Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, Intelligent Non-Invasive Neuromodulation and Transformation Joint Laboratory, School of Life Science and Technology, Xidian University, Xi'an, China.
Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, Intelligent Non-Invasive Neuromodulation and Transformation Joint Laboratory, School of Life Science and Technology, Xidian University, Xi'an, China.
Neuromodulation. 2022 Apr;25(3):433-442. doi: 10.1111/ner.13521. Epub 2021 Aug 26.
BACKGROUND: Transcutaneous auricular vagus nerve stimulation (taVNS) may modulate cardiac autonomic function. However, the response rate of the traditional tonic paradigm is low, and the results remain inconsistent. A recent pilot study presented a novel burst paradigm to activate the cardiac parasympathetic system, which might offer a new approach to treat cardiac autonomic function. The present study reassessed the effect of burst taVNS on modulating heart rate variability and explored the difference between burst and traditional tonic paradigms. MATERIALS AND METHODS: Forty-two young adults were recruited for this study. Each participant underwent three types of taVNS with sham (30 sec of stimulation), tonic (25 Hz, 500 μsec), and burst (five pulses at 500 Hz every 200 msec) paradigms, respectively, with simultaneous electrocardiogram recording. One-way analysis of variance, multivariate analysis of variance, and linear regression were used for analysis. Multiple testing was performed using Bonferroni correction. RESULTS: Both burst and tonic paradigms induced a significant decrease in heart rate, which continued until poststimulation, and increased cardiac parasympathetic activity. Moreover, two parasympathetic system indicators showed significant increase only in burst taVNS. The response rates during burst (35.7%) and tonic (38.1%) stimulations were both higher than that during sham stimulation (11.9%). The response to taVNS showed parameter specificity with few nonresponders to the tonic paradigm responding to the burst paradigm. The overall response rate increased from 38.1% in tonic taVNS to 54.8% in taVNS using both burst and tonic paradigms. For both burst and tonic responders, baseline cardiac parasympathetic activity was found to be significantly negatively correlated with changes during stimulation. CONCLUSION: The burst parameter could be used as an alternative strategy for regulating cardiac parasympathetic function by taVNS, which has the potential to be used as a complementary paradigm to traditional tonic taVNS for promoting clinical treatment efficacy.
背景：经皮耳迷走神经刺激（taVNS）可能调节心脏自主神经功能。然而，传统的连续刺激模式的反应率较低，结果也不一致。最近的一项初步研究提出了一种新的爆发模式来激活心脏副交感神经系统，这可能为治疗心脏自主神经功能提供一种新方法。本研究重新评估了爆发 taVNS 调节心率变异性的效果，并探讨了爆发和传统连续刺激模式之间的差异。
材料和方法：这项研究招募了 42 名年轻成年人。每位参与者分别接受了三种 taVNS 刺激，包括假刺激（刺激 30 秒）、连续刺激（25 Hz，500 μsec）和爆发刺激（每 200 msec 发出 5 个 500 Hz 的脉冲），同时进行心电图记录。采用单因素方差分析、多变量方差分析和线性回归进行分析。采用 Bonferroni 校正进行多重检验。
结果：爆发和连续刺激模式均导致心率显著降低，这种情况持续到刺激后，并增加了心脏副交感神经活性。此外，两个副交感神经系统指标仅在爆发 taVNS 中显示出显著增加。爆发（35.7%）和连续（38.1%）刺激的反应率均高于假刺激（11.9%）。taVNS 的反应具有参数特异性，少数对连续刺激无反应的人对爆发刺激有反应。从连续 taVNS 的 38.1%总体反应率增加到爆发和连续刺激模式的 54.8%。对于爆发和连续刺激的反应者，发现刺激期间的基线心脏副交感神经活性与变化呈显著负相关。
结论：爆发参数可作为通过 taVNS 调节心脏副交感神经功能的替代策略，这可能成为传统连续 taVNS 的补充模式，以提高临床治疗效果。
Rev Assoc Med Bras (1992). 2023-6-2
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