Electroencephalographic correlates of low-frequency vagus nerve stimulation therapy for Crohn’s disease

Kibleur, Astrid; Pellissier, Sonia; Sinniger, Valérie; J, Robert; Gronlier, Eloïse; Clarençon, Didier; Vercueil, Laurent; Hoffmann, D.; Bonaz, Bruno; David, Olivier

doi:10.1016/j.clinph.2018.02.127

Cited by 34 publications

(28 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These studies showed higher cardiac control during stronger neuro-cardiac coupling. Interestingly, EEG correlates of 10 Hz vagus nerve stimulation for Crohn's disease showed acute increases of delta and theta activity as well (Kibleur et al, 2018). This observation is also supported by previous fMRI studies, which observed an association between increased vagal cardiac control and elevated activity in frontal areas (Shoemaker et al, 2015;Ruiz Vargas et al, 2016).…”

Section: Discussionsupporting

confidence: 81%

Brain–Heart Interaction During Transcutaneous Auricular Vagus Nerve Stimulation

et al. 2021

View full text Add to dashboard Cite

ObjectivesTranscutaneous auricular vagus nerve stimulation (taVNS) modulates brain activity and heart function. The induced parasympathetic predominance leads to an increase of heart rate variability (HRV). Knowledge on the corresponding cortical activation pattern is, however, scarce. We hypothesized taVNS-induced HRV increases to be related to modulation of cortical activity that regulates the autonomic outflow to the heart.Materials and MethodsIn thirteen healthy subjects, we simultaneously recorded 64-channel electroencephalography and electrocardiography during taVNS. Two taVNS stimulation targets were investigated, i.e., the cymba conchae and inner tragus, and compared to active control stimulation in the anatomical vicinity, i.e., at the crus helicis and outer tragus. We used intermitted stimulation bursts of 25 Hz applied at a periodicity of 1 Hz. HRV was estimated with different time-domain methodologies: standard deviation of RR (SDNN), the root mean squares of successive differences (RMSSD), the percentage of RR-intervals with at least 50 ms deviation from the preceding RR-interval (pNN50), and the difference of consecutive RR intervals weighted by their mean (rrHRV).ResultsThe stimulation-induced HRV increases corresponded to frequency-specific oscillatory modulation of different cortical areas. All stimulation targets induced power modulations that were proportional to the HRV elevation. The most prominent changes that corresponded to HRV increases across all parameters and stimulation locations were frontal elevations in the theta-band. In the delta-band, there were frontal increases (RMSSD, pNN50, rrHRV, SDNN) and decreases (SDNN) across stimulation sites. In higher frequencies, there was a more divers activity pattern: Outer tragus/crus helicis stimulation increased oscillatory activity with the most prominent changes for the SDNN in frontal (alpha-band, beta-band) and fronto-parietal (gamma-band) areas. During inner tragus/cymba conchae stimulation the predominant pattern was a distributed power decrease, particularly in the fronto-parietal gamma-band.ConclusionNeuro–cardiac interactions can be modulated by electrical stimulation at different auricular locations. Increased HRV during stimulation is correlated with frequency-specific increases and decreases of oscillatory activity in different brain areas. When applying specific HRV measures, cortical patterns related to parasympathetic (RMSSD, pNN50, rrHRV) and sympathetic (SDNN) modulation can be identified. Thus, cortical oscillations may be used to define stimulation locations and parameters for research and therapeutic purposes.

show abstract

Section: Discussionsupporting

confidence: 81%

Brain–Heart Interaction During Transcutaneous Auricular Vagus Nerve Stimulation

et al. 2021

View full text Add to dashboard Cite

show abstract

“…We used the same VNS parameters as in epilepsy but with a lower frequency stimulation supposed to activate vagal efferents 28 . However, we previously reported that VNS at low frequency (5‐10Hz) of stimulation has a central effect 47,48 . VNS may have a placebo effect; however, in clinical trials with anti‐TNF drugs in CD, clinical remission during maintenance treatment ranged between 12% and 20% under placebo at 12 months 49,50 while in the present study 71% (five on seven patients) were in clinical remission.…”

