Ther Apher Dial. 2025 Jan 4. doi: 10.1111/1744-9987.14243. Online ahead of print.

ABSTRACT

INTRODUCTION: Transcutaneous auricular vagus nerve stimulation (tVNS) has shown potential in neurological, autoimmune, and cardiovascular disorders, but its effects on HD patients remain unclear. This study aimed to evaluate the efficacy and safety of tVNS in HD patients.

METHODS: We conducted a randomized controlled clinical trial on patients receiving HD ≥6 months. The tVNS group received stimulation for 1 h during the first 2 h of HD sessions, three times weekly for 8 weeks, while the control group received standard care. The primary outcomes were dialysis efficiency (Single-pool Kt/V, Sp Kt/V) and dialysis-related symptoms (Dialysis Symptom Index, DSI), assessed every 4 weeks. Secondary outcomes included pain and fatigue scores, physical performance, Hemodialysis Comfort Scale, hemoglobin levels, Mini-Mental State Examination, and anxiety and depression scores, measured at baseline and 8 weeks after intervention.

RESULTS: A total of 63 patients were enrolled in the study, with 32 patients assigned to the tVNS group and 31 patients to the control group. At 8 weeks, the tVNS group showed significant improvements in Sp Kt/V (1.31 ± 0.11 vs. 1.25 ± 0.10, p = 0.02), and DSI (12.09 ± 5.84 vs. 16.26 ± 5.27, p = 0.004), as well as reductions in pain and fatigue, and increases in physical function, comfort, and hemoglobin. However, there were no statistically significant changes observed in cognitive function, anxiety, or depression.

CONCLUSIONS: tVNS could improve dialysis efficiency, symptoms, and physical function in HD patients, indicating it may have a role as a complementary therapy.

PMID:39754453 | DOI:10.1111/1744-9987.14243

Scand J Pain. 2024 Dec 31;24(1). doi: 10.1515/sjpain-2024-0037. eCollection 2024 Jan 1.

ABSTRACT

OBJECTIVES: Autonomic regulation has been identified as a potential regulator of pain via vagal nerve mediation, assessed through heart rate variability (HRV). Non-invasive vagal nerve stimulation (nVNS) and heart rate variability biofeedback (HRVB) have been proposed to modulate pain. A limited number of studies compare nVNS and HRVB in persons with chronic pain conditions. This systematic review compared interventions of nVNS and HRVB in adults with long-standing pain conditions.

METHODS: PubMed, MEDLINE, CINAHL, SPORTDiscus, Google Scholar, and Cochrane library were used to retrieve the randomized controlled trials for this review between the years 2010 and 2023. Search terms included chronic pain, fibromyalgia, headache, migraine, vagus nerve stimulation, biofeedback, HRV, pain assessment, pain, and transcutaneous.

RESULTS: Ten full-text articles of 1,474 identified were selected for full qualitative synthesis, with a combined population of 813 subjects. There were n = 763 subjects in studies of nVNS and n = 50 subjects for HRVB. Six of the nine nVNS studies looked at headache disorders and migraines (n = 603), with two investigating effects on fibromyalgia symptoms (n = 138) and one the effects on chronic low back pain (n = 22). Of the nVNS studies, three demonstrated significant results in episode frequency, six in pain intensity (PI) reduction, and three in reduced medication use. The HRVB study showed statistically significant findings for reduced PI, depression scores, and increased HRV coherence.

CONCLUSION: Moderate to high-quality evidence suggests that nVNS is beneficial in reducing headache frequency and is well-tolerated, indicating it might be an alternative intervention to medication. HRVB interventions are beneficial in reducing pain, depression scores, use of non-steroidal anti-inflammatory medication, and in increasing HRV coherence ratio. HRVB and nVNS appear to show clinical benefits for chronic pain conditions; however, insufficient literature exists to support either approach.

PMID:39753127 | DOI:10.1515/sjpain-2024-0037

Cureus. 2024 Dec 3;16(12):e75049. doi: 10.7759/cureus.75049. eCollection 2024 Dec.

