Non-invasive vagal nerve stimulation decreases brain activity during trauma scripts.

Autor: Wittbrodt MT; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: mattwittbrodt@emory.edu., Gurel NZ; Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA., Nye JA; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA., Ladd S; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA., Shandhi MMH; Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA., Huang M; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA., Shah AJ; Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA., Pearce BD; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA., Alam ZS; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA., Rapaport MH; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA., Murrah N; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA., Ko YA; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA., Haffer AA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA., Shallenberger LH; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA., Vaccarino V; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA; Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA, USA., Inan OT; Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA., Bremner JD; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA.
Jazyk: angličtina
Zdroj: Brain stimulation [Brain Stimul] 2020 Sep - Oct; Vol. 13 (5), pp. 1333-1348. Date of Electronic Publication: 2020 Jul 10.
DOI: 10.1016/j.brs.2020.07.002
Abstrakt: Background: Traumatic stress can have lasting effects on neurobiology and result in psychiatric conditions such as posttraumatic stress disorder (PTSD). We hypothesize that non-invasive cervical vagal nerve stimulation (nVNS) may alleviate trauma symptoms by reducing stress sympathetic reactivity. This study examined how nVNS alters neural responses to personalized traumatic scripts.
Methods: Nineteen participants who had experienced trauma but did not have the diagnosis of PTSD completed this double-blind sham-controlled study. In three sequential time blocks, personalized traumatic scripts were presented to participants immediately followed by either sham stimulation (n = 8; 0-14 V, 0.2 Hz, pulse width = 5s) or active nVNS (n = 11; 0-30 V, 25 Hz, pulse width = 40 ms). Brain activity during traumatic scripts was assessed using High Resolution Positron Emission Tomography (HR-PET) with radiolabeled water to measure brain blood flow.
Results: Traumatic scripts resulted in significant activations within the bilateral medial and orbital prefrontal cortex, premotor cortex, anterior cingulate, thalamus, insula, hippocampus, right amygdala, and right putamen. Greater activation was observed during sham stimulation compared to nVNS within the bilateral prefrontal and orbitofrontal cortex, premotor cortex, temporal lobe, parahippocampal gyrus, insula, and left anterior cingulate. During the first exposure to the trauma scripts, greater activations were found in the motor cortices and ventral visual stream whereas prefrontal cortex and anterior cingulate activations were more predominant with later script presentations for those subjects receiving sham stimulation.
Conclusion: nVNS decreases neural reactivity to an emotional stressor in limbic and other brain areas involved in stress, with changes over repeated exposures suggesting a shift from scene appraisal to cognitively processing the emotional event.
Competing Interests: Declaration of competing interest Dr. Bremner reported having funding support from ElectroCore LLC. No other authors report potential conflicts of interests.
(Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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