scholarly journals Application of Noninvasive Vagal Nerve Stimulation to Stress-Related Psychiatric Disorders

2020 ◽  
Vol 10 (3) ◽  
pp. 119 ◽  
Author(s):  
James Douglas Bremner ◽  
Nil Z. Gurel ◽  
Matthew T. Wittbrodt ◽  
Mobashir H. Shandhi ◽  
Mark H. Rapaport ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Psychiatric Disorders ◽  
Brain Imaging ◽  
Nerve Stimulation ◽  
Vagal Nerve ◽  
Vagal Nerve Stimulation ◽  
Favorable Effect ◽  
Blood Biomarkers ◽  
Wearable Sensing ◽  
Widespread Implementation

Background: Vagal Nerve Stimulation (VNS) has been shown to be efficacious for the treatment of depression, but to date, VNS devices have required surgical implantation, which has limited widespread implementation. Methods: New noninvasive VNS (nVNS) devices have been developed which allow external stimulation of the vagus nerve, and their effects on physiology in patients with stress-related psychiatric disorders can be measured with brain imaging, blood biomarkers, and wearable sensing devices. Advantages in terms of cost and convenience may lead to more widespread implementation in psychiatry, as well as facilitate research of the physiology of the vagus nerve in humans. nVNS has effects on autonomic tone, cardiovascular function, inflammatory responses, and central brain areas involved in modulation of emotion, all of which make it particularly applicable to patients with stress-related psychiatric disorders, including posttraumatic stress disorder (PTSD) and depression, since dysregulation of these circuits and systems underlies the symptomatology of these disorders. Results: This paper reviewed the physiology of the vagus nerve and its relevance to modulating the stress response in the context of application of nVNS to stress-related psychiatric disorders. Conclusions: nVNS has a favorable effect on stress physiology that is measurable using brain imaging, blood biomarkers of inflammation, and wearable sensing devices, and shows promise in the prevention and treatment of stress-related psychiatric disorders.

Extrinsic inputs to intrinsic neurons in the porcine heart in vitro

1999 ◽  
Vol 276 (2) ◽  
pp. R455-R467 ◽  
Author(s):  
F. M. Smith
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Neural Control ◽  
Threshold Level ◽  
Vagal Nerve ◽  
Vagal Nerve Stimulation ◽  
Right Atrial ◽  
The Right ◽  
Β Adrenergic Receptors

Convergence of inputs from extrinsic cardiac nerves [vagus and cardiopulmonary (CPN)] on intrinsic cardiac neurons was investigated in the pig ( Sus scrofa). A segment of the right atrial wall containing epicardial neurons along with attached stumps of the right vagus nerve and CPN was maintained in vitro; intracellular recordings were made from 57 neurons. Three types of neuron were identified by their responses to long intracellular depolarizing current pulses: phasic [discharged 1 action potential (AP); 40%]; accommodating (discharged multiple APs decrementing in frequency during pulse; 33%); and tonic (discharged multiple APs at a high frequency; 27%). Sixty-six percent of the neurons responded with excitatory postsynaptic potentials (EPSP) to vagal nerve stimulation; two-thirds of these cells fired APs when EPSP amplitude exceeded threshold level. Postsynaptic responses to vagal nerve stimulation were mediated by nicotinic ion channels; responses were eliminated by hexamethonium. CPN stimulation produced EPSPs but no APs in 17% of the neurons. All neurons responding with postsynaptic depolarizations to CPN stimulation also received vagal inputs. Combined stimulation of the vagus nerve and CPN produced APs in all but one of these neurons. Timolol eliminated postsynaptic responses from CPN stimulation, indicating that these responses involved β-adrenergic receptors and likely resulted from activation of sympathetic postganglionic terminals. These results show that some intrinsic cardiac neurons receive convergent inputs from the CPN and vagus nerve. It is suggested that such neurons represent intraganglionic sites for sympathetic-parasympathetic interactions in neural control of the heart.

