Clinical perspectives on vagus nerve stimulation: present and future

Goggins, Eibhlin; Mitani, Shujiro; Tanaka, Shinji

doi:10.1042/cs20210507

Cited by 35 publications

(25 citation statements)

References 120 publications

(124 reference statements)

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“…It plays a major role in maintaining autonomic tone throughout in the brain, the thorax, and the abdomen. The vagus nerve stimulation (VNS), first approved by the US Food and Drug Association (FDA) in 1997 in the form of a cervical implantable device, is currently approved for drug-resistant epilepsy, depression, and morbid obesity 2 , 3 . Further studies have shown promising results that VNS can treat disorders such as anxiety disorder, Alzheimer’s disease, cluster headache, heart failure, sepsis, lung injury, rheumatoid arthritis, inflammatory bowel disease, obesity, and diabetes 4 – 6 .…”

Section: Introductionmentioning

confidence: 99%

“…However, it is impossible to selectively stimulate certain fibers through conventional methods, and efferent branches are unintentionally stimulated together. Efferent branches send parasympathetic cholinergic signals to target organs, including the lungs, digestive tract, and heart 3 . The most critical reports include cardiac events, such as bradycardia and asystole, occurring in approximately 1 per 1000 cases as a result of direct stimulation of the cardiac branches of the vagus nerve 7 .…”

Section: Introductionmentioning

confidence: 99%

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Safety of transcutaneous auricular vagus nerve stimulation (taVNS): a systematic review and meta-analysis

Kim

Marduy

Melo

et al. 2022

Sci Rep

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Transcutaneous auricular vagus nerve stimulation (taVNS) has been investigated as a novel neuromodulation tool. Although taVNS is generally considered safe with only mild and transient adverse effects (AEs), those specifically caused by taVNS have not yet been investigated. This systematic review and meta-analysis on taVNS aimed to (1) systematically analyze study characteristics and AE assessment, (2) characterize and analyze possible AEs and their incidence, (3) search for predictable risk factors, (4) analyze the severity of AE, and (5) suggest an evidence-based taVNS adverse events questionnaire for safety monitoring. The articles searched were published through April 7, 2022, in Medline, Embase, Web of Science, Cochrane, and Lilacs databases. In general, we evaluated 177 studies that assessed 6322 subjects. From these, 55.37% of studies did not mention the presence or absence of any AEs; only 24.86% of the studies described that at least one adverse event occurred. In the 35 studies reporting the number of subjects with at least one adverse event, a meta-analytic approach to calculate the risk differences of developing an adverse event between active taVNS and controls was used. The meta-analytic overall adverse events incidence rate was calculated for the total number of adverse events reported on a 100,000 person-minutes-days scale. There were no differences in risk of developing an adverse event between active taVNS and controls. The incidence of AE, in general, was 12.84/100,000 person-minutes-days of stimulation, and the most frequently reported were ear pain, headache, and tingling. Almost half of the studies did not report the presence or absence of any AEs. We attribute this to the absence of AE in those studies. There was no causal relationship between taVNS and severe adverse events. This is the first systematic review and meta-analysis of transcutaneous auricular stimulation safety. Overall, taVNS is a safe and feasible option for clinical intervention.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety of transcutaneous auricular vagus nerve stimulation (taVNS): a systematic review and meta-analysis

Kim

Marduy

Melo

et al. 2022

Sci Rep

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“…As diseases are already or soon to be diagnosed earlier, minimally invasive VNS modalities should also be proposed as a first-line treatment in several indications [ 54 , 105 ]. Remarkably, transcutaneous auricular VNS was recently advocated for the treatment of endometriosis [ 106 ], which is especially interesting since the diagnosis of endometriosis has become available with a simple salivary test [ 107 ].…”

Section: Discussion: Novel Therapies Targeting Vagus Nerve Stimulatio...mentioning

confidence: 99%

Understanding the Pivotal Role of the Vagus Nerve in Health from Pandemics

Rangon¹,

Niezgoda

2022

Bioengineering

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The COVID-19 pandemic seems endless with the regular emergence of new variants. Is the SARS-CoV-2 virus particularly evasive to the immune system, or is it merely disrupting communication between the body and the brain, thus pre-empting homeostasis? Retrospective analysis of the COVID-19 and AIDS pandemics, as well as prion disease, emphasizes the pivotal but little-known role of the 10th cranial nerve in health. Considering neuroimmunometabolism from the point of view of the vagus nerve, non-invasive bioengineering solutions aiming at monitoring and stimulating the vagal tone are subsequently discussed as the next optimal and global preventive treatments, far beyond pandemics.

