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Non-invasive Vagus Nerve Stimulation in Treatment of Disorders of Consciousness – Longitudinal Case Study
Neuromodulatory electroceuticals such as vagus nerve stimulation have been recently gaining traction as potential rehabilitation tools for disorders of consciousness (DoC). We present a longitudinal case study of non-invasive auricular vagus nerve stimulation (taVNS) in a patient diagnosed with chro...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120963/ https://www.ncbi.nlm.nih.gov/pubmed/35600632 http://dx.doi.org/10.3389/fnins.2022.834507 |
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author | Osińska, Albertyna Rynkiewicz, Andrzej Binder, Marek Komendziński, Tomasz Borowicz, Anna Leszczyński, Antoni |
author_facet | Osińska, Albertyna Rynkiewicz, Andrzej Binder, Marek Komendziński, Tomasz Borowicz, Anna Leszczyński, Antoni |
author_sort | Osińska, Albertyna |
collection | PubMed |
description | Neuromodulatory electroceuticals such as vagus nerve stimulation have been recently gaining traction as potential rehabilitation tools for disorders of consciousness (DoC). We present a longitudinal case study of non-invasive auricular vagus nerve stimulation (taVNS) in a patient diagnosed with chronic unresponsive wakefulness syndrome (previously known as vegetative state). Over a period of 6 months we applied taVNS daily and regularly evaluated the patient’s behavioral outcomes using Coma Recovery Scale – Revised. We also took electrophysiological measures: resting state electroencephalography (EEG), heart rate (HR) and heart rate variability (HRV). All these methods revealed signs of improvement in the patient’s condition. The total CRS-R scores fluctuated but rose from 4 and 6 at initial stages to the heights of 12 and 13 in the 3rd and 5th month, which would warrant a change in diagnosis to a Minimally Conscious State. Scores obtained in a 2 months follow-up period, though, suggest this may not have been a lasting improvement. Behavioral signs of recovery are triangulated by EEG frequency spectrum profiles with re-emergence of a second oscillatory peak in the alpha range, which has been shown to characterize aware people. However, sustained spontaneous theta oscillations did not predictably diminish, which most likely reflects structural brain damage. ECG measures revealed a steady decrease in pre-stimulation HR combined with an increase in HRV-HR. This suggests a gradual withdrawal of sympathetic and an increase in parasympathetic control of the heart, which the previous literature has also linked with DoC improvements. Together, this study suggests that taVNS stimulation holds promise as a DoC treatment. |
format | Online Article Text |
id | pubmed-9120963 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91209632022-05-21 Non-invasive Vagus Nerve Stimulation in Treatment of Disorders of Consciousness – Longitudinal Case Study Osińska, Albertyna Rynkiewicz, Andrzej Binder, Marek Komendziński, Tomasz Borowicz, Anna Leszczyński, Antoni Front Neurosci Neuroscience Neuromodulatory electroceuticals such as vagus nerve stimulation have been recently gaining traction as potential rehabilitation tools for disorders of consciousness (DoC). We present a longitudinal case study of non-invasive auricular vagus nerve stimulation (taVNS) in a patient diagnosed with chronic unresponsive wakefulness syndrome (previously known as vegetative state). Over a period of 6 months we applied taVNS daily and regularly evaluated the patient’s behavioral outcomes using Coma Recovery Scale – Revised. We also took electrophysiological measures: resting state electroencephalography (EEG), heart rate (HR) and heart rate variability (HRV). All these methods revealed signs of improvement in the patient’s condition. The total CRS-R scores fluctuated but rose from 4 and 6 at initial stages to the heights of 12 and 13 in the 3rd and 5th month, which would warrant a change in diagnosis to a Minimally Conscious State. Scores obtained in a 2 months follow-up period, though, suggest this may not have been a lasting improvement. Behavioral signs of recovery are triangulated by EEG frequency spectrum profiles with re-emergence of a second oscillatory peak in the alpha range, which has been shown to characterize aware people. However, sustained spontaneous theta oscillations did not predictably diminish, which most likely reflects structural brain damage. ECG measures revealed a steady decrease in pre-stimulation HR combined with an increase in HRV-HR. This suggests a gradual withdrawal of sympathetic and an increase in parasympathetic control of the heart, which the previous literature has also linked with DoC improvements. Together, this study suggests that taVNS stimulation holds promise as a DoC treatment. Frontiers Media S.A. 2022-05-06 /pmc/articles/PMC9120963/ /pubmed/35600632 http://dx.doi.org/10.3389/fnins.2022.834507 Text en Copyright © 2022 Osińska, Rynkiewicz, Binder, Komendziński, Borowicz and Leszczyński. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience Osińska, Albertyna Rynkiewicz, Andrzej Binder, Marek Komendziński, Tomasz Borowicz, Anna Leszczyński, Antoni Non-invasive Vagus Nerve Stimulation in Treatment of Disorders of Consciousness – Longitudinal Case Study |
title | Non-invasive Vagus Nerve Stimulation in Treatment of Disorders of Consciousness – Longitudinal Case Study |
title_full | Non-invasive Vagus Nerve Stimulation in Treatment of Disorders of Consciousness – Longitudinal Case Study |
title_fullStr | Non-invasive Vagus Nerve Stimulation in Treatment of Disorders of Consciousness – Longitudinal Case Study |
title_full_unstemmed | Non-invasive Vagus Nerve Stimulation in Treatment of Disorders of Consciousness – Longitudinal Case Study |
title_short | Non-invasive Vagus Nerve Stimulation in Treatment of Disorders of Consciousness – Longitudinal Case Study |
title_sort | non-invasive vagus nerve stimulation in treatment of disorders of consciousness – longitudinal case study |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120963/ https://www.ncbi.nlm.nih.gov/pubmed/35600632 http://dx.doi.org/10.3389/fnins.2022.834507 |
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