scholarly journals EFEKTIVITAS VAGAL NERVE STIMULATION (VNS) TERHADAP DISRITMIA JANTUNG

2020 ◽  
Vol 2 (01) ◽  
pp. 7-20
Author(s):  
Pius A. L. Berek
Keyword(s):  
Atrial Fibrillation ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Carotid Sinus ◽  
Electrical Conductance ◽  
Vagal Nerve ◽  
Vagal Nerve Stimulation ◽  
Av Node ◽  
Sa Node ◽  
Release Of Acetylcholine

Dysrhythmia is a heart rate disorder that includes frequency or rhythm disorders or both. One of the nursing actions to overcome is doing Vagal Nerve Stimulation (VNS), includes emphasis on one side of carotid sinus, emphasis on periorbital sinus, and performing valsalava maneuver by coughing. This is believed to increase release of acetylcholine in heart, where the acetylcholine is captured by SA node in left atrium and serves as an inhibitor of electrical stimulation of heart. The release of acetylcholine production is expected to inhibit cardiac irritability so ventricular contraction can be reduced to a minimum. This will appear clearly in state of dysrhythmias, especially atrial fibrillation. In atrial fibrillation, the impulses produced in atrium will exceed normal state, which results in electrical conductance of heart to SA node, continued to AV node and to purkinje fibers to increase ventricular contractions in projecting blood out of heart. If the impulses produced by atrium are irregular, the same thing happens to ventricles, which is to make irregular heart contractions as well. The result is the heart does not have time to relax to give blood to coronary arteries. If not handled properly, this is very dangerous for heart. VNS action by providing stimulation to vagus nerve will greatly help overcome this problem because the ends of the vagus nerve lead to SA node and AV node. By providing stimulation to vagus nerve, the signal will be sent to efferent to release ACh. It is hoped that this ACh will inhibit impulses from SA node and AV node so the heart can contract according to the body's needs.

scholarly journals Mixed evidence for transcutaneous vagal nerve stimulation to improve the extinction and retention of fear.

2017 ◽  
Author(s):  
Andreas Michael Burger ◽  
Bart Verkuil ◽  
Holly Fenlon ◽  
Lise Thijs ◽  
Lisse Cools ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Spontaneous Recovery ◽  
Fear Extinction ◽  
Vagal Nerve ◽  
Vagal Nerve Stimulation ◽  
Auricular Branch

We tested whether stimulating the auricular branch of the vagus nerve (transcutaneous VNS; tVNS) accelerates fear extinction and reduces spontaneous recovery of fear.

Treatment of Psychiatric Disorders

2017 ◽  
Author(s):  
Harvinder Singh ◽  
Miyun Kang ◽  
Sarah de Asis ◽  
Rajiv Radhakrishnan ◽  
Rajesh R. Tampi ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Electroconvulsive Therapy ◽  
Nerve Stimulation ◽  
Vagal Nerve ◽  
Vagal Nerve Stimulation ◽  
Mood Stabilizers ◽  
Self Help ◽  
Self Help Groups

In this chapter the treatment of psychiatric disorders are reviewed including antidepressants, mood stabilizers, antianxiety agents, antipsychotics, psychostimulants, hypnotics, sedatives, electroconvulsive therapy, vagal nerve stimulation, psychotherapy, repetitive transcranial nerve stimulation (rTMS), vagal nerve stimulation and self-help groups

scholarly journals Closed-Loop Transcutaneous Auricular Vagal Nerve Stimulation: Current Situation and Future Possibilities

2022 ◽  
Vol 15 ◽  
Author(s):  
Yutian Yu ◽  
Jing Ling ◽  
Lingling Yu ◽  
Pengfei Liu ◽  
Min Jiang
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Closed Loop ◽  
Vagal Nerve ◽  
Vagal Nerve Stimulation ◽  
Afferent Nerve ◽  
Technical Issues ◽  
Vagal Afferent ◽  
Stimulation Current

