Effects of transcutaneous auricular vagus nerve stimulation on cardiovascular autonomic control in health and disease
Author: Angelica Carandina1, Gabriel Dias Rodrigues2, Pietro Di Francesco3, Annalisa Filtz3, Chiara Bellocchi3, Ludovico Furlan3, Stefano Carugo3, Nicola Montano4, Eleonora Tobaldini3
Affiliation:
1 Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
2 Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
3 Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
4 Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. Electronic address: nicola.montano@unimi.it.
Conference/Journal: Auton Neurosci
Date published: 2021 Oct 9
Other:
Volume ID: 236 , Pages: 102893 , Special Notes: doi: 10.1016/j.autneu.2021.102893. , Word Count: 222
Autonomic nervous system (ANS) dysfunction is a well-known feature of cardiovascular diseases (CVDs). Studies on heart rate variability (HRV), a non-invasive method useful in investigating the status of cardiovascular autonomic control, have shown that a predominance of sympathetic modulation not only contributes to the progression of CVDs but has a pivotal role in their onset. Current therapies focus more on inhibition of sympathetic activity, but the presence of drug-resistant conditions and the invasiveness of some surgical procedures are an obstacle to complete therapeutic success. On the other hand, targeting the parasympathetic branch of the autonomic nervous system through invasive vagus nerve stimulation (VNS) has shown interesting results as alternative therapeutic approach for CVDs. However, the invasiveness and cost of the surgical procedure limit the clinical applicability of VNS and hinder the research on the physiological pathway involved. Transcutaneous stimulation of the auricular branch of the vagus nerve (tVNS) seems to represent an important non-invasive alternative with effects comparable to those of VNS with surgical implant. Thus, in the present narrative review, we illustrate the main studies on tVNS performed in healthy subjects and in three key examples of CVDs, namely heart failure, hypertension and atrial fibrillation, highlighting the neuromodulatory effects of this technique.
Keywords: Cardiovascular autonomic control; Cardiovascular diseases; Heart rate variability; Neuromodulation; Transcutaneous auricular vagus nerve stimulation.
PMID: 34649119 DOI: 10.1016/j.autneu.2021.102893
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