Journal of Traditional Chinese Medicine >
Transcutaneous auricular vague nerve stimulation improved brain connection activity on patients of disorders of consciousness: a pilot study
Received date: 2021-10-22
Accepted date: 2022-01-29
Online published: 2022-05-20
Supported by
Fundamental Research Funds for the Central Public Welfare Research Institutes: Brain Effects and Multimodal Imaging Mechanism of Transcutaneous Auricular Vagus Nerve Stimulation in Patients with Disorder of Consciousness(CI2021A03305)
OBJECTIVE: To evaluate the clinical effect of transcutaneous auricular vagus nerve nerve stimulation (taVNS) on disorders of consciousness (DOC) patients with Coma Recovery Scale-Revised (CRS-R) and cerebral cortex activity by electroencephalogram (EEG) detection.
METHODS: Randomized controlled methods were used to evaluate the clinical effect of taVNS on patients with DOC. Twelve patients with initial CRS-R of 6-10 were randomly divided into the treatment group of taVNS and control group of transcutaneous non-auricular vague nerve stimulation (tnVNS). According to clinical diagnosis, the treatment group was divided into vegetative state (VS) group and minimally conscious state (MCS) group.
RESULTS: The energy of delta and beta bands is positively correlated with the brain activity of patients. taVNS has different regulatory effects on patients with different conscious States. In taVNS group, the energy of delta band in local brain regions changed significantly. Significant changes in brain connection activity were limited to local brain regions. While in patients with MCS in the taVNS group, delta and beta band energy significantly changed in multiple brain regions and cross-brain connection activity also changed significantly.
CONCLUSION: These findings suggest that taVNS may be a related extra method for arousing patients' awakening by improving brain connection activity. And the effect is remarkable in MCS patients.
Yifei WANG , Yi YANG , Yu WANG , Jinling ZHANG , Weihang ZHAI , Shaoyuan LI , Mozheng WU , Jianghong HE , Peijing RONG . Transcutaneous auricular vague nerve stimulation improved brain connection activity on patients of disorders of consciousness: a pilot study[J]. Journal of Traditional Chinese Medicine, 2022 , 42(3) : 463 -471 . DOI: 10.19852/j.cnki.jtcm.2022.03.012
| 1 | Grüner ML, Terhaag D. Multimodal early onset stimulation (MEOS) in rehabilitation after brain injury. Brain injury 2000; 14:585-94. |
| 2 | Septien S, Rubin MA. Disorders of consciousness: Ethical issues of diagnosis, treatment, and prognostication. Seminars in neurology 2018; 38:548-54. |
| 3 | Johnson DA, Roethig-Johnston K, Richards D. Biochemical and physiological parameters of recovery in acute severe head injury: responses to multisensory stimulation. Brain Inj 1993; 7:491-9. |
| 4 | Jennett B, Plum F: persistent vegetative state after brain damage. A syndrome in search of a name. Lancet 1972; 1:734-37. |
| 5 | Bernat JL. Chronic disorders of consciousness. Lancet 2006; 367:1181-92. |
| 6 | Bao W, Li X, Luo B: A novel prognostic approach to predict recovery in patients with chronic disorders of consciousness. Neuroscience bulletin 2019; 35:953-4. |
| 7 | Schiff ND. Central thalamic contributions to arousal regulation and neurological disorders of consciousness. Ann N Y Acad Sci 2008; 1129:105-18. |
| 8 | Manganotti P, Formaggio E, Storti SF, et al. Effect of high-frequency repetitive transcranial magnetic stimulation on brain excitability in severely brain-injured patients in minimally conscious or vegetative state. Brain Stimul 2013; 6:913-21. |
| 9 | Shi C, Flanagan SR, Samadani U. Vagus nerve stimulation to augment recovery from severe traumatic brain injury impeding consciousness: a prospective pilot clinical trial. Neurol Res 2013; 35:263-76. |
| 10 | Rush AJ, George MS, Sackeim HA, et al. Vagus nerve stimulation (VNS) for treatment-resistant depressions: a multicenter study. Biol Psychiatry 2000; 47:276-86. |
| 11 | Oleson T. Auriculotherapy stimulation for neuro-rehabilitation. NeuroRehabilitation 2002; 17:49-62. |
| 12 | Shiozawa P, Silva ME, Carvalho TC, et al. Transcutaneous vagus and trigeminal nerve stimulation for neuropsychiatric disorders: a systematic review. Arq Neuropsiquiatr 2014; 72:542-7. |
| 13 | Butt MF, Albusoda A, Farmer AD, Aziz Q. The anatomical basis for transcutaneous auricular vagus nerve stimulation. Journal of anatomy 2020; 236:588-611. |
| 14 | Noé E, Ferri J, Colomer C, Moliner B, et al. Feasibility, safety and efficacy of transauricular vagus nerve stimulation in a cohort of patients with disorders of consciousness. Brain stimulation 2020; 13:427-9. |
| 15 | Wang Y, Li SY, Wang D, et al. Transcutaneous auricular vagus nerve stimulation: From concept to application. Neurosci Bull 2021; 37:853-62. |
