Use of Transcutaneous Auricular Vagus Nerve Stimulation as an Adjuvant Therapy for the Depressive Symptoms of COVID-19: A Literature Review

Guo, Zhiming; Sörös, Peter; Zhang, Zhuqing; Yang, Ming-Hao; Liao, Dan; Liu, Chunhong

doi:10.3389/fpsyt.2021.765106

Cited by 9 publications

(11 citation statements)

References 142 publications

(160 reference statements)

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“…To the best of our knowledge, this is the first prospective randomised study using aVNS in patients with critical Covid-19. Although the potential positive impact of vagus nerve stimulation on cytokine storm in patients with severe Covid-19 was often discussed ( Bonaz et al, 2020a , 2020b ; Bara, de Ridder and Maciaczyk, 2020 ; Kaniusas and Szeles, 2020b ; Guo et al, 2021 ; Wang et al, 2022 ), clinical data is scarce. Boezaart et al reported two cases of patients with severe Covid-19 receiving transcutaneous aVNS in addition to standard of care in which case a rapid decrease of IL-6 was observed and aVNS was well tolerated ( Boezaart and Botha, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Auricular Vagus Nerve Stimulation Reduces Inflammation in Critical Covid-19 Patients

Seitz

Széles²,

Kitzberger³

et al. 2022

Front. Physiol.

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Covid-19 is an infectious disease associated with cytokine storms and derailed sympatho-vagal balance leading to respiratory distress, hypoxemia and cardiovascular damage. We applied the auricular vagus nerve stimulation to modulate the parasympathetic nervous system, activate the associated anti-inflammatory pathways, and reestablish the abnormal sympatho-vagal balance. aVNS is performed percutaneously using miniature needle electrodes in ear regions innervated by the auricular vagus nerve. In terms of a randomized prospective study, chronic aVNS is started in critical, but not yet ventilated Covid-19 patients during their stay at the intensive care unit. The results show decreased pro-inflammatory parameters, e.g. a reduction of CRP levels by 32% after 1 day of aVNS and 80% over 7 days (from the mean 151.9 mg/dl to 31.5 mg/dl) or similarly a reduction of TNFalpha levels by 58.1% over 7 days (from a mean 19.3 pg/ml to 8.1 pg/ml) and coagulation parameters, e.g. reduction of DDIMER levels by 66% over 7 days (from a mean 4.5 μg/ml to 1.5 μg/ml) and increased anti-inflammatory parameters, e.g. an increase of IL-10 levels by 66% over 7 days (from the mean 2.7 pg/ml to 7 pg/ml) over the aVNS duration without collateral effects. aVNS proved to be a safe clinical procedure and could effectively supplement treatment of critical Covid-19 patients while preventing devastating over-inflammation.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Auricular Vagus Nerve Stimulation Reduces Inflammation in Critical Covid-19 Patients

Seitz

Széles²,

Kitzberger³

et al. 2022

Front. Physiol.

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“…Most of them are far from routine clinical practice such as immunopsychiatric strategies [51] or natural molecules such as luteolin or quercitin which appear promising and safe [55,56]. Use of transcutaneous auricular vagus nerve treatments could also help treat depressive symptoms with a good tolerance [58]. However, without any clinical trial, these therapeutics remain hypothetical and should be explored in clinical trials.…”

Section: Discussionmentioning

confidence: 99%

“…This is derived from auricular acupuncture, widely used in China [57]. These authors suggest an efficacy of taVNS on post-COVID-19 depression that involves a cholinergic anti-inflammatory pathway and modulates brain circuits via the hypothalamic-pituitary-adrenal axis [58].…”

Section: Alternative Therapeutic Devicesmentioning

confidence: 99%

“…• Some authors proposed adapting an existing cognitive behavioral therapy (CBT) manual for CFS to post-COVID-19 syndrome and called it "Fit after COVID" [58]. This psychotherapy consists of up to nine modules organized over a period of 17 weeks including an introductory module, an evaluation module to set treatment goals, and seven modules that address fatigue-perpetuating factors.…”

Section: Psychotherapeutic Treatment and Other Nonpharmacological Int...mentioning

confidence: 99%

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Update of the Potential Treatments for Psychiatric and Neuropsychiatric Symptoms in the Context of the Post-COVID-19 Condition: Still a Lot of Suffering and Many More Things to Learn

