Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress
Background: Stress is associated with activation of the sympathetic nervous system, and can lead to lasting alterations in autonomic function and in extreme cases symptoms of posttraumatic stress disorder (PTSD). Vagal nerve stimulation (VNS) is a potentially useful tool as a modulator of autonomic...
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Elsevier
2020-01-01
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Series: | Brain Stimulation |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S1935861X19303468 |
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doaj-3d9c469008df483993c80228e078385d |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nil Z. Gurel Minxuan Huang Matthew T. Wittbrodt Hewon Jung Stacy L. Ladd Md. Mobashir H. Shandhi Yi-An Ko Lucy Shallenberger Jonathon A. Nye Bradley Pearce Viola Vaccarino Amit J. Shah J. Douglas Bremner Omer T. Inan |
spellingShingle |
Nil Z. Gurel Minxuan Huang Matthew T. Wittbrodt Hewon Jung Stacy L. Ladd Md. Mobashir H. Shandhi Yi-An Ko Lucy Shallenberger Jonathon A. Nye Bradley Pearce Viola Vaccarino Amit J. Shah J. Douglas Bremner Omer T. Inan Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress Brain Stimulation Wearable bioelectronic medicine Vagal nerve stimulation Noninvasive stimulation Transcutaneous cervical stimulation Closed-loop stimulation Physiological biomarkers |
author_facet |
Nil Z. Gurel Minxuan Huang Matthew T. Wittbrodt Hewon Jung Stacy L. Ladd Md. Mobashir H. Shandhi Yi-An Ko Lucy Shallenberger Jonathon A. Nye Bradley Pearce Viola Vaccarino Amit J. Shah J. Douglas Bremner Omer T. Inan |
author_sort |
Nil Z. Gurel |
title |
Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress |
title_short |
Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress |
title_full |
Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress |
title_fullStr |
Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress |
title_full_unstemmed |
Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress |
title_sort |
quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress |
publisher |
Elsevier |
series |
Brain Stimulation |
issn |
1935-861X |
publishDate |
2020-01-01 |
description |
Background: Stress is associated with activation of the sympathetic nervous system, and can lead to lasting alterations in autonomic function and in extreme cases symptoms of posttraumatic stress disorder (PTSD). Vagal nerve stimulation (VNS) is a potentially useful tool as a modulator of autonomic nervous system function, however currently available implantable devices are limited by cost and inconvenience. Objective: The purpose of this study was to assess the effects of transcutaneous cervical VNS (tcVNS) on autonomic responses to stress. Methods: Using a double-blind approach, we investigated the effects of active or sham tcVNS on peripheral cardiovascular and autonomic responses to stress using wearable sensing devices in 24 healthy human participants with a history of exposure to psychological trauma. Participants were exposed to acute stressors over a three-day period, including personalized scripts of traumatic events, public speech, and mental arithmetic tasks. Results: tcVNS relative to sham applied immediately after traumatic stress resulted in a decrease in sympathetic function and modulated parasympathetic/sympathetic autonomic tone as measured by increased pre-ejection period (PEP) of the heart (a marker of cardiac sympathetic function) of 4.2 ms (95% CI 1.6–6.8 ms, p < 0.01), decreased peripheral sympathetic function as measured by increased photoplethysmogram (PPG) amplitude (decreased vasoconstriction) by 47.9% (1.4–94.5%, p < 0.05), a 9% decrease in respiratory rate (−14.3 to −3.7%, p < 0.01). Similar effects were seen when tcVNS was applied after other stressors and in the absence of a stressor. Conclusion: Wearable sensing modalities are feasible to use in experiments in human participants, and tcVNS modulates cardiovascular and peripheral autonomic responses to stress. |
topic |
Wearable bioelectronic medicine Vagal nerve stimulation Noninvasive stimulation Transcutaneous cervical stimulation Closed-loop stimulation Physiological biomarkers |
url |
http://www.sciencedirect.com/science/article/pii/S1935861X19303468 |
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doaj-3d9c469008df483993c80228e078385d2021-03-19T07:20:47ZengElsevierBrain Stimulation1935-861X2020-01-011314759Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stressNil Z. Gurel0Minxuan Huang1Matthew T. Wittbrodt2Hewon Jung3Stacy L. Ladd4Md. Mobashir H. Shandhi5Yi-An Ko6Lucy Shallenberger7Jonathon A. Nye8Bradley Pearce9Viola Vaccarino10Amit J. Shah11J. Douglas Bremner12Omer T. Inan13School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Corresponding author. 85 5th St NW, Atlanta, GA, 30308, USA.Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, USADepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USASchool of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USADepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USASchool of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USADepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, GA, USADepartment of Epidemiology, Rollins School of Public Health, Atlanta, GA, USADepartment of Radiology, Emory University School of Medicine, Atlanta, GA, USADepartment of Epidemiology, Rollins School of Public Health, Atlanta, GA, USADepartment of Epidemiology, Rollins School of Public Health, Atlanta, GA, USA; Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USADepartment of Epidemiology, Rollins School of Public Health, Atlanta, GA, USA; Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USADepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USASchool of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Coulter Department of Bioengineering, Georgia Institute of Technology, Atlanta, GA, USABackground: Stress is associated with activation of the sympathetic nervous system, and can lead to lasting alterations in autonomic function and in extreme cases symptoms of posttraumatic stress disorder (PTSD). Vagal nerve stimulation (VNS) is a potentially useful tool as a modulator of autonomic nervous system function, however currently available implantable devices are limited by cost and inconvenience. Objective: The purpose of this study was to assess the effects of transcutaneous cervical VNS (tcVNS) on autonomic responses to stress. Methods: Using a double-blind approach, we investigated the effects of active or sham tcVNS on peripheral cardiovascular and autonomic responses to stress using wearable sensing devices in 24 healthy human participants with a history of exposure to psychological trauma. Participants were exposed to acute stressors over a three-day period, including personalized scripts of traumatic events, public speech, and mental arithmetic tasks. Results: tcVNS relative to sham applied immediately after traumatic stress resulted in a decrease in sympathetic function and modulated parasympathetic/sympathetic autonomic tone as measured by increased pre-ejection period (PEP) of the heart (a marker of cardiac sympathetic function) of 4.2 ms (95% CI 1.6–6.8 ms, p < 0.01), decreased peripheral sympathetic function as measured by increased photoplethysmogram (PPG) amplitude (decreased vasoconstriction) by 47.9% (1.4–94.5%, p < 0.05), a 9% decrease in respiratory rate (−14.3 to −3.7%, p < 0.01). Similar effects were seen when tcVNS was applied after other stressors and in the absence of a stressor. Conclusion: Wearable sensing modalities are feasible to use in experiments in human participants, and tcVNS modulates cardiovascular and peripheral autonomic responses to stress.http://www.sciencedirect.com/science/article/pii/S1935861X19303468Wearable bioelectronic medicineVagal nerve stimulationNoninvasive stimulationTranscutaneous cervical stimulationClosed-loop stimulationPhysiological biomarkers |