Opportunities and trends of transcutaneous auricular vagus nerve stimulation
A review and bibliometric analysis
DOI:
https://doi.org/10.54844/gmiw.2024.0519Keywords:
Transcutaneous auricular vagus nerve stimulation, Non-invasive vagal nerve stimulation, Bibliometric analysis, Auricular branch of the vagus nerve, Stimulating peripheral activity to relieve conditionsAbstract
Background: After more than two decades of development, transcutaneous auricular vagus nerve stimulation (taVNS) has surpassed its role as a mere alternative to VNS and is now applied to various disorders. This study presents a bibliometric analysis to evaluate the global scientific output of taVNS research, aiming to describe its current status and identify potential future trends.
Methods: We conducted a systematic retrieval of taVNS-related studies published between 2000 and 2022 from the Web of Science database. VOSviewer was used to construct networks based on country/institution/author co-authorship, journal/reference co-citation analysis, literature citation analysis and keyword co-occurrence.
Results: A total of 523 relevant articles and reviews were included. Since 2012, there has been a rapid increase in publications and citations. China emerged as the leading contributor in terms of publication output, while Germany had the highest number of citations. Interestingly, research groups from different countries exhibited distinct research ideas and characteristics concerning taVNS, yet collaboration between these groups remained limited. Through a focused examination of key aspects in this field, we identified significant opportunities for the future advancement of taVNS.
Conclusion: This bibliometric analysis emphasizes the interest in and recognition of taVNS as a therapeutic intervention and identifies broader clinical applications, more precise stimulation, and the development and commercialization of wearable devices as key opportunities and challenges for the future.
References
Wang L, Wang Y, Wang Y, et al. Transcutaneous auricular vagus nerve stimulators: a review of past, present, and future devices. Expert Rev Med Devices. 2022;19(1):43–61.
Wang Y, Li L, Li S, et al. Toward Diverse or Standardized: A Systematic Review Identifying Transcutaneous Stimulation of Auricular Branch of the Vagus Nerve in Nomenclature. Neuromodulation. 2022;25:366–379.
Frangos E, Ellrich J, Komisaruk BR. Non-invasive access to the vagus nerve central projections via electrical stimulation of the external ear: fMRI evidence in humans. Brain Stimul. 2015;8(3):624–636. [PMID:25573069 DOI: 10.1016/j.brs.2014.11.018]
Kraus T, Hösl K, Kiess O, Schanze A, Kornhuber J, Forster C. BOLD fMRI deactivation of limbic and temporal brain structures and mood enhancing effect by transcutaneous vagus nerve stimulation. J Neural Transm. 2007;114(11):1485–1493. [PMID:17564758 DOI: 10.1007/s00702-007-0755-z]
Bonaz B, Sinniger V, Pellissier S. Anti-inflammatory properties of the vagus nerve: potential therapeutic implications of vagus nerve stimulation. J Physiol. 2016;594(20):5781–5790. [PMID:27059884 DOI: 10.1113/JP271539]
Peuker ET, Filler TJ. The nerve supply of the human auricle. Clin Anat. 2002;15:35–37. [PMID: 11835542 DOI: 10.1002/ca.1089]
Yakunina N, Kim SS, Nam E-C. Optimization of Transcutaneous Vagus Nerve Stimulation Using Functional MRI. Neuromodulation: Technology at the Neural Interface. 2017;20:290–300. [PMID: 27898202 DOI: 10.1111/ner.12541]
Kraus T, Kiess O, Hösl K, Terekhin P, Kornhuber J, Forster C. CNS BOLD fMRI Effects of Sham-Controlled Transcutaneous Electrical Nerve Stimulation in the Left Outer Auditory Canal – A Pilot Study. Brain Stimulation. 2013;6:798–804. [PMID: 23453934 DOI: 10.1016/j.brs.2013.01.011]
Ventureyra ECG. Transcutaneous vagus nerve stimulation for partial onset seizure therapy. Child's Nerv Syst. 2000;16(2):101–102.
