Non-invasive vagus nerve stimulation acutely improves spontaneous cardiac baroreflex sensitivity in healthy young men: A randomized placebo-controlled trial

Antonino, Diego; Teixeira, André L.; Maia-Lopes, Paulo M.; Souza, Mayara Caroline da Costa; Sabino‐Carvalho, Jeann L.; Murray, Aaron; Deuchars, Jim; Vianna, Lauro C.

doi:10.1016/j.brs.2017.05.006

Cited by 108 publications

(113 citation statements)

References 55 publications

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“…Thus, subjects with higher responses to 2 Hz RAVANS also showed higher responses to 100 Hz RAVANS in these nuclei. their modulation in response to RAVANS might be due to vagovagal feedback and serve as the basis of therapeutic effects observed for cardiovascular [14,16,48] and gastrointestinal [11,12] taVNS applications. The pre-B€ otzinger complex, a functionallydefined region located ventrally to the NAmb, is known to be a generator for respiratory rhythms in mammals [49], and evoked fMRI response in this nuclei may result from the respiratory-gated nature of RAVANS taVNS, which future studies should explore more explicitly.…”

Section: Discussionmentioning

confidence: 99%

Stimulus frequency modulates brainstem response to respiratory-gated transcutaneous auricular vagus nerve stimulation

et al. 2020

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a b s t r a c tBackground: The therapeutic potential of transcutaneous auricular VNS (taVNS) is currently being explored for numerous clinical applications. However, optimized response for different clinical indications may depend on specific neuromodulation parameters, and systematic assessments of their influence are still needed to optimize this promising approach. Hypothesis: We proposed that stimulation frequency would have a significant effect on nucleus tractus solitarii (NTS) functional MRI (fMRI) response to respiratory-gated taVNS (RAVANS). Methods: Brainstem fMRI response to auricular RAVANS (cymba conchae) was assessed for four different stimulation frequencies (2, 10, 25, 100 Hz). Sham (no current) stimulation was used to control for respiration effects on fMRI signal. Results: Our findings demonstrated that RAVANS delivered at 100 Hz evoked the strongest brainstem response, localized to a cluster in the left (ipsilateral) medulla and consistent with purported NTS. A colocalized, although weaker, response was found for 2 Hz RAVANS. Furthermore, RAVANS delivered at 100 Hz also evoked stronger fMRI responses for important monoamine neurotransmitter source nuclei (LC, noradrenergic; MR, DR, serotonergic) and pain/homeostatic regulation nuclei (i.e. PAG). Conclusion: Our fMRI results support previous localization of taVNS afference to pontomedullary aspect of NTS in the human brainstem, and demonstrate the significant influence of the stimulation frequency on brainstem fMRI response.

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Section: Discussionmentioning

confidence: 99%

Stimulus frequency modulates brainstem response to respiratory-gated transcutaneous auricular vagus nerve stimulation

et al. 2020

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“…Spontaneous cardiac baroreflex sensitivity. Spontaneous cardiac baroreflex sensitivity (cBRS) was assessed using the sequence technique as previously reported (CardioSeries v2.4) (Antonino et al 2017;Parati et al 2000;Teixeira et al 2018b). Sequences were detected only when the variation in RR interval was Ͼ1.0 ms, systolic BP changes were Ͼ1 mmHg, and there were Ն3 consecutive cardiac cycles.…”

Section: Methodsmentioning

confidence: 99%

Blunted cardiovascular responses to exercise in Parkinson’s disease patients: role of the muscle metaboreflex

Sabino‐Carvalho

Teixeira

Samora

et al. 2018

Journal of Neurophysiology

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Patients with Parkinson's disease (PD) exhibit attenuated cardiovascular responses to exercise. The underlying mechanisms that are potentially contributing to these impairments are not fully understood. Therefore, we sought to test the hypothesis that patients with PD exhibit blunted cardiovascular responses to isolated muscle metaboreflex activation following exercise. For this, mean blood pressure, cardiac output, and total peripheral resistance were measured using finger photoplethysmography and the Modelflow method in 11 patients with PD [66 ± 2 yr; Hoehn and Yahr score: 2 ± 1 a.u.; time since diagnosis: 7 ± 1 yr; means ± SD) and 9 age-matched controls (66 ± 3 yr). Measurements were obtained at rest, during isometric handgrip exercise performed at 40% maximal voluntary contraction, and during postexercise ischemia. Also, a cold pressor test was assessed to confirm that blunted cardiovascular responses were specific to exercise and not representative of generalized sympathetic responsiveness. Changes in mean blood pressure were attenuated in patients with PD during handgrip (PD: ∆25 ± 2 mmHg vs. controls: ∆31 ± 3 mmHg; P < 0.05), and these group differences remained during postexercise ischemia (∆17 ± 1 mmHg vs. ∆26 ± 1 mmHg, respectively; P < 0.01). Additionally, changes in total peripheral resistance were attenuated during exercise and postexercise ischemia, indicating blunted reflex vasoconstriction in patients with PD. Responses to cold pressor test did not differ between groups, suggesting no group differences in generalized sympathetic responsiveness. Our results support the concept that attenuated cardiovascular responses to exercise observed in patients with PD are, at least in part, explained by an altered skeletal muscle metaboreflex. NEW & NOTEWORTHY Patients with Parkinson's disease (PD) presented blunted cardiovascular responses to exercise. We showed that cardiovascular response evoked by the metabolic component of the exercise pressor reflex is blunted in patients with PD. Furthermore, patients with PD presented similar pressor response during the cold pressor test compared with age-matched controls. Altogether, our results support the hypothesis that attenuated cardiovascular responses to exercise observed in patients with PD are mediate by an altered skeletal muscle metaboreflex.