Section: Discussionmentioning

confidence: 64%

A 12‐month pilot study outcomes of vagus nerve stimulation in Crohn's disease

Sinniger

Pellissier

Fauvelle

et al. 2020

Neurogastroenterology Motil

Self Cite

115

View full text Add to dashboard Cite

Background The vagus nerve has anti‐inflammatory properties. We aimed to investigate vagus nerve stimulation (VNS) as a new therapeutic strategy targeting an intrinsic anti‐inflammatory pathway in a pilot study in Crohn's disease patients. The main objectives addressed the questions of long‐term safety, tolerability, and anti‐inflammatory effects of this therapy. This study is the continuation of previous reported findings at 6 months. Methods Nine patients with moderate active disease underwent VNS. An electrode wrapped around the left cervical vagus nerve was continuously stimulated over 1 year. Clinical, biological, endoscopic parameters, cytokines (plasma, gut), and mucosal metabolites were followed‐up. Key Results After 1 year of VNS, five patients were in clinical remission and six in endoscopic remission. C‐reactive protein (CRP) and fecal calprotectin decreased in six and five patients, respectively. Seven patients restored their vagal tone and decreased their digestive pain score. The patients' cytokinergic profile evolved toward a more “healthy profile”: Interleukins 6, 23, 12, tumor necrosis factor α, and transforming growth factorβ1 were the most impacted cytokines. Correlations were observed between CRP and tumor necrosis factor α, and some gut mucosa metabolites as taurine, lactate, alanine, and beta‐hydroxybutyrate. VNS was well tolerated. Conclusion & Inferences Vagus nerve stimulation appears as an innovative and well‐tolerated treatment in moderate Crohn's disease. After 12 months, VNS has restored a homeostatic vagal tone and reduced the inflammatory state of the patients. VNS has probably a global modulatory effect on the immune system along with gut metabolic regulations. This pilot study needs replication in a larger randomized double‐blinded control study.

show abstract

“…Additionally, the common frequency of brain waves ranges from 1 to 30 Hz, such as theta (4–12 Hz), delta (1–4 Hz), and beta (12–30 Hz), which has been examined to study emotional states recently. Chronic VNS has a regulatory action via afferent vagal fibers on anxiodepressive symptomatology, which could be directly highlighted by the modulation of EEG associated to depressed states ( Kibleur et al, 2018 ). It is hypothesized that beta frequency is closely associated with negative mood, stress, and depression ( Huiku et al, 2007 ; Li et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous Auricular Vagus Nerve Stimulation at 20 Hz Improves Depression-Like Behaviors and Down-Regulates the Hyperactivity of HPA Axis in Chronic Unpredictable Mild Stress Model Rats

Wang

Gao

et al. 2020

Front. Neurosci.

View full text Add to dashboard Cite

Transcutaneous auricular vagus nerve stimulation (taVNS) has gained growing interest as a non-invasive and non-pharmacologic treatment option in various neurological and psychiatric disorders. Animal experiments and clinical trials confirm that taVNS at the auricular concha region has beneficial effects on depression. However, stimulation frequencies are selected empirically, and there is no evidence showing that any frequency is superior to the others. This study explores antidepressant-like effects of three frequencies of taVNS on rats subjected to chronic unpredictable mild stress (CUMS). Sprague-Dawley rats were randomly divided into five groups, i.e., the control, CUMS, 5 Hz-taVNS, 20 Hz-taVNS, and 100 Hz-taVNS groups. The three different frequencies were administered during the 30-min taVNS procedure once a day for 28 consecutive days. Rats exposed to CUMS showed signs of depression-like behaviors, including reduction in sucrose preference and increased immobility time in forced swimming and open field tests as well as significant dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis as detected by plasma corticosterone and adrenocorticotropic hormone concentration. The 28 days’ taVNS sessions with three frequencies elicited quite different consequences. Although 20 Hz taVNS significantly reversed the depression-like behaviors and downregulated the hyperactivity of the HPA axis, neither 5 nor 100 Hz showed any antidepressant-like effect on CUMS-induced rat behavior. Based on these results, we propose that, out of the three frequencies for taVNS intervention on depression, 20 Hz may be the optimized frequency to have a better modulation effect on HPA axis function by activating the auricular vagus nerve.

show abstract

Electroencephalographic correlates of low-frequency vagus nerve stimulation therapy for Crohn’s disease

Cited by 34 publications

References 24 publications

Brain–Heart Interaction During Transcutaneous Auricular Vagus Nerve Stimulation

Brain–Heart Interaction During Transcutaneous Auricular Vagus Nerve Stimulation

A 12‐month pilot study outcomes of vagus nerve stimulation in Crohn's disease

Transcutaneous Auricular Vagus Nerve Stimulation at 20 Hz Improves Depression-Like Behaviors and Down-Regulates the Hyperactivity of HPA Axis in Chronic Unpredictable Mild Stress Model Rats

Contact Info

Product

Resources

About