Effect of a 10-day transcutaneous trigeminal nerve stimulation (TNS) protocol for depression amelioration: A randomized, double blind, and sham-controlled phase II clinical trial

Generoso, Marcelo Bruno; Taiar, Ivan; Garrocini, Lucas P.; Ribeiro, Rafael Bernardon; Cordeiro, Quirino; Uchida, Ricardo Riyoiti; Shiozawa, Pedro

doi:10.1016/j.yebeh.2019.03.025

Cited by 22 publications

(16 citation statements)

References 18 publications

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“…To answer this question, we investigated whether and how transcutaneous trigeminal nerve stimulation (TNS) modulates the HBR in healthy subjects. The TNS paradigm chosen to activate trigeminal afferents has been recently standardized in physiological [27][28][29][30] and pathological conditions, such as neuropsychiatric disorders [31][32][33][34] , where TNS is widely used as a neuromodulation treatment method 35,36 .…”

Section: Transcutaneous Trigeminal Nerve Stimulation Modulates the Hamentioning

confidence: 99%

Transcutaneous trigeminal nerve stimulation modulates the hand blink reflex

Mercante

Loi

Ginatempo

et al. 2020

Sci Rep

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The hand-blink reflex (HBR) is a subcortical response, elicited by the electrical stimulation of the median nerve, whose magnitude is specifically modulated according to the spatial properties of the defensive peripersonal space (DPPS) of the face. For these reasons, the HBR is commonly used as a model to assess the DPPS of the face. Little is known on the effects induced by the activation of cutaneous afferents from the face on the DPPS of the face. Therefore, we tested the effect of non-painful transcutaneous trigeminal nerve stimulation (TNS) on the amplitude of the HBR. Fifteen healthy participants underwent HBR recording before and after 20 min of sham- and real-TNS delivered bilaterally to the infraorbital nerve in two separate sessions. The HBR was recorded bilaterally from the orbicularis oculi muscles, following non-painful median nerve stimulation at the wrist. The HBR amplitude was assessed in the “hand‐far” and “hand‐near” conditions, relative to the hand position in respect to the face. The amplitudes of the hand-far and hand-near HBR were measured bilaterally before and after sham- and real-TNS. Real-TNS significantly reduced the magnitude of the HBR, while sham-TNS had no significant effect. The inhibitory effect of TNS was of similar extent on both the hand-far and hand-near components of the HBR, which suggests an action exerted mainly at brainstem level.

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Section: Transcutaneous Trigeminal Nerve Stimulation Modulates the Hamentioning

confidence: 99%

Transcutaneous trigeminal nerve stimulation modulates the hand blink reflex

Mercante

Loi

Ginatempo

et al. 2020

Sci Rep

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“…It seems possible that transauricular vagal stimulation of the vagus is capable of activating in addition to the cardioregulatory vagal nuclei also the noradrenergic truncated encephalic structures of the locus coeruleus and the serotonergic structures of the raphe [ 44 ]. On the other hand, transcutaneous trigeminal electrical stimulation also appears to involve, various central effects: modulating cortical activity in both healthy subjects and those with drug-resistant epilepsy [ 45 , 46 ] probably by increasing perfusion in temporal and parietal areas [ 47 ]; modulating brainstem activities acting the descending pain pathways [ 48 ]; interacting, in a way still not well known, probably on the arousal network that presides over the cortical integration of the control of affective emotional expressions [ 8 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

“…Transcutaneous trigeminal stimulation together with vagus stimulation has been used in recent years to treat a number of neurological disorders on the basis of a mechanism of action that is not well elucidated but may involve trigeminal vagal connections with arousal circuits [ 5 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Trigeminal electrical stimulation with ULFTENS of the dorsal anterior mucosal surface of the tongue: Effects on Heart Rate Variability (HRV)

Monaco,

Cattaneo,

Smurra

et al. 2023

PLoS ONE

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Background Trigeminal electrical stimulation of the dorsal anterior mucosal surface of the tongue has demonstrated its efficacy in a variety of neurological disorders in which anatomical or functional alterations are present. The pathogenesis of such disorders is often linked to altered arousal circuits, and the benefits of tongue stimulation are attributed to the rebalancing of this system. Dental ULFTENS shows efficacy in acting on the muscular, autonomic system and control of the descending pathways that modulate pain. It is administered at the skin level in the area anterior to the tragus and not on the mucosal surface of the tongue. The use of this stimulation technique at the tongue level could have new applications and clinical results if it were able to reduce the activity of arousal circuits. Material and method A new intraoral device allowed electrical stimulation of the dorsal anterior mucosa of the tongue in 32 healthy young women. The effects on HRV were monitored by photoplethysmographic wave (PPG) and compared with a control group. The HRV parameters studied were RMSSD, HF, LF, LF/HF, REC, DET. Results The group of stimulated subjects showed a significant change in some of the HRV parameters that was maintained even in the epoch after the end of electrical stimulation. This effect can be considered as a vagal activation and a change of HRV trend. The control group of unstimulated subjects showed an opposite trend. There were no undesirable or annoying effects of stimulation. Conclusion Stimulation of the dorsal anterior (trigeminal) mucosal surface of the tongue with ULFTENS applied with an intraoral device was shown to be able to increase HRV.

