Croft Jacob R, LaMacchia Zachary M, Alderete Joseph F, Maestas Adam, Nguyen Khan, O'Hara Reginald B
Department of Research and Innovation, The University of Texas at El Paso, El Paso, TX 79968, USA.
Department of Clinical Investigation, William Beaumont Army Medical Center, U.S. Army, Fort Bliss, TX 79918, USA.
Mil Med. 2025 Mar 21. doi: 10.1093/milmed/usaf063.
BACKGROUND: Transcutaneous auricular Vagus Nerve Stimulation (taVNS) is a noninvasive technique that activates vagal projections in the brain and brainstem by stimulating the auricular branch of the vagus nerve. taVNS may be a safer alternative to invasive vagal nerve stimulation for treating treatment-resistant mood disorders, chronic pain, inflammation, cardiovascular dysfunction, inflammatory bowel disease, and Crohn's disease. OBJECTIVE: This study aims to systematically review the current evidence on the efficacy and safety of taVNS in treating depressive disorders and its modulatory effects on the autonomic nervous system. METHODS: Relevant primary and secondary sources were identified through a systematic search of the PubMed and Google Scholar databases from 2008 to 2023. The review used the Scale for Assessment of Narrative Review Articles, resulting in a 0.77% intraclass correlation coefficient, 95% CI, and 0.88 inter-rater reliability. RESULTS: taVNS, a new noninvasive neuromodulation method, stimulates the auricular branch of the vagus nerve and regulates the sympathetic and parasympathetic branches of the ANS, increasing norepinephrine secretion, vagus nerve stimulation adaptability, and heart rate variability. Future studies should clarify the mechanisms and address inconsistencies in taVNS parameters. Standardizing treatment regimens can establish taVNS as a viable, noninvasive treatment. CONCLUSION: Our findings suggest that taVNS may be a safer alternative to invasive vagal nerve stimulation for treatment-resistant mood disorders, chronic pain, inflammation, cardiovascular dysfunction, inflammatory bowel disease, and Crohn's disease. However, further empirical research is needed to elucidate the mechanisms and resolve inconsistencies in the stimulation parameters, and larger studies are required to confirm taVNS as an effective noninvasive treatment.
背景：经皮耳迷走神经刺激（taVNS）是一种非侵入性技术，通过刺激迷走神经的耳支来激活大脑和脑干中的迷走神经投射。对于治疗难治性情绪障碍、慢性疼痛、炎症、心血管功能障碍、炎症性肠病和克罗恩病，taVNS可能是侵入性迷走神经刺激的一种更安全的替代方法。 目的：本研究旨在系统评价taVNS治疗抑郁症的疗效和安全性及其对自主神经系统的调节作用的现有证据。 方法：通过系统检索2008年至2023年的PubMed和谷歌学术数据库，确定了相关的一级和二级文献来源。该综述使用了叙述性综述文章评估量表，组内相关系数为0.77%，95%置信区间，评分者间信度为0.88。 结果：taVNS是一种新的非侵入性神经调节方法，刺激迷走神经的耳支，调节自主神经系统的交感和副交感分支，增加去甲肾上腺素分泌、迷走神经刺激适应性和心率变异性。未来的研究应阐明其机制，并解决taVNS参数中的不一致问题。标准化治疗方案可使taVNS成为一种可行的非侵入性治疗方法。 结论：我们的研究结果表明，对于难治性情绪障碍、慢性疼痛、炎症、心血管功能障碍、炎症性肠病和克罗恩病，taVNS可能是侵入性迷走神经刺激的一种更安全的替代方法。然而，需要进一步的实证研究来阐明其机制并解决刺激参数中的不一致问题，还需要更大规模的研究来证实taVNS是一种有效的非侵入性治疗方法。
Zotero 插件