Direct and Transcutaneous Vagus Nerve Stimulation for Treatment of Tinnitus: A Scoping Review

Yakunina, Natalia; Nam, Eui-Cheol

doi:10.3389/fnins.2021.680590

Cited by 20 publications

(15 citation statements)

References 108 publications

(178 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most studies used the left auricular branch of the vagus nerve as the stimulated sites, except one A common frequency of 20 or 25 Hz is used in these studies. It is common for the stimulation current to be set according to a subject's sensitivity or just below their pain threshold (Frangos et al, 2015;Lerman et al, 2016;Yakunina et al, 2018;Sclocco et al, 2020;Yakunina and Nam, 2021). Studies gradually raised stimulation intensity by 0.1 mA increments until the maximum level reported by participants (Redgrave J.N.…”

Section: Stimulation Parametersmentioning

confidence: 99%

“…fMRI studies have shown that nVNS increases neural activity more than sham stimulation in the left prefrontal cortex, right caudate, mid-cingulate and cerebellum ( Badran et al, 2018 ). It also decreases functional connectivity between the posterior cingulate cortex and the lingual gyrus ( Zhao B. et al, 2019 ), and suppresses processes to generate tinnitus ( Yakunina et al, 2018 ; Yakunina and Nam, 2021 ).…”

Section: Vagus Nerve Stimulationmentioning

confidence: 99%

See 1 more Smart Citation

Non-invasive Vagus Nerve Stimulation in Cerebral Stroke: Current Status and Future Perspectives

Wang

Pan

et al. 2022

Front. Neurosci.

View full text Add to dashboard Cite

Stroke poses a serious threat to human health and burdens both society and the healthcare system. Standard rehabilitative therapies may not be effective in improving functions after stroke, so alternative strategies are needed. The FDA has approved vagus nerve stimulation (VNS) for the treatment of epilepsy, migraines, and depression. Recent studies have demonstrated that VNS can facilitate the benefits of rehabilitation interventions. VNS coupled with upper limb rehabilitation enhances the recovery of upper limb function in patients with chronic stroke. However, its invasive nature limits its clinical application. Researchers have developed a non-invasive method to stimulate the vagus nerve (non-invasive vagus nerve stimulation, nVNS). It has been suggested that nVNS coupled with rehabilitation could be a promising alternative for improving muscle function in chronic stroke patients. In this article, we review the current researches in preclinical and clinical studies as well as the potential applications of nVNS in stroke. We summarize the parameters, advantages, potential mechanisms, and adverse effects of current nVNS applications, as well as the future challenges and directions for nVNS in cerebral stroke treatment. These studies indicate that nVNS has promising efficacy in reducing stroke volume and attenuating neurological deficits in ischemic stroke models. While more basic and clinical research is required to fully understand its mechanisms of efficacy, especially Phase III trials with a large number of patients, these data suggest that nVNS can be applied easily not only as a possible secondary prophylactic treatment in chronic cerebral stroke, but also as a promising adjunctive treatment in acute cerebral stroke in the near future.

show abstract

Section: Stimulation Parametersmentioning

confidence: 99%

Section: Vagus Nerve Stimulationmentioning

confidence: 99%

Non-invasive Vagus Nerve Stimulation in Cerebral Stroke: Current Status and Future Perspectives

Wang

Pan

et al. 2022

Front. Neurosci.

View full text Add to dashboard Cite

show abstract

“…Previous studies have revealed that tVNS could regulate the function of DMN in both physiological and pathological conditions (Kraus et al, 2007;Badran et al, 2018;Wang et al, 2018;Yap et al, 2020;Yakunina and Nam, 2021). Further studies suggested that tVNS would inhibit pain response through the DMN (Usichenko et al, 2017;Guo et al, 2020).…”

Section: Discussionmentioning

confidence: 96%

Predicting response to tVNS in patients with migraine using functional MRI: A voxels-based machine learning analysis

Zhang

et al. 2022

Front. Neurosci.

