Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 84, 93059 Regensburg, Germany.
Brain Stimul. 2013 Mar;6(2):202-9. doi: 10.1016/j.brs.2012.04.006. Epub 2012 May 7.
BACKGROUND: Recent preclinical work strongly suggests that vagus nerve stimulation efficiently modulates nociception and pain processing in humans. Most recently, a medical device has offered a transcutaneous electrical stimulation of the auricular branch of the vagus nerve (t-VNS) without any surgery. OBJECTIVE: Our study investigates whether t-VNS may have the potential to alter pain processing using a controlled design. METHODS: Different submodalities of the somatosensory system were assessed with quantitative sensory testing (QST) including a tonic heat pain paradigm in 48 healthy volunteers. Each subject participated in two experimental sessions with active t-VNS (stimulation) or sham t-VNS (no stimulation) on different days in a randomized order (crossed-over). One session consisted of two QST measurements on the ipsi- and contralateral hand, each before and during 1 h of a continuous t-VNS on the left ear using rectangular pulses (250 μS, 25 Hz). RESULTS: We found an increase of mechanical and pressure pain threshold and a reduction of mechanical pain sensitivity. Moreover, active t-VNS significantly reduced pain ratings during sustained application of painful heat for 5 min compared to sham condition. No relevant alterations of cardiac or breathing activity or clinical relevant side effects were observed during t-VNS. CONCLUSIONS: Our findings of a reduced sensitivity of mechanically evoked pain and an inhibition of temporal summation of noxious tonic heat in healthy volunteers may pave the way for future studies on patients with chronic pain addressing the potential analgesic effects of t-VNS under clinical conditions.
背景:最近的临床前研究强烈表明,迷走神经刺激能有效地调节人类的痛觉和疼痛处理。最近,一种医疗设备提供了一种无需手术的经皮刺激耳迷走神经分支(t-VNS)的方法。
目的:我们的研究旨在通过对照设计来探究 t-VNS 是否有可能改变疼痛处理。
方法:在 48 名健康志愿者中,使用定量感觉测试(QST)评估了感觉系统的不同亚模式,包括热痛强直范式。每个受试者在不同的日子里以随机顺序(交叉)参加两个实验,分别接受主动 t-VNS(刺激)或假 t-VNS(无刺激)。其中一个实验包括两次 QST 测量,分别在同侧和对侧手上进行,每次测量前和持续 1 小时的左侧耳部矩形脉冲(250μS,25Hz)刺激过程中进行。
结果:我们发现机械和压力痛阈值增加,机械痛敏降低。此外,与假刺激条件相比,主动 t-VNS 在持续应用热痛 5 分钟期间显著降低了疼痛评分。在 t-VNS 过程中,未观察到心脏或呼吸活动的相关改变或临床相关的副作用。
结论:我们在健康志愿者中发现机械诱发疼痛的敏感性降低和伤害性强直热的时间总和抑制,这可能为未来在慢性疼痛患者中进行研究提供依据,以确定 t-VNS 在临床条件下的潜在镇痛效果。
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