| 16 | Bernat JL. Chronic disorders of consciousness. Lancet 2006; 367:1181-92 |
| 17 | Gosseries O, Pistoia F, Charland-Verville V, et al. The role of neuroimaging techniques in establishing diagnosis, prognosis and therapy in disorders of consciousness. Open Neuroimag J 2016; 10:52-68. |
| 18 | Schnakers C, Vanhaudenhuyse A, Giacino J, et al. Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment. BMC Neurol 2009; 9:35. |
| 19 | Laureys S, Schiff ND. Coma and consciousness: paradigms (re)framed by neuroimaging. Neuroimage 2012; 61:478-91. |
| 20 | Stender J, Gosseries O, Bruno MA, et al. Diagnostic precision of PET imaging and functional MRI in disorders of consciousness: a clinical validation study. Lancet 2014; 384(9942):514-22. |
| 21 | Derakhshan I. Voluntary brain processing in disorders of consciousness. Neurology 2009; 73:1712-3. |
| 22 | Hermann DM, Gunzer M. Polymorphonuclear neutrophils play a decisive role for brain injury and neurological recovery poststroke. Stroke 2019; 50:e40-1. |
| 23 | Kondziella D, Bender A, Diserens K, et al. European academy of neurology guideline on the diagnosis of coma and other disorders of consciousness. Eur J Neurol 2020; 27:741-56. |
| 24 | Curley WH, Forgacs PB, Voss HU, et al. Characterization of EEG signals revealing covert cognition in the injured brain. Brain 2018; 141:1404-21. |
| 25 | Sitt JD, King JR, El Karoui I, et al. Large scale screening of neural signatures of consciousness in patients in a vegetative or minimally conscious state. Brain 2014; 137:2258270. |
| 26 | Rosanova M, Gosseries O, Casarotto S, et al. Recovery of cortical effective connectivity and recovery of consciousness in vegetative patients. Brain 2012; 135:1308-20. |
| 27 | Gosseries O, Schnakers C, Ledoux D, et al. Automated EEG entropy measurements in coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state. Funct Neurol 2011; 26:25-30. |
| 28 | Williams ST, Conte MM, Goldfine AM, et al. Common resting brain dynamics indicate a possible mechanism underlying zolpidem response in severe brain injury. Elife 2013; 2:e01157. |
| 29 | Farzan F, Barr MS, Wong W, et al. Suppression of gamma-oscillations in the dorsolateral prefrontal cortex following long interval cortical inhibition: a TMS-EEG study. Neurop-sychopharmacology 2009; 34:1543-51. |
| 30 | Jensen KB, Berna C, Loggia ML, et al. The use of functional neuroimaging to evaluate psychological and other non-pharmacological treatments for clinical pain. Neurosci Lett 2012; 520:156-64. |
| 31 | Pavuluri MN, Herbener ES, Sweeney JA. Affect regulation: a systems neuroscience perspective. Neuropsychiatr Dis Treat 2005; 1:9-15. |
| 32 | Laureys S, Owen AM, Schiff ND. Brain function in coma, vegetative state, and related disorders. Lancet Neurol 2004; 3:537-46. |
| 33 | Monti MM, Rosenberg M, Finoia P, et al. Thalamo-frontal connectivity mediates top-down cognitive functions in disorders of consciousness. Neurology 2015; 84:167-73. |
| 34 | Schiff ND, Nauvel T, Victor JD. Large-scale brain dynamics in disorders of consciousness. Curr Opin Neurobiol 2014; 25:7-14. |
| 35 | Kondziella D, Friberg CK, Frokjaer VG, et al. Preserved consciousness in vegetative and minimal conscious states: systematic review and Meta-analysis. J Neurol Neurosurg Psychiatry 2016; 87:485-92. |
| 36 | Li J, Shen J, Liu S, et al. Responses of patients with disorders of consciousness to habit stimulation: a quantitative EEG study. Neurosci Bull 2018; 34:691-9. |
| 37 | Wallis JD. Cross-species studies of orbitofrontal cortex and value-based decision-making. Nat Neurosci 2011; 15:13-9. |
| 38 | Corazzol M, Lio G, Lefevre A, et al. Restoring consciousness with vagus nerve stimulation. Curr Biol 2017; 27:R994-6. |
| 39 | Dietrich S, Smith J, Scherzinger C, et al. A novel transcutaneous vagus nerve stimulation leads to brainstem and cerebral activations measured by functional MRI. Biomed Tech (Berl) 2008; 53:104-11. |
| 40 | Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res 2008; 51:S225-39. |
| 41 | Sattin D, Giovannetti AM, Ciaraffa F, et al. Assessment of patients with disorder of consciousness: do different Coma Recovery Scale scoring correlate with different settings? J Neurol 2014; 261:2378-86. |
| 42 | Wannez S, Heine L, Thonnard M, et al. Coma science group collaborators. The repetition of behavioral assessments in diagnosis of disorders of consciousness. Ann Neurol 2017; 81:883-9. |
| 43 | Giacino JT, Ashwal S, Childs N, et al. The minimally conscious state: definition and diagnostic criteria. Neurology 2002; 58:349-53. |
| 44 | Cavinato M, Genna C, Manganotti P, et al. Coherence and consciousness: study of fronto-parietal gamma synchrony in patients with disorders of consciousness. Brain Topogr 2015; 28:570-9. |
/
| 〈 |
|
〉 |