Transcutaneous auricular vagus nerve stimulation at 1 Hz modulates locus coeruleus activity and resting state functional connectivity in patients with migraine: An fMRI study

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Abstract

Background

Migraine is a common episodic neurological disorder. Literature has shown that transcutaneous auricular vagus nerve stimulation (taVNS) at 1 Hz can significantly relieve migraine symptoms. However, its underlying mechanism remains unclear. This study aims to investigate the neural pathways associated with taVNS treatment of migraine.

Methods

Twenty-nine patients with migraine were recruited from outpatient neurology clinics. Each patient attended two magnetic resonance imaging/functional magnetic resonance imaging (MRI/fMRI) scan sessions separated by one week. Each session included a pre-stimulation resting state fMRI scan, fMRI scans during real or sham 1 Hz taVNS (with block design), and a post-stimulation resting state fMRI scan.

Results

Twenty-six patients were included in the final analyses. Real taVNS evoked fMRI signal decreases in brain areas belonging to the default mode network (DMN) and brain stem areas including the locus coeruleus (LC), raphe nuclei, parabrachial nucleus, and solitary nucleus. Sham taVNS evoked fMRI signal decreases in brain areas belonging to the DMN. Compared to sham taVNS, real taVNS produced greater deactivation at the bilateral LC. Resting state functional connectivity (rsFC) analysis showed that after taVNS, LC rsFC with the right temporoparietal junction and left secondary somatosensory cortex (S2) significantly increased compared to sham taVNS. The increased rsFC of the left LC-left S2 was significantly negatively associated with the frequency of migraine attacks during the preceding month.

Conclusion

Our results suggest that taVNS at 1 Hz can significantly modulate activity/connectivity of brain regions associated with the vagus nerve central pathway and pain modulation system, which may shed light on the neural mechanisms underlying taVNS treatment of migraine.

Highlights

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taVNS at l HZ evoked fMRI signal decrease in the locus coeruleus in migraine.
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After taVNS, LC rsFC with TPJ, hippocampus and S2 increased in migraine.
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The increased LC-S2 rsFC negatively associated with the frequency of migraine attacks.

Related collections

Most cited references 32

Record: found
Abstract: found
Article: not found

Descending control of pain.

Mark J Millan (2002)

Upon receipt in the dorsal horn (DH) of the spinal cord, nociceptive (pain-signalling) information from the viscera, skin and other organs is subject to extensive processing by a diversity of mechanisms, certain of which enhance, and certain of which inhibit, its transfer to higher centres. In this regard, a network of descending pathways projecting from cerebral structures to the DH plays a complex and crucial role. Specific centrifugal pathways either suppress (descending inhibition) or potentiate (descending facilitation) passage of nociceptive messages to the brain. Engagement of descending inhibition by the opioid analgesic, morphine, fulfils an important role in its pain-relieving properties, while induction of analgesia by the adrenergic agonist, clonidine, reflects actions at alpha(2)-adrenoceptors (alpha(2)-ARs) in the DH normally recruited by descending pathways. However, opioids and adrenergic agents exploit but a tiny fraction of the vast panoply of mechanisms now known to be involved in the induction and/or expression of descending controls. For example, no drug interfering with descending facilitation is currently available for clinical use. The present review focuses on: (1) the organisation of descending pathways and their pathophysiological significance; (2) the role of individual transmitters and specific receptor types in the modulation and expression of mechanisms of descending inhibition and facilitation and (3) the advantages and limitations of established and innovative analgesic strategies which act by manipulation of descending controls. Knowledge of descending pathways has increased exponentially in recent years, so this is an opportune moment to survey their operation and therapeutic relevance to the improved management of pain.

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Record: found
Abstract: found
Article: not found

The nerve supply of the human auricle.

T J Filler, E T Peuker (2001)

Knowledge of the innervation of the outer ear is crucial for surgery in this region. The aim of this study was to describe the system of the auricular nerve supply. On 14 ears of seven cadavers the complete course of the nerve supply was exposed and categorized. A heterogeneous distribution of two cranial branchial nerves and two somatic cervical nerves was found. At the lateral as well as the medial surface the great auricular nerve prevails. No region with triple innervation was found. Copyright 2002 Wiley-Liss, Inc.

0 comments Cited 216 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Optimization of Transcutaneous Vagus Nerve Stimulation Using Functional MRI.

Natalia Yakunina, Sam Soo Kim, Eui-Cheol Nam (2017)

Vagus nerve stimulation (VNS) is an established therapy for drug-resistant epilepsy, depression, and a number of other disorders. Transcutaneous stimulation of the auricular branch of the vagus nerve (tVNS) has been considered as a non-invasive alternative. Several functional magnetic resonance imaging (fMRI) studies on the effects of tVNS used different stimulation parameters and locations in the ear, which makes it difficult to determine the optimal tVNS methodology. The present study used fMRI to determine the most effective location for tVNS.

0 comments Cited 140 times – based on 0 reviews      Review now

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Author and article information

Contributors

Bo Liu

Jian Kong

Journal

Journal ID (nlm-ta): Neuroimage Clin

Journal ID (iso-abbrev): Neuroimage Clin

Title: NeuroImage : Clinical

Publisher: Elsevier

ISSN (Electronic): 2213-1582

Publication date PMC-release: 05 August 2019

Publication date Collection: 2019

Publication date (Electronic): 05 August 2019

Volume: 24

Electronic Location Identifier: 101971

Affiliations

[a ]Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China

[b ]Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 120 2nd Ave, Room 101, Charlestown, MA 02129, USA

[c ]National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, China

[d ]Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China

Author notes

[* ]Corresponding authors. lbgdhtcm@ 123456163.com kongj@ 123456nmr.mgh.harvard.edu

[1]

Yue Zhang and Jiao Liu are co-first authors.

Article

Publisher ID: S2213-1582(19)30321-3 Publisher ID: 101971

DOI: 10.1016/j.nicl.2019.101971

PMC ID: 7239932

PubMed ID: 31648171

SO-VID: 950761ff-672a-4aad-ae5c-b8352783098c

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

History

Date received : 13 May 2019

Date revision received : 22 July 2019

Date accepted : 3 August 2019

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