Neuro-cardiac coupling predicts transcutaneous auricular Vagus Nerve Stimulation effects

Author: Marius Keute1, Kathrin Machetanz2, Levan Berelidze2, Robert Guggenberger2, Alireza Gharabaghi3
Author Information:
1 Institute for Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, And Tuebingen NeuroCampus, University of Tuebingen, Tuebingen, Germany. Electronic address: marius.keute@uni-tuebingen.de.
2 Institute for Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, And Tuebingen NeuroCampus, University of Tuebingen, Tuebingen, Germany.
3 Institute for Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, And Tuebingen NeuroCampus, University of Tuebingen, Tuebingen, Germany. Electronic address: alireza.gharabaghi@uni-tuebingen.de.
Conference/Journal: Brain Stimul
Date published: 2021 Jan 7
Other: Special Notes: doi: 10.1016/j.brs.2021.01.001. , Word Count: 272


Background:
Transcutaneous auricular Vagus Nerve Stimulation (taVNS) is a non-invasive neuromodulation technique that may constitute an effective treatment for a wide range of neurological, psychiatric, and medical conditions. One key challenge in taVNS research is the high interindividual response variability. To gain an understanding of this variability, reliable biomarkers for taVNS responsiveness would be highly desirable. In this study, we investigated physiological candidate biomarkers while systematically varying stimulation conditions and observing physiological state characteristics.

Methods:
Forty-four healthy young adults received taVNS and sham-stimulation. Subjects were pseudo-randomly assigned to stimulation of the left or right ear. Each subject underwent six blocks of stimulation. Across blocks, respiration-locking (inhalation-locked taVNS vs. exhalation-locked taVNS vs. sham) and the electrode location (tragus vs. cymba conchae) were varied. We analyzed heart rate (HR), various heart rate variability (HRV) scores, and neuro-cardiac coupling (NCC), indexed by the relationship between electroencephalographic delta power and heartbeat length.

Results:
We observed an effect of taVNS on HR and HRV scores during, but not after stimulation. The direction of the effects was consistent with parasympathetic activation. We did not observe any systematic influence of the stimulation conditions that we varied. However, we found baseline NCC scores to be significant predictors for the individual effect of taVNS on HRV scores.

Conclusion:
Cardiac effects of taVNS indicate parasympathetic activation. These effects were short lived, which might explain that some previous studies were unable to detect them. We propose NCC as a novel candidate biomarker for responsiveness to taVNS.

Keywords: Auricular stimulation; autonomic nervous system; heart rate variability; neuro-cardiac coupling; non-invasive vagus nerve stimulation; parasympathetic nervous system; transcutaneous auricular vagus nerve stimulation.

PMID: 33422683 DOI: 10.1016/j.brs.2021.01.001

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