Neuromodulation : journal of the International Neuromodulation Society · 2025
Both Transcutaneous Auricular Vagus Nerve Stimulation and Great Auricular Nerve Stimulation Modulate Functional and Structural Connectivity of Brainstem Nuclei in Chronic Low Back Pain.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Li Yuanyuan, Li Tingting, Yan Keming, Wu Jiani, Reddy Sveta, Sacca Valeria, Ursitti Amy Katherine, Zhu Meixuan, Hodges Sierra, Chen Lucy, Kong Jian
Аннотация
OBJECTIVES: This study aims to investigate the modulatory effects of transcutaneous auricular vagus nerve stimulation (taVNS) and transcutaneous greater auricular nerve stimulation (tGANS) on the brainstem's vagus nerve pathway hubs-the nucleus tractus solitarius (NTS), locus coeruleus (LC), and raphe nucleus (RN)-in individuals with chronic low back pain (cLBP).
MATERIALS AND METHODS: A total of 70 patients with cLBP were randomly assigned to receive four weeks of either taVNS or tGANS. Resting-state functional and structural magnetic resonance imaging (fMRI/sMRI) data were collected at baseline and post treatment. Analyses focused on static and dynamic functional connectivity (sFC/dFC) and fractional anisotropy (FA) using the NTS, LC, and RN--three brainstem nuclei within the central vagus nerve pathway-as seed regions.
RESULTS: Overall, 51 participants completed the treatment. Both groups showed significant pain improvement, with no significant difference between the taVNS and tGANS groups. taVNS was found to influence connectivity between the NTS and cingulate cortex, sensorimotor areas, thalamus, insula, operculum, and prefrontal cortex; between the LC and primary motor area and amygdala; and between the RN and sensory and prefrontal regions. In contrast, tGANS affected connectivity between the NTS and temporoparietal junction; between the LC and prefrontal cortex; and between the RN and insula and hippocampus. Changes in FA further supported the sFC findings. Notably, in the taVNS group, an increase in FA was negatively correlated with a decrease in sFC between the LC and precentral cortex.
CONCLUSIONS: Both taVNS and tGANS can modulate functional and structural connectivity between brainstem nuclei of the central vagus nerve pathway and multiple cortical/subcortical regions, albeit through different neural circuits.
CLINICAL TRIAL REGISTRATION: The Clinicaltrials.gov registration number for the study is NCT03959111.
MATERIALS AND METHODS: A total of 70 patients with cLBP were randomly assigned to receive four weeks of either taVNS or tGANS. Resting-state functional and structural magnetic resonance imaging (fMRI/sMRI) data were collected at baseline and post treatment. Analyses focused on static and dynamic functional connectivity (sFC/dFC) and fractional anisotropy (FA) using the NTS, LC, and RN--three brainstem nuclei within the central vagus nerve pathway-as seed regions.
RESULTS: Overall, 51 participants completed the treatment. Both groups showed significant pain improvement, with no significant difference between the taVNS and tGANS groups. taVNS was found to influence connectivity between the NTS and cingulate cortex, sensorimotor areas, thalamus, insula, operculum, and prefrontal cortex; between the LC and primary motor area and amygdala; and between the RN and sensory and prefrontal regions. In contrast, tGANS affected connectivity between the NTS and temporoparietal junction; between the LC and prefrontal cortex; and between the RN and insula and hippocampus. Changes in FA further supported the sFC findings. Notably, in the taVNS group, an increase in FA was negatively correlated with a decrease in sFC between the LC and precentral cortex.
CONCLUSIONS: Both taVNS and tGANS can modulate functional and structural connectivity between brainstem nuclei of the central vagus nerve pathway and multiple cortical/subcortical regions, albeit through different neural circuits.
CLINICAL TRIAL REGISTRATION: The Clinicaltrials.gov registration number for the study is NCT03959111.