Closed-loop (CL) transcutaneous auricular vagal nerve stimulation (taVNS) was officially proposed in 2020. This work firstly reviewed two existing CL-taVNS forms: motor-activated auricular vagus nerve stimulation (MAAVNS) and respiratory-gated auricular vagal afferent nerve stimulation (RAVANS), and then proposed three future CL-taVNS systems: electroencephalography (EEG)-gated CL-taVNS, electrocardiography (ECG)-gated CL-taVNS, and subcutaneous humoral signals (SHS)-gated CL-taVNS. We also highlighted the mechanisms, targets, technical issues, and patterns of CL-taVNS. By reviewing, proposing, and highlighting, this work might draw a preliminary blueprint for the development of CL-taVNS.

scholarly journals The Safety and Efficacy of Transdermal Auricular Vagal Nerve Stimulation Earbud Electrodes for Modulating Autonomic Arousal, Attention, Sensory Gating, and Cortical Brain Plasticity in Humans

2019 ◽  
Author(s):  
William J. Tyler ◽  
Sarah Wyckoff ◽  
Taylor Hearn ◽  
Nicholas Hool
Keyword(s):  
Heart Rate ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Brain Plasticity ◽  
Foreign Language Learning ◽  
Sensory Gating ◽  
Nerve Fibers ◽  
Vagal Nerve ◽  
Vagal Nerve Stimulation ◽  
Safety And Efficacy

AbstractOur work was motivated by the goal of developing a Targeted Neuroplasticity Training (TNT) method for enhancing foreign language learning. To this end, our primary effort was to evaluate new and optimized approaches to noninvasive vagal nerve stimulation (VNS). We considered several Human Factors Dimensions to develop methods that would be amenable to comfortable, everyday use in common training environments or contexts. Several approaches to noninvasive or external vagal nerve stimulation have been described. Transcutaneous modulation of the left cervical branch of the vagus nerve can be uncomfortable for users resulting in a distracting experience, which may not be ideal for augmenting plasticity during training. Transdermal auricular vagal nerve stimulation (taVNS) offers another approach by targeting nerve fibers innervating the external ear. Prior methods have described many different approached using electrode clips on the ear or stainless-steel ball electrodes, which can respectively result in mechanical discomfort and electrical stimulus discomfort due to high current densities. Other approaches use carbon-doped or conductive rubbers, which require wetting. This is problematic since small degrees of dehydration cause significant changes in the electrical impedance of the skin-electrode interface. Detailed human cadaveric studies have shown the external auditory meatus or ear canal is highly innervated by branches of the auricular vagus nerve. Therefore, we designed taVNS electrodes that were fabricated as a biocompatible, hydrogel earbud electrodes for unilateral or bilateral use. We then evaluated the safety and efficacy of these approaches across a range of stimulus frequencies and intensities. We further evaluated the influence of this approach on autonomic physiology by recording heart rate, heart rate variability, skin conductance, skin temperature, and respiration rate. We investigated attention using simultaneous EEG and pupillometry during auditory stimulation tasks. We further studied the effects on sensory gating and plasticity by examining EEG brain activity patterns obtained during auditory mismatch negativity tasks. Finally, we investigated the basic safety and tolerability of the methods and approaches. We found that a simple, dry (hydrogel), earbud electrode design is a safe and effective method for achieving taVNS. Given the safety, preliminary efficacy, and comfort outcomes observed, we conclude taVNS approaches using earbud electrodes warrant further development and investigation as a TNT tool, to mediate human-computer interactions, for brain-computer interfaces, and as medical devices for the treatment of pervasive health disorders.

scholarly journals Noninvasive Vagus Nerve Stimulation Alters the Neural and Physiological Response to Noxious Thermal Challenge

