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October 20, 2020Neurobiology of StressOpen Access

Transcutaneous cervical vagal nerve stimulation paired with traumatic script stress significantly decreased sympathetic function, including a 5.7% reduction in heart rate compared to sham, in patients with PTSD.

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Why the study?

Exacerbated autonomic responses to acute stress are prevalent in PTSD, but the effects of transcutaneous cervical vagal nerve stimulation on these responses were unknown.

Does transcutaneous cervical vagal nerve stimulation reduce sympathetic responses to acute stress in patients with posttraumatic stress disorder?

Population

25 patients with PTSD

Comparison

Active tcVNS vs sham tcVNS

Design

Randomized, double-blind, sham-controlled trial

Follow-up

Three-day protocol

Key result

Transcutaneous cervical vagal nerve stimulation paired with traumatic script stress significantly decreased sympathetic function, including a 5.7% reduction in heart rate compared to sham, in patients with PTSD.

Authors

NGNil Z. GurelMWMatthew T. WittbrodtHJHewon Jung

Discussion

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Member takes

Overview

Supports further investigation of tcVNS for autonomic modulation; hypothesis-generating and should not change practice yet.

Study Design

Type

RCT (n=25)

Blinding

Double-blind

Randomization

Simple randomization

Multicenter

No

Structured PICO

Does transcutaneous cervical vagal nerve stimulation reduce sympathetic responses to acute stress in patients with posttraumatic stress disorder?

P
Population
25 adults aged 18-70 with current posttraumatic stress disorder underwent a three-day protocol to assess autonomic responses to acute stress.
I
Intervention
Active transcutaneous cervical vagal nerve stimulation (tcVNS) delivering 5 kHz sine waves at 25 Hz (mean 20.3 V) via a handheld device, applied after exposure to acute personalized traumatic script stress and mental stress over a 3-day protocol.
C
Comparator
Sham stimulation using an identical-appearing device delivering 0.2 Hz biphasic stepped voltage pulses (mean 13.6 V), applied after the same stress exposures.
O
Outcome
Physiological parameters related to sympathetic responses to stress (specifically heart rate, photoplethysmogram amplitude, and pulse arrival time).surrogate

Main Result

Standardized Mean Difference: 0.43

p-value: p=<0.01

Transcutaneous cervical vagal nerve stimulation significantly attenuates sympathetic arousal and cardiovascular reactivity to traumatic and mental stress in patients with PTSD.

Limitations

  • Small sample size
  • Short study duration

Cite This Study

Gurel et al. (2020) conducted an RCT in Posttraumatic stress disorder (PTSD) (n=25). Transcutaneous cervical vagal nerve stimulation (tcVNS) vs. Sham stimulation (0.2 Hz pulses, peak voltage 14 V) was evaluated on Heart rate response to traumatic script stress (adjusted β = -5.7%, 95% CI ± 3.6%, p=<0.01). Transcutaneous cervical vagal nerve stimulation paired with traumatic script stress significantly decreased sympathetic function, including a 5.7% reduction in heart rate compared to sham, in patients with PTSD.

synapsesocial.com/papers/6a3159a065e24aa33f6ab276https://doi.org/10.1016/j.ynstr.2020.100264
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