Kim AY, Marduy A, de Melo PS, et al. Safety of transcutaneous auricular vagus nerve stimulation (taVNS): a systematic review and meta-analysis. Sci Rep. 2022;12(1):22055. [PMID:36543841 DOI: 10.1038/s41598-022-25864-1]
Fang J, Rong P, Hong Y, et al. Transcutaneous vagus nerve stimulation modulates default mode network in major depressive disorder. Biol Psychiatry. 2016;79(4):266–273. [PMID:25963932 DOI: 10.1016/j.biopsych.2015.03.025]
Wang L, Zhang J, Guo C, et al. The efficacy and safety of transcutaneous auricular vagus nerve stimulation in patients with mild cognitive impairment: A double blinded randomized clinical trial. Brain Stimul. 2022;15(6):1405–1414.
Rong P, Liu J, Wang L, et al. Effect of transcutaneous auricular vagus nerve stimulation on major depressive disorder: a nonrandomized controlled pilot study. J Affect Disord. 2016;195:172–179. [PMID:26896810 DOI: 10.1016/j.jad.2016.02.031]
Rong P, Liu A, Zhang J, et al. An alternative therapy for drug-resistant epilepsy: transcutaneous auricular vagus nerve stimulation. Chin Med J. 2014;127(2):300–304. [PMID:24438620]
Huang F, Dong J, Kong J, et al. Erratum to: effect of transcutaneous auricular vagus nerve stimulation on impaired glucose tolerance: a pilot randomized study. BMC Complement Altern Med. 2016;16(1):218. [PMID:27411374 DOI: 10.1186/s12906-016-1190-1]
Tu Y, Fang J, Cao J, et al. A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder. Brain Stimul. 2018;11(3):501–508. [PMID:29398576 DOI: 10.1016/j.brs.2018.01.006]
Samoudi AM, Kampusch S, Tanghe E, et al. Numerical modeling of percutaneous auricular vagus nerve stimulation: a realistic 3D model to evaluate sensitivity of neural activation to electrode position. Med Biol Eng Comput. 2017;55(10):1763–1772.
Kaniusas E, Kampusch S, Tittgemeyer M, et al. Current directions in the auricular vagus nerve stimulation II - an engineering perspective. Front Neurosci. 2019;13:772. [PMID:31396044 DOI: 10.3389/fnins.2019.00772]
Van de Steene T, Tanghe E, Tarnaud T, et al. Sensitivity study of neuronal excitation and cathodal blocking thresholds of myelinated axons for percutaneous auricular vagus nerve stimulation. IEEE Trans Biomed Eng. 2020;67(12):3276–3287. [PMID:32203014 DOI: 10.1109/TBME.2020.2982271]
Kaniusas E, Samoudi AM, Kampusch S, et al. Stimulation pattern efficiency in percutaneous auricular vagus nerve stimulation: experimental versus numerical data. IEEE Trans Biomed Eng. 2020;67(7):1921–1935. [PMID:31675313 DOI: 10.1109/TBME.2019.2950777]
Garcia RG, Lin RL, Lee J, et al. Modulation of brainstem activity and connectivity by respiratory-gated auricular vagal afferent nerve stimulation in migraine patients. Pain. 2017;158(8):1461–1472. [PMID:28541256 DOI: 10.1097/j.pain.0000000000000930]
Neuser MP, Teckentrup V, Kühnel A, Hallschmid M, Walter M, Kroemer NB. Vagus nerve stimulation boosts the drive to work for rewards. Nat Commun. 2020;11(1):3555. [PMID:32678082 DOI: 10.1038/s41467-020-17344-9]
Kühnel A, Teckentrup V, Neuser MP, et al. Stimulation of the vagus nerve reduces learning in a go/no-go reinforcement learning task. Eur Neuropsychopharmacol. 2020;35:17–29. [PMID:32404279 DOI: 10.1016/j.euroneuro.2020.03.023]
Ferstl M, Teckentrup V, Lin WM, et al. Non-invasive vagus nerve stimulation boosts mood recovery after effort exertion. Psychol Med. 2022;52(14):3029–3039. [PMID:33586647 DOI: 10.1017/S0033291720005073]
Wang Y, Li SY, Wang D, et al. Transcutaneous auricular vagus nerve stimulation: from concept to application. Neurosci Bull. 2021;37(6):853–862.