2018 ◽  
Author(s):  
Imanuel Lerman ◽  
Bryan Davis ◽  
Mingxiong Huang ◽  
Charles Huang ◽  
Linda Sorkin ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Physiological Response ◽  
Neural Circuits ◽  
Vagal Nerve ◽  
Vagal Nerve Stimulation ◽  
Anterior Cingulate ◽  
Reticular Nucleus ◽  
Group Time ◽  
Thermal Stimuli

AbstractThe mechanisms by which noninvasive vagal nerve stimulation (nVNS) affect central and peripheral neural circuits that subserve pain and autonomic physiology are not clear, and thus remain an area of intense investigation. Effects of nVNS vs sham stimulation on subject responses to five noxious thermal stimuli (applied to left lower extremity), were measured in 30 healthy subjects (n=15 sham and n=15 nVNS), with fMRI and physiological galvanic skin response (GSR). With repeated noxious thermal stimuli a group × time analysis showed a significantly (p < .001) decreased response with nVNS in bilateral primary and secondary somatosensory cortices (SI and SII), left dorsoposterior insular cortex, bilateral paracentral lobule, bilateral medial dorsal thalamus, right anterior cingulate cortex, and right orbitofrontal cortex. A group × time × GSR analysis showed a significantly decreased response in nVNS group (p < .0005) in bilaterally in SI, lower and mid medullary brainstem, and inferior occipital cortex. Finally, nVNS treatment showed decreased activity in pronociceptive brainstem nuclei (e.g. the reticular nucleus and rostral ventromedial medulla) and key autonomic integration nuclei (e.g. the rostroventrolateral medulla, nucleus ambiguous, and dorsal motor nucleus of the vagus nerve). In aggregate, noninvasive vagal nerve stimulation reduced the physiological response to noxious thermal stimuli and impacted neural circuits important for pain processing and autonomic output.

Benefit of vagal nerve stimulation in epilepsia partialis continua: a case report

2006 ◽  
Vol 37 (03) ◽  
Author(s):  
C Bussmann ◽  
HM Meinck ◽  
HH Steiner ◽  
W Broxtermann ◽  
CG Bien ◽  
...  
Keyword(s):  
Case Report ◽  
Nerve Stimulation ◽  
Vagal Nerve ◽  
Vagal Nerve Stimulation ◽  
Epilepsia Partialis Continua

Implanted vagus nerve stimulation in 126 patients: surgical technique and complications

2020 ◽  
Vol 99 (7) ◽  
Keyword(s):  
Vagus Nerve ◽  
Vocal Cord ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Pulse Generator ◽  
Operative Procedure ◽  
Intractable Epilepsy ◽  
Vagal Nerve ◽  
University Hospital ◽  
Nerve Stimulator

Introduction: Vagus nerve stimulation is a palliative treatment for patients with refractory epilepsy to reduce the frequency and intensity of seizures. A bipolar helical electrode is placed around the left vagus nerve at the cervical level and is connected to the pulse generator placed in a subcutaneous pocket, most commonly in the subclavian region. Methods: Between March 1998 and October 2019, we performed 196 procedures related to the vagal nerve stimulation at the Neurosurgery Department in Motol University Hospital. Of these, 126 patients were vagal nerve stimulator implantation surgeries for intractable epilepsy. The cases included 69 female and 57 male patients with mean age at the time of the implantation surgery 22±12.4 years (range 2.1−58.4 years). Results: Nine patients (7.1%) were afflicted by complications related to implantation. Surgical complications included postoperative infection in 1.6%, VNS-associated arrhythmias in 1.6%, jugular vein bleeding in 0.8% and vocal cord paresis in 2.4%. One patient with vocal cord palsy also suffered from severe dysphagia. One patient (0.8%) did not tolerate extra stimulation with magnet due to a prolonged spasm in his throat. The extra added benefit of vagus stimulation in one patient was a significant reduction of previously regular severe headaches. Conclusion: Vagus nerve stimulation is an appropriate treatment for patients with drug-resistant epilepsy who are not candidates for focal resective surgery. Implantation of the vagus nerve stimulator is a relatively safe operative procedure.

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