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Cheng C, Xue X, Jiao Y, You R, Zhang M, Jia M, Du M, Zeng X, Sun JB, Qin W, Yang XJ. External trigeminal nerve stimulation (eTNS) Exhibits relaxation effects in fatigue states following napping deprivation. Neuroscience 2025; 567:123-132. [PMID: 39719246 DOI: 10.1016/j.neuroscience.2024.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 12/09/2024] [Accepted: 12/21/2024] [Indexed: 12/26/2024]
Abstract
BACKGROUND In the face of inevitable declines in alertness and fatigue resulting from sleep deprivation, effective countermeasures are essential for maintaining performance. External trigeminal nerve stimulation (eTNS) presents a potential avenue for regulating alertness by activating the locus coeruleus and reticular activating system. METHODS Here, we conducted a within-subject study with 66 habitual nappers, subjecting them to afternoon nap-deprivation and applying either 20-minute of 120 Hz eTNS or sham stimulation. We compared participants' performance in PVT and N-back tasks, subjective fatigue level and alertness ratings, and changes in heart rate variability, cortisol, and salivary alpha-amylase before and after stimulation. RESULTS The results revealed a significant decline in PVT and N-back tasks performance, along with increased subjective fatigue levels in the sham stimulation group. In contrast, the eTNS stimulation group maintained behavioral performance, with lower post-stimulation fatigue levels than sham group. After stimulation, the eTNS group exhibited decreased mean R-R interval and elevated LF/HF ratios, i.e., a shift in autonomic nervous system activity towards sympathetic dominance, and a significant reduction in cortisol levels, indicating a state of relaxation alleviating drowsiness. CONCLUSION These findings suggested that 120 Hz eTNS stimulation might induce a relaxing effect, and thereby alleviate fatigue while preserving alertness and cognitive performance.
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Affiliation(s)
- Chen Cheng
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China
| | - Xinxin Xue
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China
| | - Yunyun Jiao
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China
| | - Rui You
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China
| | - Mengkai Zhang
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China
| | - Mengnan Jia
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China
| | - Mengyu Du
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China
| | - Xiao Zeng
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China; Guangzhou Institute of Technology, Xidian University, Xi'an, Shaanxi, China
| | - Jin-Bo Sun
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China; Guangzhou Institute of Technology, Xidian University, Xi'an, Shaanxi, China
| | - Wei Qin
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China; Guangzhou Institute of Technology, Xidian University, Xi'an, Shaanxi, China
| | - Xue-Juan Yang
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, China; Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi 710126, China; Guangzhou Institute of Technology, Xidian University, Xi'an, Shaanxi, China.
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Wang L, Wang L, Wang Z, Zhao H, Wu J, Gao F, Tang H. Efficacy observation of combined transcutaneous vagus nerve stimulation and transcranial direct current stimulation on gait in 169 subacute stroke patients. J Rehabil Med 2024; 56:jrm40348. [PMID: 39508575 PMCID: PMC11558862 DOI: 10.2340/jrm.v56.40348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 09/03/2024] [Indexed: 11/15/2024] Open
Abstract
OBJECTIVE To investigate the combined effect of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation on improving lower limb function in stroke patients. DESIGN Randomized controlled trial. SUBJECTS/PATIENTS Subacute stroke patients. METHODS 169 post-stroke hemiplegia patients were randomly divided into 4 groups (control, transcranial direct current stimulation, transcutaneous auricular vagus nerve stimulation, and transcutaneous auricular vagus nerve stimulation combined with transcranial direct current stimulation) and evaluated using the Fugl-Meyer Assessment-Lower Extremity (FMA-LL), Timed Up-and-Go (TUG) test, Modified Barthel Index (MBI), Berg Balance Scale (BBS), gait parameters, and surface electromyography (sEMG). RESULTS Significant improvements in FMA-LL, MBI, BBS, TUG, gait parameters, and sEMG were noted in the intervention groups compared with the control, with the transcutaneous auricular vagus nerve stimulation combined with transcranial direct current stimulation group showing the most pronounced improvements. Differences in some outcomes were also notable between the transcutaneous auricular vagus nerve stimulation and transcranial direct current stimulation groups. CONCLUSION The combination of transcutaneous auricular vagus nerve stimulation and transcranial direct current stimulation effectively enhances gait, balance, and daily living activities in subacute stroke patients. These benefits are likely due to transcutaneous auricular vagus nerve stimulation activating the solitary and trigeminal nuclei and transcranial direct current stimulation stimulating the motor cortex. Wearable gait analysis systems and electromyography are valuable in clinical gait assessment for these patients.
