Transcutaneous auricular vagus nerve stimulation (taVNS) for migraine: an fMRI study

Abstract

BackgroundDysfunction of the thalamocortical connectivity network is thought to underlie the pathophysiology of the migraine. This current study aimed to explore the thalamocortical connectivity changes during 4 weeks of continuous transcutaneous vagus nerve stimulation (taVNS) treatment on migraine patients.Methods70 migraine patients were recruited and randomized in an equal ratio to receive real taVNS or sham taVNS treatments for 4 weeks. Resting-state functional MRI was collected before and after treatment. The thalamus was parceled into functional regions of interest (ROIs) on the basis of six priori-defined cortical ROIs covering the entire cortex. Seed-based functional connectivity analysis between each thalamic subregion and the whole brain was further compared across groups after treatment.ResultsOf the 59 patients that finished the study, those in the taVNS group had significantly reduced number of migraine days, pain intensity and migraine attack times after 4 weeks of treatment compared with the sham taVNS. Functional connectivity analysis revealed that taVNS can increase the connectivity between the motor-related thalamus subregion and anterior cingulate cortex/medial prefrontal cortex, and decrease the connectivity between occipital cortex-related thalamus subregion and postcentral gyrus/precuneus.ConclusionOur findings suggest that taVNS can relieve the symptoms of headache as well as modulate the thalamocortical circuits in migraine patients. The results provide insights into the neural mechanism of taVNS and reveal potential therapeutic targets for migraine patients.

Early Fractional Amplitude of Low Frequency Fluctuation Can Predict the Efficacy of Transcutaneous Auricular Vagus Nerve Stimulation Treatment for Migraine Without Aura

“…In our previous published article (Zhang et al, 2021) Episodic migraineurs without aura were diagnosed by licensed neurologists according to the 2nd Edition International Classification of Headache Disorders for Migraine Without Aura (Headache Classification Subcommittee of the International Headache Society, 2004). The detailed inclusion criteria for the MWoA patients are as follows: (1) aged 18-45 years old, (2) righthanded, (3) have at least 6 months of migraine duration, (4) have at least two headache attacks per month, (5) have not taken any prophylactic headache medications during the past 1 month, and (6) have not taken any psychoactive or vasoactive drugs during the past 3 months.…”

Auricular transcutaneous vagus nerve stimulation modulates the heart-evoked potential

“…Additional taVNS studies highlight increased neural activity or altered BOLD responses within the locus coeruleus 36,37,[42][43][44][45] , which is a major target of adrenergic influences that has bidirectional communication with the NST 46 . taVNS moreover elicits BOLD responses within the insula, ACC, OFC, hypothalamus, thalamus, and amygdala 36,39,44,[47][48][49] .…”

Different modulation effects of 1 Hz and 20 Hz transcutaneous auricular vagus nerve stimulation on the functional connectivity of the periaqueductal gray in patients with migraine

“…We found migraine is associated with altered posterior thalamus dynamic network functional connectivity with the visual cortex [ 79 ], and the abnormal functional connectivity within the visual, default mode, sensorimotor, and frontal-parietal networks, which could discriminate migraineurs from healthy controls, with 93% sensitivity and 89% specificity [ 95 ]. More recently, we found that 4-week taVNS at 1 Hz can decrease the connectivity between the occipital cortex-related thalamus subregion and the postcentral gyrus/precuneus [ 96 ]. Taken together, these studies demonstrate the important role of the precuneus and cuneus in the pathology of migraine.…”