Transcutaneous Vagus Nerve Stimulation Modulates Tinnitus-Related Beta- and Gamma-Band Activity

Hyvärinen, Petteri; Yrttiaho, Santeri; Ilmoniemi, Risto J.; Mäkitie, Antti; Ylikoski, Jukka; Mäkelä, Jyrki P.; Aarnisalo, Antti A.

doi:10.1097/aud.0000000000000123

Cited by 40 publications

(32 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therapeutic modulation of gamma-band oscillations with vagus nerve stimulation has been recently reported in epileptic patients. tVNS successfully also modulates tinnitus-related beta-and gammaband activity and thus could have potential as a treatment method for tinnitus [17].…”

Section: Discussionmentioning

confidence: 99%

Non-invasive vagus nerve stimulation reduces sympathetic preponderance in patients with tinnitus

Ylikoski¹,

Lehtimäki²,

Pirvola

et al. 2017

Acta Oto-Laryngologica

Self Cite

View full text Add to dashboard Cite

The pre-treatment HRV recording showed sympathetic preponderance/reduced parasympathetic activity in about three quarters (73%) of patients. Active tVNS significantly increased variability of R-R intervals in 75% of patients and HRV age was decreased in 70% of patients. Either the variability of R-R intervals was increased or the HRV age decreased in 90% of the patients. These results indicate that tVNS can induce a shift in ANS function from sympathetic preponderance towards parasympathetic predominance. tVNS caused no major morbidity, and heart rate monitoring during the tVNS treatment showed no cardiac or circulatory effects (e.g. bradycardia) in any of the patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Non-invasive vagus nerve stimulation reduces sympathetic preponderance in patients with tinnitus

Ylikoski¹,

Lehtimäki²,

Pirvola

et al. 2017

Acta Oto-Laryngologica

Self Cite

View full text Add to dashboard Cite

show abstract

“…By this mechanism, vagus nerve stimulation, paired with sound stimuli (to promote reorganisation in the auditory cortex), is a hypothesised treatment for tinnitus. Experimental studies have examined the safety and efficacy of vagus nerve stimulation, both direct (i. e. implanted electrode) and transcutaneous, paired with acoustic stimulation for tinnitus [108,129,134,136,178]. Tyler et al [171] conducted a prospective randomised double-blind controlled pilot study of the effects of direct vagus nerve stimulation paired with tones on tinnitus.…”

Section: No Recommendationmentioning

confidence: 99%

A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment

Cima

Mazurek

Haider

et al. 2019

HNO

313

334

View full text Add to dashboard Cite

“…Although Eastern medicine has utilised the analgesic effects of auricular acupuncture for thousands of years (Asher et al 2010;He et al 2012;Usichenko et al 2017), the concept of electrically stimulating the auricle is a more recent one (Ventureyra, 2000). The feasibility of auricular tVNS was first demonstrated using recordings of vagus somato-sensory evoked potentials from the scalp (Fallgatter et al 2003) and since then has been proposed as an effective therapeutic strategy in the management of several clinical disorders including epilepsy (Rong et al 2014), depression (Kong et al 2018), migraine (Straube et al 2015) and tinnitus (Hyvarinen et al 2015). The basis of auricular tVNS is the cutaneous representation of the auricular branch of the vagus nerve (ABVN), also termed Arnold's nerve, which provides somatosensory innervation to the external ear.…”

Section: Introductionmentioning

confidence: 99%

The anatomical basis for transcutaneous auricular vagus nerve stimulation

et al. 2019

View full text Add to dashboard Cite

The array of end organ innervations of the vagus nerve, coupled with increased basic science evidence, has led to vagus nerve stimulation (VNS) being explored as a management option in a number of clinical disorders, such as heart failure, migraine and inflammatory bowel disease. Both invasive (surgically implanted) and non‐invasive (transcutaneous) techniques of VNS exist. Transcutaneous VNS (tVNS) delivery systems rely on the cutaneous distribution of vagal afferents, either at the external ear (auricular branch of the vagus nerve) or at the neck (cervical branch of the vagus nerve), thus obviating the need for surgical implantation of a VNS delivery device and facilitating further investigations across a wide range of uses. The concept of electrically stimulating the auricular branch of the vagus nerve (ABVN), which provides somatosensory innervation to several aspects of the external ear, is relatively more recent compared with cervical VNS; thus, there is a relative paucity of literature surrounding its operation and functionality. Despite the increasing body of research exploring the therapeutic uses of auricular transcutaneous VNS (tVNS), a comprehensive review of the cutaneous, intracranial and central distribution of ABVN fibres has not been conducted to date. A review of the literature exploring the neuroanatomical basis of this neuromodulatory therapy is therefore timely. Our review article explores the neuroanatomy of the ABVN with reference to (1) clinical surveys examining Arnold’s reflex, (2) cadaveric studies, (3) fMRI studies, (4) electrophysiological studies, (5) acupuncture studies, (6) retrograde tracing studies and (7) studies measuring changes in autonomic (cardiovascular) parameters in response to auricular tVNS. We also provide an overview of the fibre composition of the ABVN and the effects of auricular tVNS on the central nervous system. Cadaveric studies, of which a limited number exist in the literature, would be the ‘gold‐standard’ approach to studying the cutaneous map of the ABVN; thus, there is a need for more such studies to be conducted. Functional magnetic resonance imaging (fMRI) represents a useful surrogate modality for discerning the auricular sites most likely innervated by the ABVN and the most promising locations for auricular tVNS. However, given the heterogeneity in the results of such investigations and the various limitations of using fMRI, the current literature lacks a clear consensus on the auricular sites that are most densely innervated by the ABVN and whether the brain regions secondarily activated by electrical auricular tVNS depend on specific parameters. At present, it is reasonable to surmise that the concha and inner tragus are suitable locations for vagal modulation. Given the therapeutic potential of auricular tVNS, there remains a need for the cutaneous map of the ABVN to be further refined and the effects of various stimulation parameters and stimulation sites to be determined.

show abstract

Transcutaneous Vagus Nerve Stimulation Modulates Tinnitus-Related Beta- and Gamma-Band Activity

Abstract: We conclude that tVNS was successful in modulating tinnitus-related beta- and gamma-band activity and thus could have potential as a treatment method for tinnitus.

Cited by 40 publications

References 50 publications

Non-invasive vagus nerve stimulation reduces sympathetic preponderance in patients with tinnitus

Non-invasive vagus nerve stimulation reduces sympathetic preponderance in patients with tinnitus

A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment

The anatomical basis for transcutaneous auricular vagus nerve stimulation

Contact Info

Product

Resources

About