Huang Yiting, Zhang Yue, Hodges Sierra, Li Hui, Yan Zhaoxian, Liu Xian, Hou Xiaoyan, Chen Weicui, Chai-Zhang Thalia, Kong Jian, Liu Bo
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States.
Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Mol Neurosci. 2023 Jun 2;16:1160006. doi: 10.3389/fnmol.2023.1160006. eCollection 2023.
Previous studies have shown a significant response to acute transcutaneous vagus nerve stimulation (taVNS) in regions of the vagus nerve pathway, including the nucleus tractus solitarius (NTS), raphe nucleus (RN) and locus coeruleus (LC) in both healthy human participants and migraine patients. This study aims to investigate the modulation effect of repeated taVNS on these brainstem regions by applying seed-based resting-state functional connectivity (rsFC) analysis.
70 patients with migraine were recruited and randomized to receive real or sham taVNS treatments for 4 weeks. fMRI data were collected from each participant before and after 4 weeks of treatment. The rsFC analyses were performed using NTS, RN and LC as the seeds.
59 patients (real group: = 33; sham group: = 29) completed two fMRI scan sessions. Compared to sham taVNS, real taVNS was associated with a significant reduction in the number of migraine attack days ( = 0.024) and headache pain intensity ( = 0.008). The rsFC analysis showed repeated taVNS modulated the functional connectivity between the brain stem regions of the vagus nerve pathway and brain regions associated with the limbic system (bilateral hippocampus), pain processing and modulation (bilateral postcentral gyrus, thalamus, and mPFC), and basal ganglia (putamen/caudate). In addition, the rsFC change between the RN and putamen was significantly associated with the reduction in the number of migraine days.
Our findings suggest that taVNS can significantly modulate the vagus nerve central pathway, which may contribute to the potential treatment effects of taVNS for migraine.: http://www.chictr.org.cn/hvshowproject.aspx?id=11101, identifier ChiCTR-INR-17010559.
既往研究表明，在健康受试者和偏头痛患者中，急性经皮迷走神经刺激（taVNS）可使迷走神经通路区域，包括孤束核（NTS）、中缝核（RN）和蓝斑（LC）产生显著反应。本研究旨在通过基于种子点的静息态功能连接（rsFC）分析，探讨重复taVNS对这些脑干区域的调节作用。
招募70例偏头痛患者，随机分为两组，分别接受为期4周的真实taVNS治疗或假刺激治疗。在治疗4周前后，采集每位受试者的功能磁共振成像（fMRI）数据。以NTS、RN和LC为种子点进行rsFC分析。
59例患者（真实刺激组：n = 33；假刺激组：n = 29）完成了两次fMRI扫描。与假刺激相比，真实taVNS可使偏头痛发作天数显著减少（P = 0.024），头痛疼痛强度显著降低（P = 0.008）。rsFC分析显示，重复taVNS可调节迷走神经通路脑干区域与边缘系统（双侧海马体）、疼痛处理与调节（双侧中央后回、丘脑和内侧前额叶皮质）以及基底神经节（壳核/尾状核）相关脑区之间的功能连接。此外，RN与壳核之间的rsFC变化与偏头痛天数的减少显著相关。
我们的研究结果表明，taVNS可显著调节迷走神经中枢通路，这可能是taVNS对偏头痛具有潜在治疗作用的原因。试验注册号：http://www.chictr.org.cn/hvshowproject.aspx?id=11101，识别码ChiCTR-INR-17010559 。
