Non-invasive Vagus Nerve Stimulation in Healthy Humans Reduces Sympathetic Nerve Activity

Clancy, Jennifer A.; Mary, David A.S.G.; Witte, Klaus K.; Greenwood, John P; Deuchars, Susan A.; Deuchars, Jim

doi:10.1016/j.brs.2014.07.031

Cited by 340 publications

(397 citation statements)

References 51 publications

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“…In healthy human volunteers with no history of cardiovascular disease, tVNS on the inner and outer surface of the tragus significantly improved heart rate variability (through a shift in cardiac autonomic activity towards relative parasympathetic/vagal dominance) and caused a significant decrease in muscle sympathetic nerve activity as recorded by microneurography (Clancy et al, 2014). Further evidence that electrical stimulation of the ABVN can elicit a decrease in sympathetic activity comes from a study by Wang et al (2014), where a reduction in plasma noradrenaline concentration was observed following bilateral tragus stimulation in conscious dogs with healed myocardial infarction (Wang et al, 2014).…”

Section: Mechanism Of Action Of Tvns On Cardiac Functionmentioning

confidence: 96%

“…In recent years the major sites of interest for delivering electrical stimulation to the ABVN have been the inner surface of the tragus (Busch et al, 2013;Clancy et al, 2014;Kraus et al, 2013;Stavrakis et al, 2015;Weise et al, 2015;Zhou et al, 2016), the concha (Ay et al, 2015b;Fang et al, 2015;He et al, 2013b;Liu et al, 2013), and the cymba concha (Frangos et al, 2015;Kreuzer et al, 2014). In parallel with these ear studies, a method said to allow non-invasive cervical vagus nerve stimulation through the skin of the neck has also been developed and is under investigation in patients with cluster headache (Nesbitt et al, 2015) and migraine (Barbanti et al, 2015).…”

Section: Cardiac Effects Of Tvnsmentioning

confidence: 99%

“…A key consideration is that tVNS increases heart rate variability and, critically, decreases muscle sympathetic nerve activity in healthy humans (Clancy et al, 2014). Further, such cardiovascular diseases are associated with increased inflammation and tVNS reduced plasma levels of non-specific inflammatory markers in conscious dogs with healed myocardial infarction (Wang et al, 2014;Wang et al, 2015), as well as in patients with paroxysmal atrial fibrillation (Stavrakis et al, 2015).…”

Section: Tvns and Not Vns?mentioning

confidence: 99%

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The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control

Murray

Atkinson

Mahadi

et al. 2016

Autonomic Neuroscience

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The human ear seems an unlikely candidate for therapies aimed at improving cardiac function, but the ear and the heart share a common connection: the vagus nerve. In recent years there has been increasing interest in the auricular branch of the vagus nerve (ABVN), a unique cutaneous subdivision of the vagus distributed to the external ear. Non-invasive electrical stimulation of this nerve through the skin may offer a simple, cost-effective alternative to the established method of vagus nerve stimulation (VNS), which requires a surgical procedure and has generated mixed results in a number of clinical trials for heart failure. This review discusses the available evidence in support of modulating cardiac activity using this strange auricular nerve.

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Section: Mechanism Of Action Of Tvns On Cardiac Functionmentioning

confidence: 96%

Section: Cardiac Effects Of Tvnsmentioning

confidence: 99%

Section: Tvns and Not Vns?mentioning

confidence: 99%

See 1 more Smart Citation

The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control

Murray

Atkinson

Mahadi

et al. 2016

Autonomic Neuroscience

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“…Microneurographic recordings showed a significant decrease in frequency and incidence of muscle sympathetic nerve activity. The study showed tVNS can increase HRV and reduce sympathetic nerve outflow [26]. In a study including 9 people with refractory epilepsy, the initiation or resumption of VNS following battery replacement was associated with a significant decrease in LF and LF:HF ratio indicating a change in autonomic balance in favour of parasympathetic dominance [27].…”

Section: Vns Effects On Parasympathetic Vagal Tonementioning

confidence: 89%

Can natural ways to stimulate the vagus nerve improve seizure control?

Yuen

Sander

2017

Epilepsy & Behavior

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The vagus nerve (VN) is the longest cranial nerve innervating the neck, thorax and abdomen, with afferent fibres transmitting a range of interoceptive stimuli and efferent fibres to somatic structures and autonomic preganglions. Over the last few decades, electrical stimulation of the VN using implanted devices (VNS) has been developed leading to its approval for the treatment of epilepsy and depression. More recently non-invasive devices to stimulation the VN have been developed. The VN has many functions and the activity that is most amenable to assessment is its effect in controlling the cardiac rhythm. This can be easily assessed by measuring heart rate variability (HRV). Decreased HRV is a result of poorer vagal parasympathetic tone and is associated with a wide range of ill health conditions including a higher risk of early mortality. People with epilepsy, particularly those with poorly controlled seizures have been shown to have impaired parasympathetic tone. So, might natural ways to stimulate the VN, shown to improve parasympathetic tone as indicated by increased HRV, improve seizure control? There are numerous natural ways that have been shown to stimulate the VN, improving HRV and hence parasympathetic tone. These natural ways fall mainly into 3 categories -stress reduction, exercise and nutrition. Though the natural ways to stimulate the VN have been shown to increase HRV, they have not been shown to reduce seizures. The exception is listening to Mozart's music which has been shown to increase parasympathetic tone and decrease seizures. Clearly much more work is required to examine the effect of the various ways to increase HRV on seizure occurrence.

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“…Lastly, the effect of tVNS may be influenced by age. A previous study has suggested that sedentary or old populations reduced parasympathetic activity compared with healthy participants [18] . However, only two of the patients included in this study were of 60 years of age or older.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Stimulus Intensity in Transcutaneous Vagus Nerve Stimulation for Chronic Tinnitus

et al. 2018

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OBJECTIVES:We aimed to assess the clinical significance of the intensity of transcutaneous vagus nerve stimulation (tVNS) in chronic tinnitus. MATERIALS and METHODS:Four sessions of tVNS were performed over a 2-week period for 24 patients with unilateral, non-pulsatile chronic tinnitus. The cavum, cymba, and tragus were sequentially stimulated to the maximal sensory thresholds. One month later, after the four sessions, the level of tinnitus distress and changes in stimulus intensity were assessed. RESULTS:The stimulus intensity did not differ according to sex or laterality. However, a moderate positive correlation between tinnitus distress and the initial stimulus intensity was observed. This correlation was not observed during the subsequent sessions. The stimulus intensity at the cavum changed significantly (p=0.018), and notable differences in tinnitus annoyance were observed between the responders and non-responders (p=0.006). CONCLUSION:The effect of stimulus intensity on the treatment outcome seems to be limited. An increasing trend in the stimulus intensity for tinnitus annoyance at the cavum was observed in the responders. Therefore, the cavum may be an optimal stimulation site for tVNS.

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Non-invasive Vagus Nerve Stimulation in Healthy Humans Reduces Sympathetic Nerve Activity

Abstract: Background: Vagus nerve stimulation (VNS) is currently used to treat refractory

Cited by 340 publications

References 51 publications

The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control

The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control

Can natural ways to stimulate the vagus nerve improve seizure control?

Characteristics of Stimulus Intensity in Transcutaneous Vagus Nerve Stimulation for Chronic Tinnitus

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