Benzakour

Bondolfi

2022

Trauma Care

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Background: The World Health Organization (WHO) has defined a post-COVID-19 condition. Some of these symptoms can be categorized as psychiatric long COVID-19 if they appeared in the aftermath of COVID-19, including depression, anxiety, post-traumatic stress disorder, somatic symptoms disorders such as hyperventilation syndrome, fatigue, cognitive and sleep disorders. Psychiatric and neuropsychiatric post-COVID-19 present mental health specialists with difficult challenges because of its complexity and the multiple ways in which it integrates into a singular somatic context. Methods: We conducted a systematic research paradigm from SARS-CoV-2 using LitCOVID and Web of Science to search management strategies and potential treatments for psychiatric post-COVID-19 symptoms. Results: Management strategies must be based on a multidisciplinary approach to promote the global evaluation of psychiatric and physical symptoms, systematic detection and prevention. Selective serotonin reuptake inhibitors appear to be the best choice to treat post-COVID-19 depression and anxiety disorders, and tofisopam could be helpful for anxiety. Cognitive behavioral therapy techniques adjusted to post-COVID-19 fatigue, functional remediation, extracorporeal apheresis, transcutaneous auricular vagus nerve stimulation, monoclonal antibodies, flavonoids, oxytocin or L-carnitine all represent hypothetical therapeutic avenues that remain to be evaluated in clinical trials. Conclusions: Psychiatric and neuropsychiatric post-COVID-19 symptoms occur frequently and are debilitating. Attention should be paid to this condition and studies undertaken to specify the effective treatments.

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“…For example, a recent report has indicated that >87% of COVID-19 patients continue to experience at least one symptom following acute recovery (144), the most frequent of which was fatigue. Noninvasive brain stimulation approaches have reliable benefit for fatigue (145), as well as for psychological symptoms such as depression and anxiety that are common in the recovery period (146)(147)(148).…”

Section: Future Perspectivesmentioning

confidence: 99%

Neuromodulation Strategies to Reduce Inflammation and Improve Lung Complications in COVID-19 Patients

Czura¹,

Bikson

Charvet

et al. 2022

Front. Neurol.

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Since the outbreak of the COVID-19 pandemic, races across academia and industry have been initiated to identify and develop disease modifying or preventative therapeutic strategies has been initiated. The primary focus has been on pharmacological treatment of the immune and respiratory system and the development of a vaccine. The hyperinflammatory state (“cytokine storm”) observed in many cases of COVID-19 indicates a prognostically negative disease progression that may lead to respiratory distress, multiple organ failure, shock, and death. Many critically ill patients continue to be at risk for significant, long-lasting morbidity or mortality. The human immune and respiratory systems are heavily regulated by the central nervous system, and intervention in the signaling of these neural pathways may permit targeted therapeutic control of excessive inflammation and pulmonary bronchoconstriction. Several technologies, both invasive and non-invasive, are available and approved for clinical use, but have not been extensively studied in treatment of the cytokine storm in COVID-19 patients. This manuscript provides an overview of the role of the nervous system in inflammation and respiration, the current understanding of neuromodulatory techniques from preclinical and clinical studies and provides a rationale for testing non-invasive neuromodulation to modulate acute systemic inflammation and respiratory dysfunction caused by SARS-CoV-2 and potentially other pathogens. The authors of this manuscript have co-founded the International Consortium on Neuromodulation for COVID-19 to advocate for and support studies of these technologies in the current coronavirus pandemic.

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Use of Transcutaneous Auricular Vagus Nerve Stimulation as an Adjuvant Therapy for the Depressive Symptoms of COVID-19: A Literature Review

Cited by 9 publications

References 142 publications

Percutaneous Auricular Vagus Nerve Stimulation Reduces Inflammation in Critical Covid-19 Patients

Percutaneous Auricular Vagus Nerve Stimulation Reduces Inflammation in Critical Covid-19 Patients

Update of the Potential Treatments for Psychiatric and Neuropsychiatric Symptoms in the Context of the Post-COVID-19 Condition: Still a Lot of Suffering and Many More Things to Learn

Neuromodulation Strategies to Reduce Inflammation and Improve Lung Complications in COVID-19 Patients

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