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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...

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Autores principales: Osińska, Albertyna, Rynkiewicz, Andrzej, Binder, Marek, Komendziński, Tomasz, Borowicz, Anna, Leszczyński, Antoni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
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.
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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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