View full text Add to dashboard Cite

BackgroundMigraine is a common disorder, affecting many patients. However, for one thing, lacking objective biomarkers, misdiagnosis, and missed diagnosis happen occasionally. For another, though transcutaneous vagus nerve stimulation (tVNS) could alleviate migraine symptoms, the individual difference of tVNS efficacy in migraineurs hamper the clinical application of tVNS. Therefore, it is necessary to identify biomarkers to discriminate migraineurs as well as select patients suitable for tVNS treatment.MethodsA total of 70 patients diagnosed with migraine without aura (MWoA) and 70 matched healthy controls were recruited to complete fMRI scanning. In study 1, the fractional amplitude of low-frequency fluctuation (fALFF) of each voxel was calculated, and the differences between healthy controls and MWoA were compared. Meaningful voxels were extracted as features for discriminating model construction by a support vector machine. The performance of the discriminating model was assessed by accuracy, sensitivity, and specificity. In addition, a mask of these significant brain regions was generated for further analysis. Then, in study 2, 33 of the 70 patients with MWoA in study 1 receiving real tVNS were included to construct the predicting model in the generated mask. Discriminative features of the discriminating model in study 1 were used to predict the reduction of attack frequency after a 4-week tVNS treatment by support vector regression. A correlation coefficient between predicted value and actual value of the reduction of migraine attack frequency was conducted in 33 patients to assess the performance of predicting model after tVNS treatment. We vislized the distribution of the predictive voxels as well as investigated the association between fALFF change (post-per treatment) of predict weight brain regions and clinical outcomes (frequency of migraine attack) in the real group.ResultsA biomarker containing 3,650 features was identified with an accuracy of 79.3%, sensitivity of 78.6%, and specificity of 80.0% (p < 0.002). The discriminative features were found in the trigeminal cervical complex/rostral ventromedial medulla (TCC/RVM), thalamus, medial prefrontal cortex (mPFC), and temporal gyrus. Then, 70 of 3,650 discriminative features were identified to predict the reduction of attack frequency after tVNS treatment with a correlation coefficient of 0.36 (p = 0.03). The 70 predictive features were involved in TCC/RVM, mPFC, temporal gyrus, middle cingulate cortex (MCC), and insula. The reduction of migraine attack frequency had a positive correlation with right TCC/RVM (r = 0.433, p = 0.021), left MCC (r = 0.451, p = 0.016), and bilateral mPFC (r = 0.416, p = 0.028), and negative with left insula (r = −0.473, p = 0.011) and right superior temporal gyrus/middle temporal gyrus (r = −0.684, p < 0.001), respectively.ConclusionsBy machine learning, the study proposed two potential biomarkers that could discriminate patients with MWoA and predict the efficacy of tVNS in reducing migraine attack frequency. The pivotal features were mainly located in the TCC/RVM, thalamus, mPFC, and temporal gyrus.

show abstract

“…The concept of bimodal auditory and central stimulation has already been investigated by combinations of acoustic stimulation/ sound therapies with transcranial direct current stimulation, likewise demonstrating inconclusive findings so far [53][54][55]. However, acoustic stimulation combined with stimulation of cranial nerves such as the vagus or the trigeminal nerve shows promising findings [56][57][58][59].…”

Section: Discussionmentioning

confidence: 99%

Activate & fire: a feasibility study in combining acoustic stimulation and continuous theta burst stimulation in chronic tinnitus

et al. 2023

View full text Add to dashboard Cite

Background Low frequency repetitive transcranial magnetic stimulation (rTMS) is commonly used to inhibit pathological hyperactivity of the auditory cortex in tinnitus. Novel and supposedly superior and faster inhibitory protocols such as continuous theta burst stimulation (cTBS) were examined as well, but so far there is not sufficient evidence for a treatment application in chronic tinnitus. rTMS effects in general are dependent on the brain state immediate before stimulation. This feasibility study was designed based on the concept to shift the pathological intrinsic brain state of tinnitus patients via acoustic stimulation (“activate”) and induce inhibitory effects via cTBS (“fire”). Methods Seven tinnitus patients with response in residual inhibition received 10 consecutive daily sessions of a combinatory treatment comprised of 3-minute acoustic stimulation with white noise followed by 600 pulses of cTBS over the left temporo-parietal cortex (activate & fire). A control group of 5 patients was treated parallel to the activate & fire data collection with 10 sessions á 3000 pulses of 1 Hz rTMS over the left temporo-parietal cortex. Results The activate & fire protocol was well tolerated except in one patient with tinnitus loudness increase. This patient was excluded from analyses. No statistical superiority of the activate & fire treatment approach in alleviating tinnitus-related symptoms was evident. Power calculations showed an effect size of 0.706 and a needed sample size of 66 for statistical significant group differences. On a descriptive level the activate & fire group demonstrated a stronger decrease in tinnitus-related symptoms. Conclusion The present feasibility study showed that combining acoustic stimulation with magnetic brain stimulation may be well-tolerable in the majority of patients and represents a promising treatment approach for tinnitus by hypothetically alter the intrinsic state prior to brain stimulation.

show abstract

Direct and Transcutaneous Vagus Nerve Stimulation for Treatment of Tinnitus: A Scoping Review

Cited by 20 publications

References 108 publications

Non-invasive Vagus Nerve Stimulation in Cerebral Stroke: Current Status and Future Perspectives

Non-invasive Vagus Nerve Stimulation in Cerebral Stroke: Current Status and Future Perspectives

Predicting response to tVNS in patients with migraine using functional MRI: A voxels-based machine learning analysis

Activate & fire: a feasibility study in combining acoustic stimulation and continuous theta burst stimulation in chronic tinnitus

Contact Info

Product

Resources

About