Non-invasive vagus nerve stimulation decreases vagally mediated heart rate variability

Kaduk, Kristin; Petrella, Alessandro; Müller, Sophie J.; Koenig, Julian; Kroemer, Nils B

doi:10.1101/2023.05.30.542695

Cited by 2 publications

(1 citation statement)

References 83 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…BI is a clinical assessment tool used to measure an individual's ability to independently perform activities of daily living (ADLs). EMG will be recorded automatically by a computer software along with each treatment session, and the ECG features, including heart rate variability (HRV) and heart rate (HR) will be recorded before and after each taVNS treatment session as biomarkers reflecting the activation of vagal tone (33,34). Primary and secondary outcome measures, except for EMG and ECG, will be assessed the day before or at the latest the day after the first session and again after the 14th session.…”

Section: Outcome Measuresmentioning

confidence: 99%

Closed-loop transcutaneous auricular vagus nerve stimulation for the improvement of upper extremity motor function in stroke patients: a study protocol

Xiao,

Li,

et al. 2024

Front. Neurol.

View full text Add to dashboard Cite

BackgroundTranscutaneous auricular vagus nerve stimulation (taVNS) has garnered attention for stroke rehabilitation, with studies demonstrating its benefits when combined with motor rehabilitative training or delivered before motor training. The necessity of concurrently applying taVNS with motor training for post-stroke motor rehabilitation remains unclear. We aimed to investigate the necessity and advantages of applying the taVNS concurrently with motor training by an electromyography (EMG)-triggered closed-loop system for post-stroke rehabilitation.MethodsWe propose a double-blinded, randomized clinical trial involving 150 stroke patients assigned to one of three groups: concurrent taVNS, sequential taVNS, or sham control condition. In the concurrent group, taVNS bursts will synchronize with upper extremity motor movements with EMG-triggered closed-loop system during the rehabilitative training, while in the sequential group, a taVNS session will precede the motor rehabilitative training. TaVNS intensity will be set below the pain threshold for both concurrent and sequential conditions and at zero for the control condition. The primary outcome measure is the Fugl-Meyer Assessment of Upper Extremity (FMA-UE). Secondary measures include standard upper limb function assessments, as well as EMG and electrocardiogram (ECG) features.Ethics and disseminationEthical approval has been granted by the Medical Ethics Committee, affiliated with Zhujiang Hospital of Southern Medical University for Clinical Studies (2023-QX-012-01). This study has been registered on ClinicalTrials (NCT05943431). Signed informed consent will be obtained from all included participants. The findings will be published in peer-reviewed journals and presented at relevant stakeholder conferences and meetings.DiscussionThis study represents a pioneering effort in directly comparing the impact of concurrent taVNS with motor training to that of sequential taVNS with motor training on stroke rehabilitation. Secondly, the incorporation of an EMG-triggered closed-loop taVNS system has enabled the automation and individualization of both taVNS and diverse motor training tasks—a novel approach not explored in previous research. This technological advancement holds promise for delivering more precise and tailored training interventions for stroke patients. However, it is essential to acknowledge a limitation of this study, as it does not delve into examining the neural mechanisms underlying taVNS in the context of post-stroke rehabilitation.

show abstract

Section: Outcome Measuresmentioning

confidence: 99%

Closed-loop transcutaneous auricular vagus nerve stimulation for the improvement of upper extremity motor function in stroke patients: a study protocol

Xiao,

Li,

et al. 2024

Front. Neurol.

View full text Add to dashboard Cite

show abstract

Unraveling the temporal interplay of slow‐paced breathing and prefrontal transcranial direct current stimulation on cardiac indices of autonomic activity

Li,

Schoonjans,

Allaert

et al. 2024

Psychophysiology

View full text Add to dashboard Cite

The neurovisceral integration model proposes that information flows bidirectionally between the brain and the heart via the vagus nerve, indexed by vagally mediated heart rate variability (vmHRV). Voluntary reduction in breathing rate (slow‐paced breathing, SPB, 5.5 Breathing Per Minute (BPM)) can enhance vmHRV. Additionally, prefrontal transcranial direct current stimulation (tDCS) can modulate the excitability of the prefrontal region and influence the vagus nerve. However, research on the combination of SPB and prefrontal tDCS to increase vmHRV and other cardiac (heart rate (HR) and blood pressure) and peripheral (skin conductance) indices is scarce. We hypothesized that the combination of 20 min of SPB and prefrontal tDCS would have a greater effect than each intervention in isolation. Hence, 200 participants were divided into four groups: active tDCS with SPB, active tDCS with 15 BPM breathing, sham tDCS with SPB, and sham tDCS with 15 BPM breathing. Regardless of the tDCS condition, the 5.5 BPM group showed a significant increase in vmHRV over 20 minutes and significant decreases in HR at the first and second 5‐min epochs of the intervention. Regardless of breathing condition, the active tDCS group exhibited higher HR at the fourth 5‐min epoch of the intervention than the sham tDCS group. No other effects were observed. Overall, SPB is a robust technique for increasing vmHRV, whereas prefrontal tDCS may produce effects that counteract those of SPB. More research is necessary to test whether and how SPB and neuromodulation approaches can be combined to improve cardiac vagal tone.

show abstract

Non-invasive vagus nerve stimulation decreases vagally mediated heart rate variability

Cited by 2 publications

References 83 publications

Closed-loop transcutaneous auricular vagus nerve stimulation for the improvement of upper extremity motor function in stroke patients: a study protocol

Closed-loop transcutaneous auricular vagus nerve stimulation for the improvement of upper extremity motor function in stroke patients: a study protocol

Unraveling the temporal interplay of slow‐paced breathing and prefrontal transcranial direct current stimulation on cardiac indices of autonomic activity

Contact Info

Product

Resources

About