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Critical Review of Transcutaneous Vagus Nerve Stimulation: Challenges for Translation to Clinical Practice.

作者信息

Yap Jonathan Y Y, Keatch Charlotte, Lambert Elisabeth, Woods Will, Stoddart Paul R, Kameneva Tatiana

机构信息

ARC Training Centre in Biodevices, Swinburne University of Technology, Hawthorn, VIC, Australia.

Faculty of Science, Engineering and Technology, Swinburne University of Technology, Hawthorn, VIC, Australia.

出版信息

Front Neurosci. 2020 Apr 28;14:284. doi: 10.3389/fnins.2020.00284. eCollection 2020.


DOI:10.3389/fnins.2020.00284
PMID:32410932
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7199464/
Abstract

Several studies have illustrated that transcutaneous vagus nerve stimulation (tVNS) can elicit therapeutic effects that are similar to those produced by its invasive counterpart, vagus nerve stimulation (VNS). VNS is an FDA-approved therapy for the treatment of both depression and epilepsy, but it is limited to the management of more severe, intervention-resistant cases as a second or third-line treatment option due to perioperative risks involved with device implantation. In contrast, tVNS is a non-invasive technique that involves the application of electrical currents through surface electrodes at select locations, most commonly targeting the auricular branch of the vagus nerve (ABVN) and the cervical branch of the vagus nerve in the neck. Although it has been shown that tVNS elicits hypo- and hyperactivation in various regions of the brain associated with anxiety and mood regulation, the mechanism of action and influence of stimulation parameters on clinical outcomes remains predominantly hypothetical. Suppositions are largely based on correlations between the neurobiology of the vagus nerve and its effects on neural activity. However, tVNS has also been investigated for several other disorders, including tinnitus, migraine and pain, by targeting the vagus nerve at sites in both the ear and the neck. As most of the described methods differ in the parameters and protocols applied, there is currently no firm evidence on the optimal location for tVNS or the stimulation parameters that provide the greatest therapeutic effects for a specific condition. This review presents the current status of tVNS with a focus on stimulation parameters, stimulation sites, and available devices. For tVNS to reach its full potential as a non-invasive and clinically relevant therapy, it is imperative that systematic studies be undertaken to reveal the mechanism of action and optimal stimulation modalities.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/47a2474af152/fnins-14-00284-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/dc2c62c99e84/fnins-14-00284-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/de3f6b0dd94c/fnins-14-00284-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/238b7712877a/fnins-14-00284-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/8fda1792024e/fnins-14-00284-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/47a2474af152/fnins-14-00284-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/dc2c62c99e84/fnins-14-00284-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/de3f6b0dd94c/fnins-14-00284-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/238b7712877a/fnins-14-00284-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/8fda1792024e/fnins-14-00284-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f81/7199464/47a2474af152/fnins-14-00284-g0005.jpg

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[6]
Transcutaneous vagal nerve stimulation for the treatment of trauma- and stressor-related disorders: systematic review of randomised controlled studies.

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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
The anatomical basis for transcutaneous auricular vagus nerve stimulation.

J Anat. 2020-4

[2]
Current Directions in the Auricular Vagus Nerve Stimulation I - A Physiological Perspective.

Front Neurosci. 2019-8-9

[3]
Current Directions in the Auricular Vagus Nerve Stimulation II - An Engineering Perspective.

Front Neurosci. 2019-7-24

[4]
Cardiovascular autonomic effects of transcutaneous auricular nerve stimulation via the tragus in the rat involve spinal cervical sensory afferent pathways.

Brain Stimul. 2019-5-6

[5]
Transcutaneous Vagus Nerve Stimulation (tVNS) and the Dynamics of Visual Bistable Perception.

Front Neurosci. 2019-3-8

[6]
Transcutaneous auricular vagus nerve stimulation in treating post-stroke insomnia monitored by resting-state fMRI: The first case report.

Brain Stimul. 2019

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Global, regional, and national burden of epilepsy, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.

Lancet Neurol. 2019-2-14

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BOLD fMRI effects of transcutaneous vagus nerve stimulation in patients with chronic tinnitus.

PLoS One. 2018-11-28

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Efficacy and Safety of Treatment with Transcutaneous Vagus Nerve Stimulation in 17 Patients with Refractory Epilepsy Evaluated by Electroencephalogram, Seizure Frequency, and Quality of Life.

Med Sci Monit. 2018-11-23

[10]
Safety and tolerability of Transcutaneous Vagus Nerve stimulation in humans; a systematic review.

Brain Stimul. 2018-8-23

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