Transcutaneous Vagal Nerve Stimulation (tVNS): a new neuromodulation tool in healthy humans?

Frontiers in Psychology

Jelle W. R. Van Leusden¹ 

关键词: tVNS;    neuromodulation;    cognitive neuroscience;    norepinephrine;    GABA;   

DOI  :  10.3389/fpsyg.2015.00102

学科分类：心理学（综合）

来源: Frontiers

【 摘 要 】

The idea that we can influence neurons with electricity is not new. Earlier this century patients were treated, and still are, with electro convulsive therapy as a treatment for severe depression (Fink, 1984). Fortunately, new devices were invented that use electricity to influence neuronal activity in a less invasive way: transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and vagus nerve stimulation (VNS). In contrast to imaging techniques, which are only correlational, by means of these techniques it is possible to infer a causal relation between the stimulated neurotransmitter/brain area and a related cognitive function. Recently, Cerbomed (Erlangen, Germany) engineered a noninvasive, transcutaneous (through the skin) VNS device (tVNS) that stimulates the afferent auricular branch of the vagus nerve located medial of the tragus at the entry of the acoustic meatus (Kreuzer et al., 2012). This device has received CE approval as indication that it complies with essential health and safety requirements. Thus, tVNS is safe and accompanied only by minor side effects such as slight pain, burning, tingling, or itching sensation under the electrodes. Nevertheless, as specified in the instructions manual, the use of the device is contraindicated in the case of pregnancy, cardiac diseases, head trauma, alcoholism, migraine, medication or drug use, neurological or psychiatric disorders, metal pieces in the body (pacemaker), active implants such as a cochlear implant, wounds and diseased skin. A number of studies using high intensity tVNS have not found any major side-effects (Kraus et al., 2007; Dietrich et al., 2008). Given that the right vagal nerve has efferent fibers to the heart, tVNS is safe to be performed only in the left ear (Sperling et al., 2010; Kreuzer et al., 2012). Following Kraus et al. (2007), a clever way to create a sham condition using tVNS is by attaching the stimulation electrodes to the center of the left ear lobe, which is known to be free of cutaneous vagal innervation (Peuker and Filler, 2002), see Figure ​Figure1.1. Indeed, a recent functional magnetic resonance imaging (fMRI) study showed that this sham condition produced no activation in the cortex and brain stem (Kraus et al., 2013).

【 授权许可】

CC BY