous Electrostimulation,Electric Stimulation, Transcutaneous,Electroanalgesia,Percutaneous Electric Nerve Stimulation,TENS,Transdermal Electrostimulation,Electrical Stimulation, Transcutaneous,Percutaneous Electrical Nerve Stimulation,Percutaneous Electrical Neuromodulation,Percutaneous Neuromodulation Therapy,Transcutaneous Electrical Nerve Stimulation,Transcutaneous Nerve Stimulation,Cutaneous Electrostimulation, Analgesic,Electrical Neuromodulation, Percutaneous,Electrical Neuromodulations, Percutaneous,Electroanalgesias,Electrostimulation, Analgesic Cutaneous,Electrostimulation, Transdermal,Nerve Stimulation, Transcutaneous,Neuromodulation Therapy, Percutaneous,Neuromodulation, Percutaneous Electrical,Neuromodulations, Percutaneous Electrical,Percutaneous Electrical Neuromodulations,Percutaneous Neuromodulation Therapies,Stimulation, Transcutaneous Electric,Stimulation, Transcutaneous Nerve,Therapy, Percutaneous Neuromodulation,Transcutaneous Electric Stimulation,Transcutaneous Electrical Stimulation
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014630 Vagus Nerve The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). Cranial Nerve X,Pneumogastric Nerve,Tenth Cranial Nerve,Nerve X,Nervus Vagus,Cranial Nerve, Tenth,Cranial Nerves, Tenth,Nerve X, Cranial,Nerve Xs,Nerve, Pneumogastric,Nerve, Tenth Cranial,Nerve, Vagus,Nerves, Pneumogastric,Nerves, Tenth Cranial,Nerves, Vagus,Pneumogastric Nerves,Tenth Cranial Nerves,Vagus Nerves,Vagus, Nervus
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D055536 Vagus Nerve Stimulation An adjunctive treatment for PARTIAL EPILEPSY and refractory DEPRESSION that delivers electrical impulses to the brain via the VAGUS NERVE. A battery implanted under the skin supplies the energy. Vagal Nerve Stimulation,Nerve Stimulation, Vagal,Nerve Stimulation, Vagus,Nerve Stimulations, Vagal,Nerve Stimulations, Vagus,Stimulation, Vagal Nerve,Stimulation, Vagus Nerve,Stimulations, Vagal Nerve,Stimulations, Vagus Nerve,Vagal Nerve Stimulations,Vagus Nerve Stimulations
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

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