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“…As shown in the study by Antonino et al., the resting HR and LF/HF ratio of HRV in healthy men were significantly decreased and significantly increased, respectively, during active transcutaneous VNS via the AB‐VN. Thus, AB‐VNS acutely improves spontaneous cardiac baroreflex sensitivity and autonomic modulation in healthy men.…”

Section: Discussionmentioning

confidence: 67%

“…Next, the efferent fibers of the vagus nerve are activated by the dorsal motor nucleus of the vagus nerve (DMNV), a cranial nerve nucleus for the vagus nerve in the medulla (which contains the cardiac centers). 21 As shown in the study by Antonino et al, 22 the resting HR and LF/HF ratio of HRV in healthy men were significantly decreased and significantly increased, respectively, during active transcutaneous VNS via the AB-VN. Thus, AB-VNS acutely improves spontaneous cardiac baroreflex sensitivity and autonomic modulation in healthy men.…”

Section: Possible Mechanisms Of Chronic Ab-vns Therapymentioning

confidence: 73%

Vagus nerve stimulation reduces ventricular arrhythmias and increases ventricular electrical stability

Nasi-Er

Zhang

Sun

et al. 2019

Pacing Clinical Electrophis

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Background Transcutaneous stimulation of the auricular branch of the vagus nerve (AB‐VNS) is a potentially noninvasive, inexpensive, and safe approach for vagus nerve stimulation that suppresses the induction and duration of atrial fibrillation and reduces sympathetic nerve outflow in healthy humans. Researchers have not determined whether AB‐VNS affects ventricular arrhythmias. Objective To evaluate the antiarrhythmic effects of noninvasive AB‐VNS on ventricular arrhythmias induced by myocardial infarction (MI). Methods and Results Twelve beagle dogs were randomly divided into the following two groups: a AB‐VNS group (coronary artery occlusion and noninvasive AB‐VNS) and a control group (coronary artery occlusion but without AB‐VNS). We examined spontaneous ventricular arrhythmias, ventricular electrophysiological properties, and cardiac function in conscious dogs. Morphology, fibrosis, and http://ultrastructures were also assessed. AB‐VNS significantly reduced the occurrence of spontaneous ventricular arrhythmias, including isolated premature ventricular complexes, ventricular couplets, ventricular bigeminy, ventricular trigeminy, and ventricular tachycardia. AB‐VNS effectively increased ventricular electrical stability, including significantly prolonged ventricular effective refractory periods, decreased the dispersion of effective refractory period, enhanced the ventricular fibrillation threshold, and decreased the maximum slope of the monophasic action potential duration restitution curve. AB‐VNS treatments alleviate ventricular interstitial fibrosis after MI. However, cardiac function was not improved, and MI‐induced ultrastructural changes in the myocardium were not reversed by 4 weeks of AB‐VNS. In addition, AB‐VNS for 4 weeks resulted in mild mitochondrial swelling within the neuronal axons of the auricular vagus fiber. Conclusions Noninvasive AB‐VNS reduces the occurrence of spontaneous ventricular arrhythmias in conscious dogs with MI. AB‐VNS increases ventricular electrical stability and alleviates ventricular interstitial fibrosis induced by MI.

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Non-invasive vagus nerve stimulation acutely improves spontaneous cardiac baroreflex sensitivity in healthy young men: A randomized placebo-controlled trial

Abstract: tVNS acutely improves cBRS and autonomic modulation in healthy young men.

Cited by 108 publications

References 55 publications

Stimulus frequency modulates brainstem response to respiratory-gated transcutaneous auricular vagus nerve stimulation

Stimulus frequency modulates brainstem response to respiratory-gated transcutaneous auricular vagus nerve stimulation

Blunted cardiovascular responses to exercise in Parkinson’s disease patients: role of the muscle metaboreflex

Vagus nerve stimulation reduces ventricular arrhythmias and increases ventricular electrical stability

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