Dedoncker J, Vanderhasselt MA, Ottaviani C, Slavich GM. Mental health during the COVID-19 pandemic and beyond: the importance of the vagus nerve for biopsychosocial resilience. Neurosci Biobehav Rev. 2021;125:1–10. [PMID:33582230 DOI: 10.1016/j.neubiorev.2021.02.010]
Yap JYY, Keatch C, Lambert E, Woods W, Stoddart PR, Kameneva T. Critical review of transcutaneous vagus nerve stimulation: challenges for translation to clinical practice. Front Neurosci. 2020;14:284. [PMID:32410932 DOI: 10.3389/fnins.2020.00284]
Kaniusas E, Kampusch S, Tittgemeyer M, et al. Current directions in the auricular vagus nerve stimulation I - A physiological perspective. Front Neurosci. 2019;13:854. [PMID:31447643 DOI: 10.3389/fnins.2019.00854]
Redgrave J, Day D, Leung H, et al. Safety and tolerability of Transcutaneous Vagus Nerve stimulation in humans; a systematic review. Brain Stimul. 2018;11(6):1225–1238. [PMID:30217648 DOI: 10.1016/j.brs.2018.08.010]
Gao Y, Zhu Y, Lu X, et al. Vagus nerve stimulation paired with rehabilitation for motor function, mental health and activities of daily living after stroke: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2023;94(4):257–266. [PMID:36600569 DOI: 10.1136/jnnp-2022-329275]
Meints SM, Garcia RG, Schuman-Olivier Z, et al. The effects of combined respiratory-gated auricular vagal afferent nerve stimulation and mindfulness meditation for chronic low back pain: a pilot study. Pain Med. 2022;23(9):1570–1581. [PMID:35148407 DOI: 10.1093/pm/pnac025]
Vanderhasselt M, Ottaviani C. Combining top-down and bottom-up interventions targeting the vagus nerve to increase resilience. Neurosci Biobehav Rev. 2021;132:725–729.
Finisguerra A, Crescentini C, Urgesi C. Transcutaneous vagus nerve stimulation affects implicit spiritual self-representations. Neuroscience. 2019;412:144–159. [PMID:31176701 DOI: 10.1016/j.neuroscience.2019.05.059]
Yan L, Qian Y, Li H. Transcutaneous vagus nerve stimulation combined with rehabilitation training in the intervention of upper limb movement disorders after stroke: a systematic review. Neuropsychiatr Dis Treat. 2022;18:2095–2106.
Colzato L, Beste C. A literature review on the neurophysiological underpinnings and cognitive effects of transcutaneous vagus nerve stimulation: challenges and future directions. J Neurophysiol. 2020;123:1739–1755. [DOI: 10.1152/jn.00057.2020]
Broncel A, Bocian R, Kłos-Wojtczak P, Kulbat-Warycha K, Konopacki J. Vagal nerve stimulation as a promising tool in the improvement of cognitive disorders. Brain Res Bull. 2020;155:37–47. [PMID:31790720 DOI: 10.1016/j.brainresbull.2019.11.011]
Zhao R, Chang MY, Cheng C, et al. Transcutaneous auricular vagus stimulation (taVNS) improves human working memory performance under sleep deprivation stress. Behav Brain Res. 2023;439:114247.
