Department of Neurology, Otto von Guericke University, Magdeburg, Germany.
Neuroprotection Group, German Center for Neurodegenerative Diseases, Magdeburg, Germany.
Sci Rep. 2019 Aug 7;9(1):11452. doi: 10.1038/s41598-019-47961-4.
Transcutaneous auricular vagus nerve stimulation (taVNS) bears therapeutic potential for a wide range of medical conditions. However, previous studies have found substantial interindividual variability in responsiveness to taVNS, and no reliable predictive biomarker for stimulation success has been developed so far. In this study, we investigate pupil size and event-related pupil response as candidate biomarkers. Both measures have a direct physiological link to the activity of the locus coeruleus (LC), a brainstem structure and the main source of norepinephrine in the brain. LC activation is considered one of the key mechanisms of action of taVNS, therefore, we expected a clear increase of the pupillary measures under taVNS compared to sham (placebo) stimulation, such that it could serve as a prospective predictor for individual clinical and physiological taVNS effects in future studies. We studied resting pupil size and pupillary responses to target stimuli in an auditory oddball task in 33 healthy young volunteers. We observed stronger pupil responses to target than to standard stimuli. However, and contrary to our hypothesis, neither pupil size nor the event-related pupil response nor behavioral performance were modulated by taVNS. We discuss potential explanations for this negative finding and its implications for future clinical investigation and development of taVNS.
经皮耳迷走神经刺激(taVNS)在治疗多种医学病症方面具有巨大潜力。然而,既往研究发现 taVNS 的反应存在显著的个体间差异,迄今为止尚未开发出可靠的刺激成功预测生物标志物。在这项研究中,我们研究了瞳孔大小和事件相关的瞳孔反应作为候选生物标志物。这两种测量方法都与蓝斑(LC)的活动有直接的生理联系,LC 是脑干结构,也是大脑中去甲肾上腺素的主要来源。LC 的激活被认为是 taVNS 的主要作用机制之一,因此,我们预计 taVNS 会比假刺激(安慰剂)引起明显的瞳孔增大,因此它可能成为未来研究中个体临床和生理 taVNS 效果的前瞻性预测指标。我们在 33 名健康年轻志愿者中研究了静息时的瞳孔大小和听觉Oddball 任务中的瞳孔对目标刺激的反应。我们观察到,与标准刺激相比,瞳孔对目标刺激的反应更强。然而,与我们的假设相反,无论是瞳孔大小还是事件相关的瞳孔反应,还是行为表现,都不受 taVNS 的调节。我们讨论了这一阴性结果的潜在解释及其对未来临床研究和 taVNS 开发的影响。
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