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“…The form of stimulus for tDCS is a direct current; electrodes can be put in several regions but the dorsolateral prefrontal cortex (DLPFC) is the most common target brain region in the literature (Mehrsafar, Rosa, Zadeh, & Gazerani, 2020; Wolkenstein, Zeiller, Kanske, & Plewnia, 2014). Among other treatment options, transcranial alternating current stimulation, transcranial random noise stimulation (these two treatments are similar to tDCS in their current ranges and electrode placement but their waveforms are distinct) and percutaneous mastoid electrical stimulation are focused on the stimulation of the central nervous system with different waveforms; transcutaneous VNS and trigeminal nerve stimulation are techniques that stimulate the peripheral nervous system (the targeted areas of these two treatments are the cranial nerves) (Generoso et al, 2019; Guleyupoglu et al, 2013; Hein et al, 2013; Lu et al, 2020; Reed & Cohen Kadosh, 2018; Shiozawa, da Silva, Netto, Taiar, & Cordeiro, 2015). The effects of these therapies have been widely investigated on depression, anxiety and sleep disturbance in the psychiatric field (Kosari, Dadashi, Maghbouli, & Mostafavi, 2019; Lin et al, 2021; Morriss, Xydopoulos, Craven, Price, & Fordham, 2019; Taremian, Nazari, Moradveisi, & Moloodi, 2019; Wagenseil, Garcia, Suvorov, Fietze, & Penzel, 2018; Yennurajalingam et al, 2018; Zanardi et al, 2020; Zhou et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

The efficacy of non-invasive, non-convulsive electrical neuromodulation on depression, anxiety and sleep disturbance: a systematic review and meta-analysis

Cheng

Kuo

et al. 2022

Psychol. Med.

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The effects of non-invasive, non-convulsive electrical neuromodulation (NINCEN) on depression, anxiety and sleep disturbance are inconsistent in different studies. Previous meta-analyses on transcranial direct current stimulation (tDCS) and cerebral electrotherapy stimulation (CES) suggested that these methods are effective on depression. However, not all types of NINECN were included; results on anxiety and sleep disturbance were lacking and the influence of different populations and treatment parameters was not completely analyzed. We searched PubMed, Embase, PsycInfo, PsycArticles and CINAHL before March 2021 and included published randomized clinical trials of all types of NINCEN for symptoms of depression, anxiety and sleep in clinical and non-clinical populations. Data were pooled using a random-effects model. The main outcome was change in the severity of depressive symptoms after NINCEN treatment. A total of 58 studies on NINCEN were included in the meta-analysis. Active tDCS showed a significant effect on depressive symptoms (Hedges' g = 0.544), anxiety (Hedges' g = 0.667) and response rate (odds ratio = 1.9594) compared to sham control. CES also had a significant effect on depression (Hedges' g = 0.654) and anxiety (Hedges' g = 0.711). For all types of NINCEN, active stimulation was significantly effective on depression, anxiety, sleep efficiency, sleep latency, total sleep time, etc. Our results showed that tDCS has significant effects on both depression and anxiety and that these effects are robust for different populations and treatment parameters. The rational expectation of the tDCS effect is ‘response’ rather than ‘remission’. CES also is effective for depression and anxiety, especially in patients with disorders of low severity.

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Effect of a 10-day transcutaneous trigeminal nerve stimulation (TNS) protocol for depression amelioration: A randomized, double blind, and sham-controlled phase II clinical trial

Cited by 22 publications

References 18 publications

Transcutaneous trigeminal nerve stimulation modulates the hand blink reflex

Transcutaneous trigeminal nerve stimulation modulates the hand blink reflex

Trigeminal electrical stimulation with ULFTENS of the dorsal anterior mucosal surface of the tongue: Effects on Heart Rate Variability (HRV)

The efficacy of non-invasive, non-convulsive electrical neuromodulation on depression, anxiety and sleep disturbance: a systematic review and meta-analysis

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