Transcutaneous auricular Vagus Nerve Stimulation and Median Nerve Stimulation reduce acute stress in young healthy adults: a single-blind sham-controlled crossover study

Author: Jesus Antonio Sanchez-Perez1, Asim H Gazi1, Farhan N Rahman1, Alexis Seith2, Georgia Saks2, Srirakshaa Sundararaj3, Rachel Erbrick1, Anna B Harrison1, Christopher J Nichols1, Mihir Modak4, Yekanth R Chalumuri5, Teresa K Snow6, Jin-Oh Hahn5, Omer T Inan1
Affiliation:
1 School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States.
2 Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States.
3 College of Sciences, Georgia Institute of Technology, Atlanta, GA, United States.
4 Department of Bioengineering, University of Maryland, College Park, MD, United States.
5 Department of Mechanical Engineering, University of Maryland, College Park, MD, United States.
6 School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States.
Conference/Journal: Front Neurosci
Date published: 2023 Sep 7
Other: Volume ID: 17 , Pages: 1213982 , Special Notes: doi: 10.3389/fnins.2023.1213982. , Word Count: 263


Stress is a major determinant of health and wellbeing. Conventional stress management approaches do not account for the daily-living acute changes in stress that affect quality of life. The combination of physiological monitoring and non-invasive Peripheral Nerve Stimulation (PNS) represents a promising technological approach to quantify stress-induced physiological manifestations and reduce stress during everyday life. This study aimed to evaluate the effectiveness of three well-established transcutaneous PNS modalities in reducing physiological manifestations of stress compared to a sham: auricular and cervical Vagus Nerve Stimulation (taVNS and tcVNS), and Median Nerve Stimulation (tMNS). Using a single-blind sham-controlled crossover study with four visits, we compared the stress mitigation effectiveness of taVNS, tcVNS, and tMNS, quantified through physiological markers derived from five physiological signals peripherally measured on 19 young healthy volunteers. Participants underwent three acute mental and physiological stressors while receiving stimulation. Blinding effectiveness was assessed via subjective survey. taVNS and tMNS relative to sham resulted in significant changes that suggest a reduction in sympathetic outflow following the acute stressors: Left Ventricular Ejection Time Index (LVETI) shortening (tMNS: p = 0.007, taVNS: p = 0.015) and Pre-Ejection Period (PEP)-to-LVET ratio (PEP/LVET) increase (tMNS: p = 0.044, taVNS: p = 0.029). tMNS relative to sham also reduced Pulse Pressure (PP; p = 0.032) and tonic EDA activity (tonicMean; p = 0.025). The nonsignificant blinding survey results suggest these effects were not influenced by placebo. taVNS and tMNS effectively reduced stress-induced sympathetic arousal in wearable-compatible physiological signals, motivating their future use in novel personalized stress therapies to improve quality of life.

Keywords: Median Nerve Stimulation; Vagus Nerve Stimulation; multimodal sensing; non-invasive; physiological signals; stress.

PMID: 37746156 PMCID: PMC10512834 DOI: 10.3389/fnins.2023.1213982

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