Non-invasive vagus nerve stimulation reduces sympathetic preponderance in patients with tinnitus

Abstract

The pre-treatment HRV recording showed sympathetic preponderance/reduced parasympathetic activity in about three quarters (73%) of patients. Active tVNS significantly increased variability of R-R intervals in 75% of patients and HRV age was decreased in 70% of patients. Either the variability of R-R intervals was increased or the HRV age decreased in 90% of the patients. These results indicate that tVNS can induce a shift in ANS function from sympathetic preponderance towards parasympathetic predominance. tVNS caused no major morbidity, and heart rate monitoring during the tVNS treatment showed no cardiac or circulatory effects (e.g. bradycardia) in any of the patients.

A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment

“…By this mechanism, vagus nerve stimulation, paired with sound stimuli (to promote reorganisation in the auditory cortex), is a hypothesised treatment for tinnitus. Experimental studies have examined the safety and efficacy of vagus nerve stimulation, both direct (i. e. implanted electrode) and transcutaneous, paired with acoustic stimulation for tinnitus [108,129,134,136,178]. Tyler et al [171] conducted a prospective randomised double-blind controlled pilot study of the effects of direct vagus nerve stimulation paired with tones on tinnitus.…”

Intestinal macrophages and their interaction with the enteric nervous system in health and inflammatory bowel disease

“…One of these techniques involves transcutaneous activation of the vagus nerve via the auricular concha innervated by vagal afferents . Several studies showed that transcutaneous VNS (ta‐VNS) can induce a shift in autonomic function towards increased vagal tone and reduce inflammatory cytokine release in whole blood in healthy volunteers and tinnitus patients. fMRI evidence further substantiated the fact that transcutaneous VNS can activate “classical” central vagal projections including NTS, locus coeruleus, PVN and amydgdala .…”

Non-invasive biomarkers of fetal brain development reflecting prenatal stress: An integrative multi-scale multi-species perspective on data collection and analysis

“…(Borovikova et al, 2000;Kwan et al, 2016;Pavlov & Tracey, 2017) VNS reduced sympathetic tone, stress-induced anxiety behaviors and depression symptoms in animal models and in clinical studies. (O'Keane et al, 2005;George et al, 2008;Caliskan & Albrecht, 2013;Liu et al, 2013;Clancy et al, 2014;Pena et al, 2014;Ylikoski et al, 2017) VNS is thought to facilitate tonic inhibition of the basolateral amygdala by the infralimbic region of the medial prefrontal cortex, which results in reduced fear response. (Caliskan & Albrecht, 2013) VNS increases CRH expression in hypothalamus (Hosoi et al, 2000) and CRH receptor 1 agonism increases vagal modulation of HRV.…”

“…Notably, novel non-invasive methods of VNS are being developed which will not require surgical cervical VNS implants, have minimal to no side effects, and are low-cost. (Liu et al, 2013;Clancy et al, 2014;Frangos et al, 2015;Ylikoski et al, 2017) , It is now possible to conceive of VNS treatment of neonates.…”