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Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress.

Abstract

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.

Authors+Show Affiliations

School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA. Electronic address: nil@gatech.edu.Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, USA.Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA.Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA.School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA.Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, GA, USA.Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, USA.Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA.Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, USA.Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, USA; Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA.Department 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, USA.Department 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, USA.School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Coulter Department of Bioengineering, Georgia Institute of Technology, Atlanta, GA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31439323

Citation

Gurel, Nil Z., et al. "Quantifying Acute Physiological Biomarkers of Transcutaneous Cervical Vagal Nerve Stimulation in the Context of Psychological Stress." Brain Stimulation, 2019.
Gurel NZ, Huang M, Wittbrodt MT, et al. Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress. Brain Stimul. 2019.
Gurel, N. Z., Huang, M., Wittbrodt, M. T., Jung, H., Ladd, S. L., Shandhi, M. M. H., ... Inan, O. T. (2019). Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress. Brain Stimulation, doi:10.1016/j.brs.2019.08.002.
Gurel NZ, et al. Quantifying Acute Physiological Biomarkers of Transcutaneous Cervical Vagal Nerve Stimulation in the Context of Psychological Stress. Brain Stimul. 2019 Aug 6; PubMed PMID: 31439323.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress. AU - Gurel,Nil Z, AU - Huang,Minxuan, AU - Wittbrodt,Matthew T, AU - Jung,Hewon, AU - Ladd,Stacy L, AU - Shandhi,Md Mobashir H, AU - Ko,Yi-An, AU - Shallenberger,Lucy, AU - Nye,Jonathon A, AU - Pearce,Bradley, AU - Vaccarino,Viola, AU - Shah,Amit J, AU - Bremner,J Douglas, AU - Inan,Omer T, Y1 - 2019/08/06/ PY - 2019/03/26/received PY - 2019/07/24/revised PY - 2019/08/04/accepted PY - 2019/8/24/entrez KW - Closed-loop stimulation KW - Mental stress KW - Noninvasive stimulation KW - Physiological biomarkers KW - Transcutaneous cervical stimulation KW - Traumatic stress KW - Vagal nerve stimulation KW - Wearable bioelectronic medicine JF - Brain stimulation JO - Brain Stimul N2 - 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. SN - 1876-4754 UR - https://www.unboundmedicine.com/medline/citation/31439323/Quantifying_acute_physiological_biomarkers_of_transcutaneous_cervical_vagal_nerve_stimulation_in_the_context_of_psychological_stress L2 - https://linkinghub.elsevier.com/retrieve/pii/S1935-861X(19)30346-8 DB - PRIME DP - Unbound Medicine ER -