Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Conditioned Pain Modulation in Trigeminal Neuralgia Patients

IF 4.1 2区医学 Q1 CLINICAL NEUROLOGY

Pain and Therapy Pub Date : 2024-09-11 DOI:10.1007/s40122-024-00654-x

Yu Zhang, Yiyuan Luo, Qixing Wu, Mingming Han, Haitao Wang, Fang Kang

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引用次数: 0

Abstract

Introduction

Conditioned pain modulation (CPM) is a quantitative estimation of the capacity for endogenous pain modulation. Reduced CPM enables chronic painful event development or exacerbates pre-existing pain symptoms. Emerging reports indicate that patients with trigeminal neuralgia (TN) have dysregulated endogenous pain modulation. Transauricular vagus nerve stimulation (taVNS) is known to alleviate both acute and chronic pain symptoms. Its role in modulation or management of TN remains unknown. Here, we evaluated the taVNS efficacy in modulating CPM among TN patients. Conclusions from this investigation may facilitate establishment of novel non-invasive adjunctive approaches to treating TN patients.

Methods

All research work was conducted at the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital). In all, we recruited 62 study participants, 31 TN patients and 31 healthy volunteers, for a 2-day experimental test. At the beginning of the experiment (Day 1), all subjects received 30 min of active taVNS. On Day 2, they received sham taVNS with the same duration and intensity. Meanwhile, technicians documented participant pressure pain thresholds (PPT) and CPM values at baseline, and at 15 and 30 min post-active or sham taVNS.

Results

A 30-min active taVNS exposure substantially elevated the PPT and CPM effect (P < 0.05) among TN patients, and we also observed a notable rise in the PPT and CPM effect (P < 0.05) among healthy controls. Additionally, there were no serious adverse events from the administered treatment.

Conclusion

Exposure to 30 min of active taVNS strongly augmented the CPM effect and elevated the PPT among TN patients and healthy controls. These effects were not observed with sham stimulation. Despite the limitations inherent to survey studies, such as duration and compliance biases, we consider that taVNS is a promising, safe, and cost-effective therapy. In future investigations, we recommend assessment of long-term taVNS application and its effects on CPM and clinical pain.

Trial Registration

ChiCTR2300078673 (www.Chictr.org.cn).

Abstract Image

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经皮耳廓迷走神经刺激对三叉神经痛患者条件性疼痛调节的影响

导言：条件性疼痛调节（CPM）是对内源性疼痛调节能力的定量评估。降低 CPM 会导致慢性疼痛事件的发生或加重原有的疼痛症状。最新报告显示，三叉神经痛（TN）患者的内源性疼痛调节能力失调。经耳迷走神经刺激（taVNS）可减轻急性和慢性疼痛症状。但它在 TN 的调节或治疗中的作用仍然未知。在此，我们评估了 taVNS 在 TN 患者中调节 CPM 的功效。所有研究工作均在中国科学技术大学附属第一医院（安徽省立医院）进行。我们共招募了62名研究对象，包括31名TN患者和31名健康志愿者，进行了为期2天的实验测试。实验开始时（第1天），所有受试者都接受了30分钟的主动taVNS治疗。第 2 天，他们接受了相同时间和强度的假性 taVNS。结果 30 分钟的主动 taVNS 暴露大大提高了 TN 患者的 PPT 和 CPM 效应（P < 0.05），我们还观察到健康对照组的 PPT 和 CPM 效应也显著提高（P < 0.05）。结论在 TN 患者和健康对照组中，暴露于 30 分钟的活性 taVNS 强烈增强了 CPM 效果并提高了 PPT。假刺激未观察到这些效果。尽管调查研究存在固有的局限性，如持续时间和依从性偏差，但我们认为 taVNS 是一种有前景、安全且经济有效的疗法。在未来的调查中，我们建议对长期应用 taVNS 及其对 CPM 和临床疼痛的影响进行评估。试验注册ChiCTR2300078673 (www.Chictr.org.cn)。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.