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经皮迷走神经刺激对风湿性多肌痛患者的影响。

The Effect of Transcutaneous Vagus Nerve Stimulation in Patients with Polymyalgia Rheumatica.

作者信息

Venborg Jacob, Wegeberg Anne-Marie, Kristensen Salome, Brock Birgitte, Brock Christina, Pfeiffer-Jensen Mogens

机构信息

Department of Rheumatology, Aarhus University Hospital, 8200 Aarhus, Denmark.

Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark.

出版信息

Pharmaceuticals (Basel). 2021 Nov 16;14(11):1166. doi: 10.3390/ph14111166.


DOI:10.3390/ph14111166
PMID:34832948
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8621661/
Abstract

(1) Polymyalgia rheumatica (PMR) is an inflammatory disease characterised by pain, morning stiffness, and reduced quality of life. Recently, vagus nerve stimulation (VNS) was shown to have anti-inflammatory effects. We aimed to examine the effect of transcutaneous VNS (t-VNS) on PMR. (2) Fifteen treatment-naïve PMR patients completed the study. Patients underwent a 5-day protocol, receiving 2 min of t-VNS stimulation bilaterally on the neck, three times daily. Cardiac vagal tone (CVT) measured on a linear vagal scale (LVS), blood pressure, heart rate, patient-reported outcome, and biochemical changes were assessed. (3) t-VNS induced a 22% increase in CVT at 20 min after initial stimulations compared with baseline (3.4 ± 2.2 LVS vs. 4.1 ± 2.9 LVS, = 0.02) and was accompanied by a 4 BPM reduction in heart rate (73 ± 11 BPM vs. 69 ± 9, < 0.01). No long-term effects were observed. Furthermore, t-VNS induced a 14% reduction in the VAS score for the hips at day 5 compared with the baseline (5.1 ± 2.8 vs. 4.4 ± 2.8, = 0.04). No changes in CRP or proinflammatory analytes were observed. (4) t-VNS modulates the autonomic nervous system in patients with PMR, but further investigation of t-VNS in PMR patients is warranted.

摘要

(1)风湿性多肌痛(PMR)是一种以疼痛、晨僵和生活质量下降为特征的炎症性疾病。最近,迷走神经刺激(VNS)被证明具有抗炎作用。我们旨在研究经皮迷走神经刺激(t-VNS)对PMR的影响。(2)15例未经治疗的PMR患者完成了该研究。患者接受了为期5天的方案,每天双侧颈部接受2分钟的t-VNS刺激,共3次。评估了基于线性迷走神经量表(LVS)测量的心脏迷走神经张力(CVT)、血压、心率、患者报告的结果以及生化变化。(3)与基线相比,初始刺激后20分钟时t-VNS使CVT增加了22%(3.4±2.2 LVS对4.1±2.9 LVS,P = 0.02),同时心率降低了4次/分钟(73±11次/分钟对69±9次/分钟,P < 0.01)。未观察到长期影响。此外,与基线相比,第5天时t-VNS使髋部视觉模拟评分(VAS)降低了14%(5.1±2.8对4.4±2.8,P = 0.04)。未观察到CRP或促炎分析物的变化。(4)t-VNS可调节PMR患者的自主神经系统,但有必要对PMR患者中的t-VNS进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b88a/8621661/3e272f036b81/pharmaceuticals-14-01166-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b88a/8621661/3e272f036b81/pharmaceuticals-14-01166-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b88a/8621661/3e272f036b81/pharmaceuticals-14-01166-g001.jpg

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BMC Musculoskelet Disord. 2025-1-20

[2]
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J Clin Med. 2024-12-30

[3]
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[4]
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本文引用的文献

[1]
Vagal Nerve Stimulation-Modulation of the Anti-Inflammatory Response and Clinical Outcome in Psoriatic Arthritis or Ankylosing Spondylitis.

Mediators Inflamm. 2021

[2]
Cardiac vagal tone as a novel screening tool to recognize asymptomatic cardiovascular autonomic neuropathy: Aspects of utility in type 1 diabetes.

Diabetes Res Clin Pract. 2020-12

[3]
Short-term transcutaneous non-invasive vagus nerve stimulation may reduce disease activity and pro-inflammatory cytokines in rheumatoid arthritis: results of a pilot study.

Scand J Rheumatol. 2021-1

[4]
Tocilizumab monotherapy for polymyalgia rheumatica: A prospective, single-center, open-label study.

Int J Rheum Dis. 2019-12

[5]
Pathogenesis, Diagnosis and Management of Polymyalgia Rheumatica.

Drugs Aging. 2019-11

[6]
Dissecting the inflammatory response in polymyalgia rheumatica: the relative role of IL-6 and its inhibition.

Rheumatol Int. 2018-6-26

[7]
Vagal influences in rheumatoid arthritis.

Scand J Rheumatol. 2018-1

[8]
Cardiac vagal tone, a non-invasive measure of parasympathetic tone, is a clinically relevant tool in Type 1 diabetes mellitus.

Diabet Med. 2017-8-17

[9]
Acute physiological and electrical accentuation of vagal tone has no effect on pain or gastrointestinal motility in chronic pancreatitis.

J Pain Res. 2017-5-31

[10]
Transcutaneous cervical vagal nerve stimulation modulates cardiac vagal tone and tumor necrosis factor-alpha.

Neurogastroenterol Motil. 2017-5

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