Abstract
Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation (tVNS) across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation(VNS) and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice.
Highlights
Brief History of Transcutaneous VagusNerve StimulationThe vagus nerve (VN) is the Xth cranial nerve and the longest nerve, which courses from the brainstem to the distal third of the colon
20 Hz continuous sinusoidal wave 2 weeks transcutaneous vagus nerve stimulation (tVNS) resulted in decreased depression severity
Based on studies using tVNS, Implantable VNS (iVNS), and other electrical stimulation techniques, we suggest that investigators consider the following variables that can influence the responsiveness to tVNS and can confound the results in their studies
Summary
The vagus nerve (VN) is the Xth cranial nerve and the longest nerve, which courses from the brainstem to the distal third of the colon It is the main neural substrate of the parasympathetic nervous system and is composed of afferent and efferent pathways, the former predominate (80%) (Butt et al, 2020). The vagus “nerve” is two nerves, a left vagus and a right vagus, with slightly different neural origins and targets It is composed of different types of fibers that vary in myelination, size, and conduction speed (e.g., for an excellent review on vagus nerve physiology see Yuan and Silberstein, 2016a,b). An understanding of the complex anatomy and physiology of the vagus nerve is essential to an understanding of vagus nerve stimulation
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