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Affiliation(s)
- Litong Wang
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Dalian, China; Rehabilitation Medicine Department, The Second Hospital of Dalian Medical University, Dalian, China
| | - Likai Wang
- Rehabilitation Medicine Department, The Second Hospital of Dalian Medical University, Dalian, China
| | - Zhan Wang
- Rehabilitation Medicine Department, The Second Hospital of Dalian Medical University, Dalian, China
| | - Hongyu Zhao
- Lab of Intelligent System, School of Control and Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian, China
| | - Jingyi Wu
- Rehabilitation Medicine Department, The Second Hospital of Dalian Medical University, Dalian, China
| | - Fei Gao
- Rehabilitation Medicine Department, The Second Hospital of Dalian Medical University, Dalian, China
| | - Hong Tang
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Dalian, China.
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Chen J, Ke Y, Ni G, Ming D. Transcutaneous auricular vagus nerve stimulation does not modulate working memory capacity but alters pupillary responses in the change detection task. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2024; 2024:1-4. [PMID: 40039171 DOI: 10.1109/embc53108.2024.10782958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2025]
Abstract
Transcutaneous vagus nerve stimulation (taVNS) offers an effective, non-invasive alternative to implantable vagus nerve stimulation and it is considered to be a promising cognitive modulation tool. However, at present, the effect of taVNS on working memory is not clear, Simultaneously, the potential pupillary responses stemming from taVNS require more empirical inquiry. Herein, we investigated the influence of taVNS on working memory capacity and its link to pupillary responses during the change detection task. A sham-controlled, randomized, crossover-designed experiment was applied to 16 participants. Within each session, participants received a Sham or Active taVNS stimulation for 12 minutes and then achieved 3 blocks of change detection task. Each trial exceeds for 5s. The pupil and behavior responses were recorded during the task. We hypothesized that Active taVNS can improve the performance of the change detection task and influence the pupil corresponding to different numbers of target stimuli. For the results, we observed no significant modulation of working memory capacity by taVNS but did note distinct alterations in pupillary response (mean amplitude and extremes) during specified intervals in the change detection task. These findings point to an underexplored avenue of research into the neural or psychological processes affected by taVNS and provides a new insight for taVNS to modulate working memory capacity.
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Liu W, Cheng X, Zhang Y, Liao W. Effect of transcranial direct current stimulation combined with transcutaneous auricular vagus nerve stimulation on poststroke cognitive impairment: a study protocol for a randomised controlled trial. BMJ Open 2024; 14:e082764. [PMID: 38604630 PMCID: PMC11015246 DOI: 10.1136/bmjopen-2023-082764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/20/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION Poststroke cognitive impairment is a common complication in stroke survivors, seriously affecting their quality of life. Therefore, it is crucial to improve cognitive function of patients who had a stroke. Transcranial direct current stimulation (tDCS) and transcutaneous auricular vagus nerve stimulation (taVNS) are non-invasive, safe treatments with great potential to improve cognitive function in poststroke patients. However, further improvements are needed in the effectiveness of a single non-invasive brain stimulation technique for cognitive rehabilitation. This study protocol aims to investigate the effect and neural mechanism of the combination of tDCS and taVNS on cognitive function in patients who had a stroke. METHODS AND ANALYSIS In this single-centre, prospective, parallel, randomised controlled trial, a total of 66 patients with poststroke cognitive impairment will be recruited and randomly assigned (1:1:1) to the tDCS group, the taVNS group and the combination of tDCS and taVNS group. Each group will receive 30 min of treatment daily, five times weekly for 3 weeks. Primary clinical outcome is the Montreal Cognitive Assessment. Secondary clinical outcomes include the Mini-Mental State Examination, Stroop Colour Word Test, Trail Marking Test, Symbol Digit Modalities Test and Modified Barthel Index. All clinical outcomes, functional MRI and diffusion tensor imaging will be measured at preintervention and postintervention. ETHICS AND DISSEMINATION The trial has been approved by the Ethics Committee of the First Affiliated Hospital of Yangtze University (approval no: KY202390). The results will be submitted for publication in peer-reviewed journals or at scientific conferences. TRIAL REGISTRATION NUMBER ChiCTR2300076632.
