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Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy.

作者信息

Wong Marlon L, Widerström-Noga Eva, Bolanos Jessica L, Gonzalez Gabriel, Penedo Frank J, Hosein Peter J, Tovin Melissa M, Gonzalez Juan P, McTeague Lisa M

机构信息

Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL, United States.

The Miami Project to Cure Paralysis, University of Miami, Miami, FL, United States.

出版信息

Front Pain Res (Lausanne). 2025 Jan 17;5:1516196. doi: 10.3389/fpain.2024.1516196. eCollection 2024.


DOI:10.3389/fpain.2024.1516196
PMID:39896735
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11782131/
Abstract

INTRODUCTION: Peripheral neuropathy (PN) is the most common neurodegenerative disorder, and the primary causes are chemotherapy-induced peripheral neuropathy (CIPN) and diabetic neuropathy (DN). Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising non-pharmacological and non-invasive intervention that targets key pathways involved with PN. However, research is needed to determine the feasibility, acceptability, and effects of taVNS in people with PN. It is also critical that this research on taVNS include the perspectives of Black and Hispanic/Latino patients, who are often underrepresented in research. METHODS: This research was comprised of two consecutive studies: a survey and a pilot randomized sham-controlled trial (RCT). The survey assessed symptom burden, management strategies, and interest in taVNS among CIPN patients. The pilot RCT evaluated the feasibility, acceptability, and preliminary effects of taVNS in Black and Hispanic/Latino patients with CIPN or diabetic neuropathy. Participants were recruited from the University of Miami medical system, with culturally sensitive approaches to enhance minority participation. RESULTS: The survey included 62 respondents, 78% Black or Hispanic/Latino, revealing high symptom burden and significant interest in taVNS (82% expressed moderate to high interest). The pilot RCT enrolled 28 participants, achieving a 42% recruitment rate and 86% retention. taVNS was well tolerated, with no significant adverse effects. Preliminary data indicated a decrease in neuropathic symptoms and an increased heart rate variability (HRV) during active taVNS, suggesting autonomic modulation. Tingling sensation and pain decreased by median values of 2.0 and 1.5, respectively. Additionally, the median values for standard deviation of the RR interval increased from 34.9 (CI = 21.6-44.8) at baseline to 44.8 (CI = 26.5-50.3) during intervention. Exit interviews highlighted positive participant experiences and identified potential barriers, such as protocol length and distrust in medical research. CONCLUSION: The findings underscore the need for novel CIPN treatments and demonstrate the feasibility of conducting taVNS research in historically underrepresented populations. High interest in taVNS and successful recruitment and retention rates suggest that culturally sensitive approaches can enhance minority participation in clinical trials. These findings will be used to develop a large clinical trial to determine the efficacy of repeated taVNS in a diverse cohort. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov, identifier (NCT05896202).

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/ce600d666f42/fpain-05-1516196-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/8364ed4ef125/fpain-05-1516196-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/5c947b35177e/fpain-05-1516196-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/228957285bdc/fpain-05-1516196-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/0644d2d65c16/fpain-05-1516196-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/909c41f838d7/fpain-05-1516196-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/ce600d666f42/fpain-05-1516196-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/8364ed4ef125/fpain-05-1516196-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/5c947b35177e/fpain-05-1516196-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/228957285bdc/fpain-05-1516196-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/0644d2d65c16/fpain-05-1516196-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/909c41f838d7/fpain-05-1516196-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11782131/ce600d666f42/fpain-05-1516196-g007.jpg

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引用本文的文献

[1]
Transcranial magnetic stimulation measures of corticospinal excitability in Black and Hispanic/Latino people with painful peripheral neuropathy.

Front Hum Neurosci. 2025-6-2

本文引用的文献

[1]
One Nervous System: Critical Links Between Central and Peripheral Nervous System Health and Implications for Obesity and Diabetes.

Diabetes. 2024-12-1

[2]
Transcutaneous vagus nerve stimulation effects on chronic pain: systematic review and meta-analysis.

Pain Rep. 2024-8-7

[3]
Centralizing the Knowledge and Interpretation of Pain in Chemotherapy-Induced Peripheral Neuropathy: A Paradigm Shift towards Brain-Centric Approaches.

Brain Sci. 2024-6-28

[4]
Advances in Spinal Neuromodulation for Chemotherapy-induced Peripheral Neuropathy.

Anticancer Res. 2024-7

[5]
National Estimates of the Participation of Patients With Cancer in Clinical Research Studies Based on Commission on Cancer Accreditation Data.

J Clin Oncol. 2024-6-20

[6]
Clinical application of transcutaneous auricular vagus nerve stimulation: a scoping review.

Disabil Rehabil. 2024-12

[7]
Non-invasive vagus nerve stimulation for rheumatoid arthritis: a proof-of-concept study.

Lancet Rheumatol. 2021-4

[8]
Differences in Pain Experience Among Different Racial and Ethnic Groups.

Phys Ther. 2024-10-2

[9]
Efficacy of transauricular vagus nerve stimulation for the treatment of chemotherapy-induced painful peripheral neuropathy: a randomized controlled exploratory study.

Neurol Sci. 2024-5

[10]
Racial and Ethnic Disparities in the Management of Diabetic Feet.

Curr Rev Musculoskelet Med. 2023-11

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