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“…Left vagus nerve stimulation (LVNS) has been approved by the Food and Drug Administration (FDA) for the treatment of epilepsy, depression, migraines, cluster headaches, pain, and obesity ( 15 ). Recently, LVNS has been explored for the treatment of PD.…”

Section: Introductionmentioning

confidence: 99%

“…Right vagus nerve stimulation (RVNS) has not been employed for the treatment of brain diseases due to its possible cardiac side effects ( 15 ). However, no studies have reported any incidences of cardiac side effects with RVNS.…”

Section: Introductionmentioning

confidence: 99%

Right vagus nerve stimulation improves motor behavior by exerting neuroprotective effects in Parkinson’s disease rats

Wang¹,

Su²,

Xiao³

et al. 2022

Ann Transl Med

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Background: Parkinson's disease (PD) is a common movement disorder disease. Left vagus nerve stimulation (LVNS) is a potential treatment option for PD. Compared with the left vagus nerve, the right vagus nerve is more closely connected with the midbrain dopaminergic neurons, which are the lesion locations of PD. However, whether right vagus nerve stimulation (RVNS) has a therapeutic effect on PD has not yet been studied. Therefore, in this study, we studied the therapeutic effect and underlying mechanism of RVNS using a PD rat model. Methods:To establish the PD rat model, 8-week-old male Sprague-Dawley rats were intraperitoneally injected with rotenone for 21 days. The cuff electrodes were implanted into the right cervical vagal carotid sheaths of the rats. The right vagus nerve was continuously stimulated for 14 days using a radio stimulation system. Behavioral tests were performed before and after stimulation. Finally, tyrosine hydroxylase (TH), vesicular monoamine transporter 2 (VMAT2), and α-synuclein in the midbrain, including the substantia nigra (SN) and ventral tegmental area (VTA), were detected by immunofluorescence.Results: A markedly lower distance traveled and rearing number was observed in the rotenone, rotenone + sham, and rotenone + RVNS groups compared to the vehicle group. After the stimulation days, the distance traveled and rearing number were both higher in the rotenone + RVNS group compared to the rotenone and rotenone + sham groups (P<0.01, P<0.0001). A remarkable increase in distance traveled and rearing number was observed in the rotenone + RVNS group after stimulation. TH expression in the vehicle group was significantly up-regulated than the other groups. RVNS markedly up-regulated TH expression level. A significantly higher expression of α-synuclein was observed in the rotenone, rotenone + sham, and rotenone + RVNS groups compared to the vehicle group. The expression of α-synuclein was lower in the rotenone + RVNS group compared to the rotenone and rotenone + sham groups. A markedly higher VMAT2 expression was observed in the vehicle group compared to other groups. RVNS significantly up-regulated VMAT2 expression. Conclusions:The improved motor behavior and neuroprotective effects on the midbrain dopaminergic neurons in the PD rat model suggest that RVNS could be used as a potential treatment for PD.

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Clinical perspectives on vagus nerve stimulation: present and future

Cited by 35 publications

References 120 publications

Safety of transcutaneous auricular vagus nerve stimulation (taVNS): a systematic review and meta-analysis

Safety of transcutaneous auricular vagus nerve stimulation (taVNS): a systematic review and meta-analysis

Understanding the Pivotal Role of the Vagus Nerve in Health from Pandemics

Right vagus nerve stimulation improves motor behavior by exerting neuroprotective effects in Parkinson’s disease rats

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