Noninvasive vagus nerve stimulation promising for treating postural tachycardia syndrome
USA: Findings from a recent study published in JACC: Clinical Electrophysiology support the emerging paradigm of noninvasive neuromodulation for treating postural tachycardia syndrome (POTS). This effect, mechanistically, appears to be related to a reduction of inflammatory cytokines and antiautonomic autoantibodies, and an improvement in autonomic tone.
Low-level transcutaneous stimulation of the auricular branch of the vagus nerve at the tragus is anti-inflammatory and antiarrhythmic in humans and animals. Preliminary studies demonstrated that transcutaneous vagus nerve stimulation (tVNS) benefits animal models of POTS. Stavros Stavrakis, University of Oklahoma Health Sciences Center, Oklahoma, USA, and colleagues conducted a double-blind, sham-controlled, randomized clinical trial to investigate the effect of tVNS on POTS over 2 months relative to sham stimulation.
For this purpose, the researchers delivered transcutaneous vagus nerve stimulation (20 Hz, 1 mA below discomfort threshold) using an ear clip attached to either the tragus (active; n = 12) or the ear lobe (sham; n = 14) daily for 1 hour over 2 months. Postural tachycardia was evaluated during the baseline and 2-month visit. Heart rate variability based on a 5-minute electrocardiogram, antiautonomic autoantibodies, and serum cytokines were measured at the respective time points. The mean age of the participants was 34 ± 11 years (100% female; 81% Caucasian).
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