Ridgewell C, Heaton KJ, Hildebrandt A, Couse J, Leeder T, Neumeier WH. The effects of transcutaneous auricular vagal nerve stimulation on cognition in healthy individuals: a meta-analysis. Neuropsychology. 2021;35(4):352–365. [PMID:34043386 DOI: 10.1037/neu0000735]
Zhao R, He ZY, Cheng C, et al. Assessing the effect of simultaneous combining of transcranial direct current stimulation and transcutaneous auricular vagus nerve stimulation on the improvement of working memory performance in healthy individuals. Front Neurosci. 2022;16:947236. [PMID:35928012 DOI: 10.3389/fnins.2022.947236]
Pihlaja M, Failla L, Peräkylä J, Hartikainen KM. Reduced frontal nogo-N2 with uncompromised response inhibition during transcutaneous vagus nerve stimulation-more efficient cognitive control? Front Hum Neurosci. 2020;14:561780. [PMID:33132877 DOI: 10.3389/fnhum.2020.561780]
Szeska C, Richter J, Wendt J, Weymar M, Hamm AO. Attentive immobility in the face of inevitable distal threat-Startle potentiation and fear bradycardia as an index of emotion and attention. Psychophysiology. 2021;58(6):e13812. [PMID:33759212 DOI: 10.1111/psyp.13812]
Bretherton B, Atkinson L, Murray A, Clancy J, Deuchars S, Deuchars J. Effects of transcutaneous vagus nerve stimulation in individuals aged 55 years or above: potential benefits of daily stimulation. Aging. 2019;11(14):4836–4857. [PMID:31358702 DOI: 10.18632/aging.102074]
Bustamante-Sánchez Á, Tornero-Aguilera JF, Fernández-Elías VE, Hormeño-Holgado AJ, Dalamitros AA, Clemente-Suárez VJ. Effect of stress on autonomic and cardiovascular systems in military population: a systematic review. Cardiol Res Pract. 2020;2020:7986249. [PMID:32850146 DOI: 10.1155/2020/7986249]
Sellaro R, de Gelder B, Finisguerra A, Colzato LS. Transcutaneous vagus nerve stimulation (tVNS) enhances recognition of emotions in faces but not bodies. Cortex. 2018;99:213–223. [PMID:29275193 DOI: 10.1016/j.cortex.2017.11.007]
Borges U, Knops L, Laborde S, Klatt S, Raab M. Transcutaneous vagus nerve stimulation may enhance only specific aspects of the core executive functions. A randomized crossover trial. Front Neurosci. 2020;14:523. [PMID:32523510 DOI: 10.3389/fnins.2020.00523]
Colzato LS, Wolters G, Peifer C. Transcutaneous vagus nerve stimulation (tVNS) modulates flow experience. Exp Brain Res. 2018;236(1):253–257. [PMID:29128975 DOI: 10.1007/s00221-017-5123-0]
Colzato LS, Ritter SM, Steenbergen L. Transcutaneous vagus nerve stimulation (tVNS) enhances divergent thinking. Neuropsychologia. 2018;111:72–76. [PMID:29326067 DOI: 10.1016/j.neuropsychologia.2018.01.003]
Llanos F, McHaney JR, Schuerman WL, Yi HG, Leonard MK, Chandrasekaran B. Non-invasive peripheral nerve stimulation selectively enhances speech category learning in adults. NPJ Sci Learn. 2020;5:12. [PMID:32802406 DOI: 10.1038/s41539-020-0070-0]
Thakkar VJ, Engelhart AS, Khodaparast N, Abadzi H, Centanni TM. Transcutaneous auricular vagus nerve stimulation enhances learning of novel letter-sound relationships in adults. Brain Stimul. 2020;13(6):1813–1820. [PMID:33127581 DOI: 10.1016/j.brs.2020.10.012]
Kaan E, De Aguiar I, Clarke C, Lamb DG, Williamson JB, Porges EC. A transcutaneous vagus nerve stimulation study on verbal order memory. J Neurolinguistics. 2021;59:100990.
Phillips I, Calloway RC, Karuzis VP, Pandža NB, O’Rourke P, Kuchinsky SE. Transcutaneous auricular vagus nerve stimulation strengthens semantic representations of foreign language tone words during initial stages of learning. J Cogn Neurosci. 2021;34(1):127–152.
