Auricular Vagal Nerve Stimulation Improves Constipation by Enhancing Colon Motility via the Central-Vagal Efferent Pathway in Opioid-Induced Constipated Rats

Zhang, Yiling; Lu, Tao; Meng, Yan; Maisiyiti, Alimujiang; Yan, Dong; Li, Shiying; Chen, Yan; Yin, Jieyun; Chen, Jiande D.Z.

doi:10.1111/ner.13406

Cited by 14 publications

(7 citation statements)

References 71 publications

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“…More recent data also show compelling safety and efficacy in children with functional dyspepsia with long-term benefits on disability, pain, and psychological comorbidities (15). Clinical and preclinical data of various auricular neurostimulation interventions suggest a mechanism of action that safely targets autonomic and central pathways (14,(34)(35)(36). Both animal and human data have shown that PENFS stimulates remotely to modulate central pain regions (amygdala/limbic system) and functional brain connectivity (37,38).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Electrical Nerve Field Stimulation for Drug-Refractory Pediatric Cyclic Vomiting Syndrome

Karrento,

Venkatesan,

Zhang

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Background: Cyclic vomiting syndrome (CVS) is a disabling condition frequently refractory to pharmacologic therapy. The aim of this study was to evaluate the effects of noninvasive, auricular percutaneous electrical nerve field stimulation (PENFS) as prophylactic therapy for pediatric CVS. Methods: Children 8–18 years with drug-refractory CVS were prospectively enrolled from a tertiary care CVS clinic. Subjects received 6 consecutive weeks of PENFS. CVS severity was quantified by episode frequency and duration score (range 0–25) at baseline and at extended follow-up (4–6 months after end of therapy). Response was classified as ≥50% improvement in either frequency or duration of attacks at extended follow-up. Subjects also completed validated surveys of nausea, disability, and global response. Results: Thirty subjects completed the study. Median (interquartile range, IQR) age was 10.5 (8.5–15.5) years; 60% were female. At follow-up, 80% met criteria for treatment response with a median (IQR) response duration of 113 (61–182) days. The frequency-duration score improved from baseline median (IQR) 12.0 (9.0–16.0) to 3.0 (1.0–6.0) at follow-up, P < 0.0001. Median (IQR) nausea and disability scores decreased from baseline to week 6: 2.1 (1.3–2.7) to 0.9 (0–1.6), P = 0.003 and 47.5 (41.0–53.0) to 38.0 (16.0–51.0), P = 0.001, respectively. At end of therapy, 66% and 55% patients reported global response of at least “moderately better” and “a good deal better,” respectively. There were no serious side effects. Conclusions: This study suggests long-term benefits of PENFS for children with CVS. PENFS improves several disabling aspects of CVS, including episode frequency, duration, and functional disability.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Electrical Nerve Field Stimulation for Drug-Refractory Pediatric Cyclic Vomiting Syndrome

Karrento,

Venkatesan,

Zhang

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…A method involving the stimulation of the auricular vagal nerve (aVNS), using consistent parameters, was discovered to accelerate the movement of the lower part of the colon, which lacks direct innervation by the vagus nerve. This effect was accompanied by a simultaneous rise in the activity of neurons in the nucleus tractus solitarius (NTS) in a mouse model experiencing constipation induced by opioids [ 132 ]. These observations suggest that aVNS could impact the motility and sensation of the colorectum through both the vago-vagal and vago-sacral routes.…”

Section: Discussionmentioning

confidence: 99%

Neuromodulation and the Gut–Brain Axis: Therapeutic Mechanisms and Implications for Gastrointestinal and Neurological Disorders

Aljeradat,

Kumar,

Abdulmuizz

et al. 2024

Pathophysiology

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The gut–brain axis (GBA) represents a complex, bidirectional communication network that intricately connects the gastrointestinal tract with the central nervous system (CNS). Understanding and intervening in this axis opens a pathway for therapeutic advancements for neurological and gastrointestinal diseases where the GBA has been proposed to play a role in the pathophysiology. In light of this, the current review assesses the effectiveness of neuromodulation techniques in treating neurological and gastrointestinal disorders by modulating the GBA, involving key elements such as gut microbiota, neurotrophic factors, and proinflammatory cytokines. Through a comprehensive literature review encompassing PubMed, Google Scholar, Web of Science, and the Cochrane Library, this research highlights the role played by the GBA in neurological and gastrointestinal diseases, in addition to the impact of neuromodulation on the management of these conditions which include both gastrointestinal (irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and gastroesophageal reflux disease (GERD)) and neurological disorders (Parkinson’s disease (PD), Alzheimer’s disease (AD), autism spectrum disorder (ASD), and neuropsychiatric disorders). Despite existing challenges, the ability of neuromodulation to adjust disrupted neural pathways, alleviate pain, and mitigate inflammation is significant in improving the quality of life for patients, thereby offering exciting prospects for future advancements in patient care.

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“…In a rodent model of opioid-induced constipation, auricular vagal nerve stimulation (aVNS) with similar stimulation parameters was reported to accelerate transit of the distal colon (not innervated with the vagus nerve) with a concurrent increase in activated neurons in the NTS. [ 2 ] These findings suggest that aVNS may alter colorectum motility and sensation via both vago-vagal pathway and vago-sacral pathway.…”

mentioning

confidence: 94%

“…We postulate that these effects were mediated via the vagal-sacral pathway as follows: taVNS activated the nucleus tractus solitarius (NTS) that projected to other parts of the brain to yield an enhanced sacral efferent activity, acting on the rectum and anal sphincter. In a rodent model of opioid-induced constipation, auricular vagal nerve stimulation (aVNS) with similar stimulation parameters was reported to accelerate transit of the distal colon (not innervated with the vagus nerve) with a concurrent increase in activated neurons in the NTS [2] . These findings suggest that aVNS may alter colorectum motility and sensation via both vago-vagal pathway and vago-sacral pathway.…”

mentioning

confidence: 95%

Parasympathetic control of gastrointestinal motility and cross-branch actions of parasympathetic neuromodulation

Chen¹

2023

Chinese Medical Journal

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Auricular Vagal Nerve Stimulation Improves Constipation by Enhancing Colon Motility via the Central-Vagal Efferent Pathway in Opioid-Induced Constipated Rats

Cited by 14 publications

References 71 publications

Percutaneous Electrical Nerve Field Stimulation for Drug-Refractory Pediatric Cyclic Vomiting Syndrome

Percutaneous Electrical Nerve Field Stimulation for Drug-Refractory Pediatric Cyclic Vomiting Syndrome

Neuromodulation and the Gut–Brain Axis: Therapeutic Mechanisms and Implications for Gastrointestinal and Neurological Disorders

Parasympathetic control of gastrointestinal motility and cross-branch actions of parasympathetic neuromodulation

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