Transcutaneous Cervical Vagal Nerve Stimulation in Patients with Posttraumatic Stress Disorder (PTSD): A Pilot Study of Effects on PTSD Symptoms and Interleukin-6 Response to Stress.

Autor:	Bremner JD; Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.; Atlanta VA Medical Center, Decatur, Georgia., Wittbrodt MT; Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia., Gurel NZ; School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia., Shandhi MH; School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia., Gazi AH; School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia., Jiao Y; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Levantsevych OM; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Huang M; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Beckwith J; Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia., Herring I; Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia., Murrah N; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Driggers EG; Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Ko YA; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia., Alkhalaf ML; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Soudan M; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Shallenberger L; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Hankus AN; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Nye JA; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia., Park J; Atlanta VA Medical Center, Decatur, Georgia.; Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia., Woodbury A; Atlanta VA Medical Center, Decatur, Georgia.; Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia., Mehta PK; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia., Rapaport MH; Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah., Vaccarino V; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia., Shah AJ; Atlanta VA Medical Center, Decatur, Georgia.; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia., Pearce BD; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Inan OT; School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia.; Coulter Department of Bioengineering, Georgia Institute of Technology, Atlanta, Georgia.
Jazyk:	angličtina
Zdroj:	Journal of affective disorders reports [J Affect Disord Rep] 2021 Dec; Vol. 6. Date of Electronic Publication: 2021 Jul 10.
DOI:	10.1016/j.jadr.2021.100190
Abstrakt:	Background: Posttraumatic stress disorder (PTSD) is a highly disabling condition associated with alterations in multiple neurobiological systems, including increases in inflammatory and sympathetic function, responsible for maintenance of symptoms. Treatment options including medications and psychotherapies have limitations. We previously showed that transcutaneous Vagus Nerve Stimulation (tcVNS) blocks inflammatory (interleukin (IL)-6) responses to stress in PTSD. The purpose of this study was to assess the effects of tcVNS on PTSD symptoms and inflammatory responses to stress. Methods: Twenty patients with PTSD were randomized to double blind active tcVNS (N=9) or sham (N=11) stimulation in conjunction with exposure to personalized traumatic scripts immediately followed by active or sham tcVNS and measurement of IL-6 and other biomarkers of inflammation. Patients then self administered active or sham tcVNS twice daily for three months. PTSD symptoms were measured with the PTSD Checklist (PCL) and the Clinician Administered PTSD Scale (CAPS), clinical improvement with the Clinical Global Index (CGI) and anxiety with the Hamilton Anxiety Scale (Ham-A) at baseline and one-month intervals followed by a repeat of measurement of biomarkers with traumatic scripts. After three months patients self treated with twice daily open label active tcVNS for another three months followed by assessment with the CGI. Results: Traumatic scripts increased IL-6 in PTSD patients, an effect that was blocked by tcVNS (p<.05). Active tcVNS treatment for three months resulted in a 31% greater reduction in PTSD symptoms compared to sham treatment as measured by the PCL (p=0.013) as well as hyperarousal symptoms and somatic anxiety measured with the Ham-A p<0.05). IL-6 increased from baseline in sham but not tcVNS. Open label tcVNS resulted in improvements measured with the CGI compared to the sham treatment period p<0.05). Conclusions: These preliminary results suggest that tcVNS reduces inflammatory responses to stress, which may in part underlie beneficial effects on PTSD symptoms.
Databáze:	MEDLINE
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