ABSTRACT

Objectives The aim of this anatomical study was to analyze distances and anatomical relations between the lower cranial nerves and important neck landmarks. Methods Anatomical study based on neck dissection in Thiel-embalmed cadavers. Anatomical relations and distances between the vagus (X), accessory (XI), and hypoglossal (XII) nerves and important neck landmarks were registered and compared. The relation between the emergence of the great auricular nerve and the posterior border of the sternocleidomastoid muscle and certain anatomical aspects of the ansa cervicalis were also studied. Results A total of 18 neck dissections (seven bilateral, four unilateral) were performed on 11 adult cadavers (mean (SD) age: 74.2 (12.9) years, four male, seven female). The X nerve was posterolateral to the common carotid artery and medial to the internal jugular vein (IJV) in 55.6% of the cases. In relation to the IJV, the XI nerve traveled mostly anteromedial (44.4%) at the level of the jugular foramen, posterior (50%) at the posterior belly of the digastric muscle, and posterolateral (77.8%) below the digastric muscle. The XII nerve was inferior (50%), medial (33.3%), and superior (16.7%) to the digastric tendon. The distance between the XII nerve and the carotid bifurcation was significantly superior in the male gender (mean (SD): 31.7 (6.8) mm vs. 18.5 (7.9) mm, p = .003). Also, the distance between the origin of the occipital artery and the point where it crosses the XII nerve was significantly higher in females (median (IQR): 7 (12.0) vs. 4 (4.0), p = .012). Conclusions There is a great variability in the anatomical position, course, and distances between the lower cranial nerves and traditional anatomical landmarks in the neck. The topography of the lower cranial nerves can vary even with the gender. Proper anatomical knowledge is crucial in neck surgery to prevent potential nerve injuries.

PMID:39749067 | PMC:PMC11695066 | DOI:10.7759/cureus.75049

Brain Res Bull. 2024 Dec 31:111186. doi: 10.1016/j.brainresbull.2024.111186. Online ahead of print.

ABSTRACT

Liangxue Tongyu Prescription (LTP) is a classic herbal formula for treating acute intracerebral hemorrhage (AICH) in China. Previous studies have shown that LTP significantly ameliorates neurological impairments and gastrointestinal dysfunction in patients with AICH. However, the underlying molecular mechanism remains unclear. The aim of this study is to investigate whether LTP exerts its neuroprotective effect on AICH rats through the microbiota-gut-brain axis and explore its potential underlying mechanism. In the current study, AICH models were established by injecting autologous whole blood into the right caudate nucleus of rats. Behavioural and pathological evaluations demonstrated that LTP ameliorated neuronal and intestinal damage in AICH rats. Analysis via western blot, quantitative real-time PCR, immunohistochemistry (IHC) and tunel staining indicated that LTP upregulated the expression of brain-derived neurotrophic factor (BDNF) and nerve growth factor(NGF) and reduced neuronal cell apoptosis. Additionally, 16S rDNA sequencing revealed that LTP mitigated dysbiosis of intestinal microbiota in AICH rats. LTP increased the levels of noradrenaline (NA), dopamine (DA), glutamate (GLU) and modulated brain-gut peptides such as gastrin (GAS), motilin (MTL), ghrelin in AICH rats. Furthermore, LTP enhanced vagus nerve discharge. In summary, this research provides evidence suggesting that LTP’s influence on AICH may involve modulation of the microbiota-gut-brain axis, offering a potential scientific rationale for its therapeutic efficacy in improving outcomes of AICH.

PMID:39746523 | DOI:10.1016/j.brainresbull.2024.111186

Int Immunopharmacol. 2025 Jan 1;147:113941. doi: 10.1016/j.intimp.2024.113941. Online ahead of print.

ABSTRACT

During the process of acute lung injury (ALI) associated with sepsis, the α7nAChR in the cholinergic anti-inflammatory pathway (CAP) plays a crucial role. However, the roles of electroacupuncture (EA) and specialized pro-resolving mediators (SPMs) in this context remain unclear. In this study, we demonstrated that EA activates CAP via α7nAChR, reducing lung permeability and inflammatory cytokine release. Our results highlighted lipoxin A4 (LXA4) as a crucial SPM in this process. EA was shown to enhance LXA4 synthesis and alleviate symptoms in patients with sepsis-related acute respiratory distress syndrome (ARDS). Studies using α7nAChR-deficient mice confirmed its essential role in LXA4 regulation. Macrophages in bronchoalveolar lavage fluid (BALF) were identified as key contributors to the protective effects of LXA4, further supported by experiments involving pulmonary macrophage depletion. In summary, we discovered a novel anti-inflammatory pathway where EA activates α7nAChR, leading to increased LXA4 production and lung protection.

PMID:39746272 | DOI:10.1016/j.intimp.2024.113941

Brain. 2025 Jan 2:awae385. doi: 10.1093/brain/awae385. Online ahead of print.

