Effect of transcutaneous cervical vagus nerve stimulation on declarative and working memory in patients with Posttraumatic Stress Disorder (PTSD): A pilot study

Author: Tilendra Choudhary1, Marcus Elliott2, Neil R Euliano2, Nil Z Gurel3, Amanda G Rivas4, Matthew T Wittbrodt4, Viola Vaccarino5, Amit J Shah6, Omer T Inan7, J Douglas Bremner8
Affiliation:
1 Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: tilendra.choudhary@emory.edu.
2 Evren Technologies, Gainesville, FL, USA.
3 Reality Labs, Meta Platforms Inc., Menlo Park, CA, USA.
4 Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
5 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Medicine, Cardiology Division, Emory University School of Medicine, Atlanta, GA, USA.
6 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Medicine, Cardiology Division, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA.
7 School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Coulter Department of Bioengineering, Georgia Institute of Technology, Atlanta, GA, USA.
8 Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Conference/Journal: J Affect Disord
Date published: 2023 Jul 11
Other: Special Notes: doi: 10.1016/j.jad.2023.07.025. , Word Count: 263

Background:
Posttraumatic stress disorder (PTSD) is associated with changes in multiple neurophysiological systems, including verbal declarative memory deficits. Vagus Nerve Stimulation (VNS) has been shown in preliminary studies to enhance function when paired with cognitive and motor tasks. The purpose of this study was to analyze the effect of transcutaneous cervical VNS (tcVNS) on attention, declarative and working memory in PTSD patients.

Methods:
Fifteen PTSD patients were randomly assigned to active tcVNS (N = 8) or sham (N = 7) stimulation in a double-blinded fashion. Memory assessment tests including paragraph recall and N-back tests were performed to assess declarative and working memory function when paired with active/sham tcVNS once per month in a longitudinal study during which patients self-administered tcVNS/sham twice daily.

Results:
Active tcVNS stimulation resulted in a significant improvement in paragraph recall performance following pairing with paragraph encoding for PTSD patients at two months (p < 0.05). It resulted in a 91 % increase in paragraph recall performance within group (p = 0.03), while sham tcVNS exhibited no such trend in performance improvement. In the N-back study, positive deviations in accuracy, precision and recall measures on different day visits (7,34,64,94) of patients with respect to day 1 revealed a pattern of better performance of the active tcVNS population compared to sham VNS which did not reach statistical significance.

Limitations:
Our sample size was small.

Conclusions:
These preliminary results suggest that tcVNS improves attention, declarative and working memory, which may improve quality of life and productivity for patients with PTSD. Future studies are required to confirm these results.

Keywords: N-back test; PTSD; Paragraph recall; Stress; Working memory.

PMID: 37442455 DOI: 10.1016/j.jad.2023.07.025

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