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Affiliation(s)
- Wulong Liu
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
| | - Xianglin Cheng
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
| | - Yao Zhang
- Department of Radiology, the First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
| | - Weijing Liao
- Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
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Tian QQ, Cheng C, Liu PH, Yin ZX, Zhang MK, Cui YP, Zhao R, Deng H, Lu LM, Tang CZ, Xu NG, Yang XJ, Sun JB, Qin W. Combined effect of transcutaneous auricular vagus nerve stimulation and 0.1 Hz slow-paced breathing on working memory. Front Neurosci 2023; 17:1133964. [PMID: 36968483 PMCID: PMC10034029 DOI: 10.3389/fnins.2023.1133964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundPrevious research has found that transcutaneous auricular vagus nerve stimulation (taVNS) can improve working memory (WM) performance. It has also been shown that 0.1 Hz slow-paced breathing (SPB, i.e., breathing at a rate of approximately 6 breaths/min) can significantly influence physical state and cognitive function via changes in autonomic afferent activity. In the present study, we investigated the synergistic effects of taVNS and SPB on WM performance.MethodsA total of 96 healthy people participated in this within-subjects experiment involving four conditions, namely taVNS, SPB, combined taVNS with SPB (taVNS + SPB), and sham. Each participant underwent each intervention for 30 min and WM was compared pre- and post-intervention using the spatial and digit n-back tasks in a random order four times. Permutation-based analysis of variance was used to assess the interaction between time and intervention.ResultsFor the spatial 3-back task, a significant interaction between time and intervention was found for the accuracy rate of matching trials (mACC, p = 0.03). Post hoc analysis suggested that both taVNS and taVNS + SPB improved WM performance, however, no significant difference was found in the SPB or sham groups.ConclusionThis study has replicated the effects of taVNS on WM performance reported in previous studies. However, the synergistic effects of combined taVNS and SPB warrant further research.
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Affiliation(s)
- Qian-Qian Tian
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Chen Cheng
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Peng-Hui Liu
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Zi-Xin Yin
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Meng-Kai Zhang
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Ya-Peng Cui
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Rui Zhao
- School of Electronics and Information, Xi’an Polytechnic University, Xi’an, Shaanxi, China
| | - Hui Deng
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi’an, Shaanxi, China
| | - Li-Ming Lu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chun-Zhi Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Neng-Gui Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xue-Juan Yang
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi’an, Shaanxi, China
- Xue-Juan Yang,
| | - Jin-Bo Sun
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi’an, Shaanxi, China
- *Correspondence: Jin-Bo Sun,
| | - Wei Qin
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi’an, Shaanxi, China
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Transcutaneous auricular vagus stimulation (taVNS) improves human working memory performance under sleep deprivation stress. Behav Brain Res 2023; 439:114247. [PMID: 36473677 DOI: 10.1016/j.bbr.2022.114247] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
Many human activities require high cognitive performance over long periods, while impairments induced by sleep deprivation influence various aspects of cognitive abilities, including working memory (WM), attention, and processing speed. Based on previous research, vagal nerve stimulation can modulate cognitive abilities, attention, and arousal. Two experiments were conducted to assess the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) to relieve the deleterious effects of sleep deprivation. In the first experiment, 35 participants completed N-back tasks at 8:00 a.m. for two consecutive days in a within-subject study. Then, the participants received either taVNS or earlobe stimulation (active control) intervention in two sessions at random orders after 24 h of sustained wakefulness. Then, they completed the N-back tasks again. In the second experiment, 30 participants completed the psychomotor vigilance task (PVT), and 32 completed the N-back tasks at 8:00 a.m. on the first and second days. Then, they received either taVNS or earlobe stimulation at random orders and finished the N-back and PVT tasks immediately after one hour. In Experiment 1, taVNS could significantly improve the accuracy rate of participants in spatial 3-back tasks compared to active control, which was consistent with experiment 2. However, taVNS did not specifically enhance PVT performance. Therefore, taVNS could be a powerful intervention for acute sleep deprivation as it can improve performance on high cognitive load tasks and is easy to administer.
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