ABSTRACT

Brain stimulation has, for many decades, been considered as a potential solution for the unmet needs of the many people living with drug-resistant epilepsy. Clinically, there are several different approaches in use, including vagus nerve stimulation (VNS), deep brain stimulation of the thalamus, and responsive neurostimulation (RNS). Across populations of patients, all deliver reductions in seizure load and SUDEP risk, yet do so variably, and the improvements seem incremental rather than transformative. In contrast, within the field of experimental neuroscience, the transformational impact of optogenetic stimulation is evident; by providing a means to control subsets of neurons in isolation, it has revolutionized our ability to dissect out the functional relations within neuronal microcircuits. It is worth asking, therefore, how pre-clinical optogenetics research could advance clinical practice in epilepsy? Here, we review the state of the clinical field, and the recent progress in pre-clinical animal research. We report various breakthrough results, including the development of new models of seizure initiation, its use for seizure prediction, and for fast, closed-loop control of pathological brain rhythms, and what these experiments tell us about epileptic pathophysiology. Finally, we consider how these pre-clinical research advances may be translated into clinical practice.

PMID:39745924 | DOI:10.1093/brain/awae385

Int J Neurosci. 2025 Jan 2:1-13. doi: 10.1080/00207454.2024.2449382. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the activity of default mode network (DMN), frontoparietal network (FPN) and cerebellar network (CN) in drug-resistant epilepsy (DRE) patients undergoing vagus nerve stimulation (VNS).

METHODS: Fifteen patients were recruited and underwent resting-state fMRI scans. Independent component analysis and paired sample t-tests were used to examine activity changes of DMN, FPN and CN before and after VNS.

RESULTS: Compared with preoperative patients, DMN exhibited decreased activity in left cuneus/precuneus, left median cingulate gyrus, left superior/middle occipital gyrus, right superior parietal gyrus, right precentral/postcentral gyrus, right rolandic operculum and right insula, while increased activity was observed in right supramarginal gyrus, left fusiform gyrus, right supplementary motor area, left amygdala, and right inferior frontal gyrus. FPN displayed decreased activity in left cuneus, left anterior cingulate gyrus, right precentral gyrus, left middle/inferior frontal gyrus, right middle frontal gyrus, left superior/middle temporal gyrus, left superior/middle occipital gyrus, and right superior parietal gyrus, but increased activity in right inferior temporal gyrus. CN showed decreased activity in left superior/middle frontal gyrus, right inferior frontal gyrus, left supplementary motor area, left precuneus, left postcentral gyrus, left middle occipital gyrus, right middle temporal gyrus, and left inferior cerebellum, while increased activity was detected in bilateral superior cerebellum and right fusiform gyrus.

CONCLUSIONS: DMN, FPN and CN exhibited distinct changes in DRE patients following VNS. The suppression or activation of sensorimotor, language, memory and emotion-related regions may represent the underlying neurological mechanisms of VNS. However, the contrasting activity patterns between superior and inferior cerebellum require further investigation.

PMID:39745504 | DOI:10.1080/00207454.2024.2449382

United European Gastroenterol J. 2025 Jan 2. doi: 10.1002/ueg2.12751. Online ahead of print.

NO ABSTRACT

PMID:39744780 | DOI:10.1002/ueg2.12751

Front Mol Neurosci. 2024 Dec 16;17:1452327. doi: 10.3389/fnmol.2024.1452327. eCollection 2024.

ABSTRACT

INTRODUCTION: Recognition memory, an essential component of cognitive health, can suffer from biological limitations of stress, aging, or neurodegenerative disease. Vagus nerve stimulation (VNS) is a neuromodulation therapy with the potential to improve cognitive function. This study investigated the effectiveness of multiple sessions of VNS to enhance recognition memory in healthy rodents and the underlying cognitive benefits of VNS by proteomic analysis of the synaptosome.

METHODS: Rats demonstrated VNS-induced recognition memory improvements using a novel object recognition (NOR) task. Using the LC-MS/MS method, roughly 3,000 proteins in the synaptosome of the hippocampus were analyzed.

RESULTS: Protein-protein interaction (PPI) enrichment analysis found differentially expressed proteins related to synaptic signaling and neurotransmitter pathways. PPI network analysis identified six unique protein clusters, including a cluster of synaptic signaling related pathways. Using ingenuity pathway analysis (IPA), rapamycin-insensitive companion of mTOR was identified as an upstream regulator of synaptosome changes due to VNS-paired training.

DISCUSSION: Based on these results, it is proposed that VNS may mediate cognitive enhancement via increases in glutamatergic signaling and early LTP during the consolidation period, followed by sustained synaptic plasticity via modified post-synaptic receptor expression and dendritic outgrowth. Further investigation is required to determine if VNS is a good candidate to ameliorate cognitive impairment.

PMID:39741691 | PMC:PMC11685747 | DOI:10.3389/fnmol.2024.1452327

Front Aging Neurosci. 2024 Dec 17;16:1538891. doi: 10.3389/fnagi.2024.1538891. eCollection 2024.

ABSTRACT

[This corrects the article DOI: 10.3389/fnagi.2024.1444703.].

PMID:39741519 | PMC:PMC11685105 | DOI:10.3389/fnagi.2024.1538891