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Optimization of respiratory-gated auricular vagus afferent nerve stimulation for the modulation of blood pressure in hypertension

BACKGROUND: The objective of this pilot study was to identify frequency-dependent effects of respiratory-gated auricular vagus afferent nerve stimulation (RAVANS) on the regulation of blood pressure and heart rate variability in hypertensive subjects and examine potential differential effects by sex...

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Autores principales: Garcia, Ronald G., Staley, Rachel, Aroner, Sarah, Stowell, Jessica, Sclocco, Roberta, Napadow, Vitaly, Barbieri, Riccardo, Goldstein, Jill M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783922/
https://www.ncbi.nlm.nih.gov/pubmed/36570845
http://dx.doi.org/10.3389/fnins.2022.1038339
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author Garcia, Ronald G.
Staley, Rachel
Aroner, Sarah
Stowell, Jessica
Sclocco, Roberta
Napadow, Vitaly
Barbieri, Riccardo
Goldstein, Jill M.
author_facet Garcia, Ronald G.
Staley, Rachel
Aroner, Sarah
Stowell, Jessica
Sclocco, Roberta
Napadow, Vitaly
Barbieri, Riccardo
Goldstein, Jill M.
author_sort Garcia, Ronald G.
collection PubMed
description BACKGROUND: The objective of this pilot study was to identify frequency-dependent effects of respiratory-gated auricular vagus afferent nerve stimulation (RAVANS) on the regulation of blood pressure and heart rate variability in hypertensive subjects and examine potential differential effects by sex/gender or race. METHODS: Twenty hypertensive subjects (54.55 ± 6.23 years of age; 12 females and 8 males) were included in a within-person experimental design and underwent five stimulation sessions where they received RAVANS at different frequencies (i.e., 2 Hz, 10 Hz, 25 Hz, 100 Hz, or sham stimulation) in a randomized order. EKG and continuous blood pressure signals were collected during a 10-min baseline, 30-min stimulation, and 10-min post-stimulation periods. Generalized estimating equations (GEE) adjusted for baseline measures were used to evaluate frequency-dependent effects of RAVANS on heart rate, high frequency power, and blood pressure measures, including analyses stratified by sex and race. RESULTS: Administration of RAVANS at 100 Hz had significant overall effects on the reduction of heart rate (β = −2.03, p = 0.002). It was also associated with a significant reduction of diastolic (β = −1.90, p = 0.01) and mean arterial blood pressure (β = −2.23, p = 0.002) in Black hypertensive participants and heart rate in female subjects (β = −2.83, p = 0.01) during the post-stimulation period when compared to sham. CONCLUSION: Respiratory-gated auricular vagus afferent nerve stimulation exhibits frequency-dependent rapid effects on the modulation of heart rate and blood pressure in hypertensive patients that may further differ by race and sex. Our findings highlight the need for the development of optimized stimulation protocols that achieve the greatest effects on the modulation of physiological and clinical outcomes in this population.
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spelling pubmed-97839222022-12-24 Optimization of respiratory-gated auricular vagus afferent nerve stimulation for the modulation of blood pressure in hypertension Garcia, Ronald G. Staley, Rachel Aroner, Sarah Stowell, Jessica Sclocco, Roberta Napadow, Vitaly Barbieri, Riccardo Goldstein, Jill M. Front Neurosci Neuroscience BACKGROUND: The objective of this pilot study was to identify frequency-dependent effects of respiratory-gated auricular vagus afferent nerve stimulation (RAVANS) on the regulation of blood pressure and heart rate variability in hypertensive subjects and examine potential differential effects by sex/gender or race. METHODS: Twenty hypertensive subjects (54.55 ± 6.23 years of age; 12 females and 8 males) were included in a within-person experimental design and underwent five stimulation sessions where they received RAVANS at different frequencies (i.e., 2 Hz, 10 Hz, 25 Hz, 100 Hz, or sham stimulation) in a randomized order. EKG and continuous blood pressure signals were collected during a 10-min baseline, 30-min stimulation, and 10-min post-stimulation periods. Generalized estimating equations (GEE) adjusted for baseline measures were used to evaluate frequency-dependent effects of RAVANS on heart rate, high frequency power, and blood pressure measures, including analyses stratified by sex and race. RESULTS: Administration of RAVANS at 100 Hz had significant overall effects on the reduction of heart rate (β = −2.03, p = 0.002). It was also associated with a significant reduction of diastolic (β = −1.90, p = 0.01) and mean arterial blood pressure (β = −2.23, p = 0.002) in Black hypertensive participants and heart rate in female subjects (β = −2.83, p = 0.01) during the post-stimulation period when compared to sham. CONCLUSION: Respiratory-gated auricular vagus afferent nerve stimulation exhibits frequency-dependent rapid effects on the modulation of heart rate and blood pressure in hypertensive patients that may further differ by race and sex. Our findings highlight the need for the development of optimized stimulation protocols that achieve the greatest effects on the modulation of physiological and clinical outcomes in this population. Frontiers Media S.A. 2022-12-09 /pmc/articles/PMC9783922/ /pubmed/36570845 http://dx.doi.org/10.3389/fnins.2022.1038339 Text en Copyright © 2022 Garcia, Staley, Aroner, Stowell, Sclocco, Napadow, Barbieri and Goldstein. 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
Garcia, Ronald G.
Staley, Rachel
Aroner, Sarah
Stowell, Jessica
Sclocco, Roberta
Napadow, Vitaly
Barbieri, Riccardo
Goldstein, Jill M.
Optimization of respiratory-gated auricular vagus afferent nerve stimulation for the modulation of blood pressure in hypertension
title Optimization of respiratory-gated auricular vagus afferent nerve stimulation for the modulation of blood pressure in hypertension
title_full Optimization of respiratory-gated auricular vagus afferent nerve stimulation for the modulation of blood pressure in hypertension
title_fullStr Optimization of respiratory-gated auricular vagus afferent nerve stimulation for the modulation of blood pressure in hypertension
title_full_unstemmed Optimization of respiratory-gated auricular vagus afferent nerve stimulation for the modulation of blood pressure in hypertension
title_short Optimization of respiratory-gated auricular vagus afferent nerve stimulation for the modulation of blood pressure in hypertension
title_sort optimization of respiratory-gated auricular vagus afferent nerve stimulation for the modulation of blood pressure in hypertension
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783922/
https://www.ncbi.nlm.nih.gov/pubmed/36570845
http://dx.doi.org/10.3389/fnins.2022.1038339
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