The effect of transcutaneous vagus nerve stimulation on cortical excitability
The effect of transcutaneous vagus nerve stimulation on cortical excitability
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DOI：
10.1007/s00702-014-1299-7
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发表时间：
2015-05-01
影响因子：
3.3
通讯作者：
Di Lazzaro, Vincenzo
中科院分区：
文献类型：
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作者：
Capone, Fioravante;Assenza, Giovanni;Di Lazzaro, Vincenzo
经皮迷走神经刺激（tVNS）应用于神经精神疾病的治疗潜力引起了极大的兴趣。然而，tVNS的作用机制及其对皮层兴奋性的影响尚不清楚。在这方面，经颅磁刺激（TMS）可以是有用的，因为它能够评估非侵入性的兴奋和抑制回路的人类皮层。本研究的目的是通过经颅磁刺激（TMS）研究tVNS对健康志愿者大脑皮层兴奋性的影响。10名健康受试者参加了这项随机、安慰剂对照、双盲研究。在左侧外耳道给予真实的tVNS，在左侧耳垂进行假刺激，均持续60 min。检测左右两侧运动皮层的运动阈值、运动诱发电位振幅、募集曲线和短间期皮层内抑制（SICI）。在暴露于tVNS之前和之后60分钟，对真实的和假刺激的这些参数进行评价。刺激期间监测心血管参数。实施了重复测量的广义线性模型，以评估时间和刺激类型对心血管和神经生理变量的影响。SICI是一种可提供GABA-A活性信息的双脉冲TMS范式，在真实的tVNS后右侧运动皮质显着增加。其他神经生理学参数以及心血管变量保持不变。我们的研究结果证实，tVNS是一种安全有效的方式来刺激迷走神经，并提供了创新的数据，可能的作用机制，支持这种技术的潜在治疗应用。
There is great interest about the therapeutic potentialities of transcutaneous vagus nerve stimulation (tVNS) applied to neuropsychiatric disorders. However, the mechanisms of action of tVNS and its impact on cortical excitability are unclear. To this regard, transcranial magnetic stimulation (TMS) can be useful because it is able of evaluating non-invasively excitatory and inhibitory circuitry of the human cortex. Aim of the present study is to investigate the effects of tVNS on cerebral cortex excitability in healthy volunteers by means of TMS. Ten healthy subjects participated in this randomized placebo-controlled double-blind study. Real tVNS was administered at left external acoustic meatus, while sham stimulation was performed at left ear lobe, both of them for 60 min. We evaluated motor thresholds, motor evoked potential amplitude, recruitment curves, and short-interval intracortical inhibition (SICI) in right and left motor cortex. Such parameters were evaluated before and 60 min after the exposure to tVNS, for both the real and the sham stimulation. Cardiovascular parameters were monitored during the stimulation. A generalized linear model for repeated measures was implemented to assess the effect of time and stimulation type on cardiovascular and neurophysiological variables. SICI, a double-pulse TMS paradigm informative of GABA-A activity, was significantly increased in right motor cortex after real tVNS. Other neurophysiological parameters, as well as cardiovascular variables, remained unchanged. Our findings confirm that tVNS is a safe and effective way to stimulate vagus nerve and provide innovative data about the possible mechanisms of action that supports the potential therapeutic application of this technique.