Steenbergen L, Colzato LS, Maraver MJ. Vagal signaling and the somatic marker hypothesis: the effect of transcutaneous vagal nerve stimulation on delay discounting is modulated by positive mood. Int J Psychophysiol. 2020;148:84–92. [PMID:31734442 DOI: 10.1016/j.ijpsycho.2019.10.010][
National Institutes of Health. Stimulating Peripheral Activity to Relieve Conditions (SPARC) Phase 2 2022. Accessed May 16, 2023. https://commonfund.nih.gov/sparc/fundedresearch/phase2
Ahmed U, Chang YC, Zafeiropoulos S, Nassrallah Z, Miller L, Zanos S. Strategies for precision vagus neuromodulation. Bioelectron Med. 2022;8(1):9. [PMID:35637543 DOI: 10.1186/s42234-022-00091-1]
Bonaz B, Sinniger V, Pellissier S. The Vagus Nerve in the Neuro-Immune Axis: Implications in the Pathology of the Gastrointestinal Tract. Front Immunol. 2017;8:1452. [DOI: 10.3389/fimmu.2017.01452]
Tynan A, Brines M, Chavan SS. Control of inflammation using non-invasive neuromodulation: past, present and promise. Int Immunol. 2022;34(2):119–128. [PMID:34558623 DOI: 10.1093/intimm/dxab073]
Cirillo G, Negrete-Diaz F, Yucuma D, et al. Vagus nerve stimulation: a personalized therapeutic approach for Crohn’s and other inflammatory bowel diseases. Cells. 2022;11(24):4103. [PMID:36552867 DOI: 10.3390/cells11244103]
Sen T, Cawthon CR, Ihde BT, et al. Diet-driven microbiota dysbiosis is associated with vagal remodeling and obesity. Physiol Behav. 2017;173:305–317. [PMID:28249783 DOI: 10.1016/j.physbeh.2017.02.027]
Furman D, Campisi J, Verdin E, et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822–1832. [PMID:31806905 DOI: 10.1038/s41591-019-0675-0]
Straub RH, Cutolo M, Buttgereit F, Pongratz G. Energy regulation and neuroendocrine-immune control in chronic inflammatory diseases. J Intern Med. 2010;267(6):543–560. [PMID:20210843 DOI: 10.1111/j.1365-2796.2010.02218.x]
Straub RH. The brain and immune system prompt energy shortage in chronic inflammation and ageing. Nat Rev Rheumatol. 2017;13(12):743–751. [PMID:29021568 DOI: 10.1038/nrrheum.2017.172]
Martel J, Chang SH, Ko YF, Hwang TL, Young JD, Ojcius DM. Gut barrier disruption and chronic disease. Trends Endocrinol Metab. 2022;33(4):247–265. [PMID:35151560 DOI: 10.1016/j.tem.2022.01.002]
Wang P, Song M, Eliassen AH, et al. Optimal dietary patterns for prevention of chronic disease. Nat Med. 2023;29(3):719–728. [PMID:36914892 DOI: 10.1038/s41591-023-02235-5][PubMed]
SPARC. [SPARC Portal]. Accessed January 2, 2023. https://sparc.science/
Capogrosso M, Lempka SF. A computational outlook on neurostimulation. Bioelectron Med. 2020;6:10. [PMID:32490037 DOI: 10.1186/s42234-020-00047-3]
Dabiri B, Zeiner K, Nativel A, Kaniusas E. Auricular vagus nerve stimulator for closed-loop biofeedback-based operation. Analog Integr Circuits Process. 2022;112:237–46. [PMID:35571976 DOI: 10.1007/s10470-022-02037-8]
Cook DN, Thompson S, Stomberg-Firestein S, Bikson M, George MS, Jenkins DD, et al. Design and validation of a closed-loop, motor-activated auricular vagus nerve stimulation (MAAVNS) system for neurorehabilitation. Brain Stimul 2020;13:800–3. [PMID: 32289710 DOI: 10.1016/j.brs.2020.02.028]
Burger AM, D’Agostini M, Verkuil B, Van Diest I. Moving beyond belief: A narrative review of potential biomarkers for transcutaneous vagus nerve stimulation. Psychophysiology. 2020;57:e13571. [PMID: 32202671 DOI: 10.1111/psyp.13571]
Marsal S, Corominas H, de Agustín JJ, et al. Non-invasive vagus nerve stimulation for rheumatoid arthritis: a proof-of-concept study. Lancet Rheumatol. 2021;3(4):e262–e269. [PMID:38279410 DOI: 10.1016/S2665-9913(20)30425-2]
Bremner JD, Gurel NZ, Wittbrodt MT, et al. Application of noninvasive vagal nerve stimulation to stress-related psychiatric disorders. J Pers Med. 2020;10(3):119. [PMID:32916852 DOI: 10.3390/jpm10030119]
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