The physiological and neurobiological effects of transcutaneous auricular vagus nerve stimulation (taVNS)

Badran, Bashar W.; Glusman, Chloe E.; Badran, Alan W.; Austelle, Christopher W.; DeVries, William H.; Borckhardt, J.J.; George, Mark S.

doi:10.1016/j.brs.2017.01.118

Cited by 16 publications

(10 citation statements)

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“…Cadaveric studies, of which a limited number exist in the literature, would be the 'gold-standard' approach to studying the cutaneous map of the ABVN and thus there is a need for more such studies to be conducted by individuals with advanced training in microdissection of the head and neck, as the ABVN diameter is only of 1 µm resolution. Teams should also consider age, ethnicity, trauma and prior health history in their selection of cadavers (Badran et al 2018a). fMRI may (in theory) offer a useful surrogate modality for determining the auricular locations that best activate central vagal centres (when compared with the fMRI patterns observed with invasive vagal nerve stimulation), accepting that its use has several limitations.…”

Section: Resultsmentioning

confidence: 99%

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The anatomical basis for transcutaneous auricular vagus nerve stimulation

et al. 2019

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The array of end organ innervations of the vagus nerve, coupled with increased basic science evidence, has led to vagus nerve stimulation (VNS) being explored as a management option in a number of clinical disorders, such as heart failure, migraine and inflammatory bowel disease. Both invasive (surgically implanted) and non‐invasive (transcutaneous) techniques of VNS exist. Transcutaneous VNS (tVNS) delivery systems rely on the cutaneous distribution of vagal afferents, either at the external ear (auricular branch of the vagus nerve) or at the neck (cervical branch of the vagus nerve), thus obviating the need for surgical implantation of a VNS delivery device and facilitating further investigations across a wide range of uses. The concept of electrically stimulating the auricular branch of the vagus nerve (ABVN), which provides somatosensory innervation to several aspects of the external ear, is relatively more recent compared with cervical VNS; thus, there is a relative paucity of literature surrounding its operation and functionality. Despite the increasing body of research exploring the therapeutic uses of auricular transcutaneous VNS (tVNS), a comprehensive review of the cutaneous, intracranial and central distribution of ABVN fibres has not been conducted to date. A review of the literature exploring the neuroanatomical basis of this neuromodulatory therapy is therefore timely. Our review article explores the neuroanatomy of the ABVN with reference to (1) clinical surveys examining Arnold’s reflex, (2) cadaveric studies, (3) fMRI studies, (4) electrophysiological studies, (5) acupuncture studies, (6) retrograde tracing studies and (7) studies measuring changes in autonomic (cardiovascular) parameters in response to auricular tVNS. We also provide an overview of the fibre composition of the ABVN and the effects of auricular tVNS on the central nervous system. Cadaveric studies, of which a limited number exist in the literature, would be the ‘gold‐standard’ approach to studying the cutaneous map of the ABVN; thus, there is a need for more such studies to be conducted. Functional magnetic resonance imaging (fMRI) represents a useful surrogate modality for discerning the auricular sites most likely innervated by the ABVN and the most promising locations for auricular tVNS. However, given the heterogeneity in the results of such investigations and the various limitations of using fMRI, the current literature lacks a clear consensus on the auricular sites that are most densely innervated by the ABVN and whether the brain regions secondarily activated by electrical auricular tVNS depend on specific parameters. At present, it is reasonable to surmise that the concha and inner tragus are suitable locations for vagal modulation. Given the therapeutic potential of auricular tVNS, there remains a need for the cutaneous map of the ABVN to be further refined and the effects of various stimulation parameters and stimulation sites to be determined.

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Section: Resultsmentioning

confidence: 99%

“… Results published in a separate article (Badran et al ) with a different group of healthy participants ( n = 15) …”

Section: Contemporary Studies Exploring the Cutaneous Distribution Ofmentioning

confidence: 99%

The anatomical basis for transcutaneous auricular vagus nerve stimulation

et al. 2019

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“…These findings suggest the tragus is a likely, biologically active target [25]. We proceeded to develop a taVNS system that is compatible with functional magnetic resonance imaging (fMRI) in order to further test the afferent brain activation of electrical stimulation of the tragus.…”

Section: Introductionmentioning

confidence: 99%

“…Our group has conducted a series of safety and parametric physiological work demonstrating the autonomic effects of electrical stimulation of the tragus. These findings suggest the tragus is a likely, biologically active target [25]. We proceeded to develop a taVNS system that is compatible with functional magnetic resonance imaging (fMRI) in order to further test the afferent brain activation of electrical stimulation of the tragus.…”

Section: Introductionmentioning

confidence: 99%

Neurophysiologic effects of transcutaneous auricular vagus nerve stimulation (taVNS) via electrical stimulation of the tragus: A concurrent taVNS/fMRI study and review

et al. 2018

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“…Strategies to control inflammation usually include pharmacological approaches ( 35 – 37 ), but especially given incomplete efficacy and complications in many patients, alternative treatments approaches are relevant. Non-invasive brain stimulation ( 38 – 40 ) and vagus nerve stimulation ( 41 ) have the potential to reduce inflammation. These techniques can be used in the management of psychiatric symptoms associated with the COVID-19 pandemic ( 39 , 42 , 43 ).…”

Section: Introductionmentioning

confidence: 99%

Applications of Non-invasive Neuromodulation for the Management of Disorders Related to COVID-19

et al. 2020

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Background: Novel coronavirus disease (COVID-19) morbidity is not restricted to the respiratory system, but also affects the nervous system. Non-invasive neuromodulation may be useful in the treatment of the disorders associated with COVID-19.Objective: To describe the rationale and empirical basis of the use of non-invasive neuromodulation in the management of patients with COVID-10 and related disorders.Methods: We summarize COVID-19 pathophysiology with emphasis of direct neuroinvasiveness, neuroimmune response and inflammation, autonomic balance and neurological, musculoskeletal and neuropsychiatric sequela. This supports the development of a framework for advancing applications of non-invasive neuromodulation in the management COVID-19 and related disorders.Results: Non-invasive neuromodulation may manage disorders associated with COVID-19 through four pathways: (1) Direct infection mitigation through the stimulation of regions involved in the regulation of systemic anti-inflammatory responses and/or autonomic responses and prevention of neuroinflammation and recovery of respiration; (2) Amelioration of COVID-19 symptoms of musculoskeletal pain and systemic fatigue; (3) Augmenting cognitive and physical rehabilitation following critical illness; and (4) Treating outbreak-related mental distress including neurological and psychiatric disorders exacerbated by surrounding psychosocial stressors related to COVID-19. The selection of the appropriate techniques will depend on the identified target treatment pathway.Conclusion: COVID-19 infection results in a myriad of acute and chronic symptoms, both directly associated with respiratory distress (e.g., rehabilitation) or of yet-to-be-determined etiology (e.g., fatigue). Non-invasive neuromodulation is a toolbox of techniques that based on targeted pathways and empirical evidence (largely in non-COVID-19 patients) can be investigated in the management of patients with COVID-19.

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The physiological and neurobiological effects of transcutaneous auricular vagus nerve stimulation (taVNS)

Cited by 16 publications

References 0 publications

The anatomical basis for transcutaneous auricular vagus nerve stimulation

The anatomical basis for transcutaneous auricular vagus nerve stimulation

Neurophysiologic effects of transcutaneous auricular vagus nerve stimulation (taVNS) via electrical stimulation of the tragus: A concurrent taVNS/fMRI study and review

Applications of Non-invasive Neuromodulation for the Management of Disorders Related to COVID-19

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