Safety and preliminary efficacy of transcutaneous auricular vagus nerve stimulation on chronic knee pain: A pilot trial

Osteoarthritis and cartilage open Pub Date : 2024-11-23 DOI:10.1016/j.ocarto.2024.100545

Kosaku Aoyagi , Elias Rivas , Roxanna Shababi , Robert Edwards , Michael LaValley , Julia Lechuga , Vitaly Napadow , Tuhina Neogi

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Abstract

Objective

Transcutaneous auricular vagus nerve stimulation (tVNS) may be an innovative treatment for symptoms of knee osteoarthritis (OA) due to possible shared pathological mechanisms between diminished parasympathetic function, central pain mechanisms, and knee pain. Thus, we sought to test the safety and preliminary efficacy of tVNS in people with knee OA.

Design

A pilot trial in which participants received a 60-min tVNS was conducted. At baseline, immediately after, and 15 min after tVNS, we assessed knee pain, pressure pain threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM), and high-frequency power of heart rate variability (HF). We examined the extent to which these outcome measures changed after tVNS using linear mixed models.

Results

30 participants with knee OA were included, and all completed the intervention without any major side effects. Compared to baseline, knee pain was reduced by 1.27 (95 % CI, −1.74, −0.80) immediately after and by 1.87 (−2.33, −1.40) 15 min after tVNS; CPM improved by 0.11 (0.04, 0.19) and 0.07 (−0.01, 0.15); and HF improved by 213.29 (−0.38, 426.96) and 234.17 (20.49, 447.84). PPT and TS were not changed after tVNS.

Conclusions

Our preliminary data demonstrated that tVNS may be a safe pain-relieving treatment for people with knee OA. Our findings suggest that improvement of knee pain might be derived from improvement of parasympathetic function and central pain mechanisms as no local therapy was applied. A large study is needed to confirm that tVNS is a novel intervention to ameliorate knee pain in people with knee OA.

Clinical Trial

ClinicalTrials.gov (NCT05625178).

查看原文本刊更多论文

经皮耳迷走神经刺激治疗慢性膝关节疼痛的安全性和初步疗效：一项先导试验

目的：经皮耳迷走神经刺激（tVNS）可能是治疗膝关节骨关节炎（OA）症状的一种创新方法，因为副交感神经功能减退、中枢疼痛机制和膝关节疼痛之间可能存在共同的病理机制。因此，我们试图测试tVNS在膝关节OA患者中的安全性和初步有效性。DesignA进行了一项试点试验，参与者获得了60分钟的电视节目。在基线、tVNS后立即和tVNS后15分钟，我们评估了膝关节疼痛、压痛阈值（PPT）、时间累积（TS）、条理性疼痛调节（CPM）和心率变异性的高频功率（HF）。我们使用线性混合模型检验了tVNS后这些结果测量变化的程度。结果纳入30例膝关节OA患者，所有患者均完成干预，无重大副作用。与基线相比，膝关节疼痛在tVNS后立即减少1.27 (95% CI, - 1.74, - 0.80)，在tVNS后15分钟减少1.87 (- 2.33,- 1.40)；CPM分别提高0.11（0.04,0.19）和0.07 (- 0.01,0.15)；HF分别提高213.29（- 0.38,426.96）和234.17（20.49,447.84）。tVNS后PPT和TS均未改变。结论初步数据表明，tVNS可能是一种安全的缓解膝关节OA患者疼痛的方法。我们的研究结果表明，在没有局部治疗的情况下，膝关节疼痛的改善可能源于副交感神经功能和中枢疼痛机制的改善。需要大量的研究来证实tVNS是一种新的干预措施来改善膝关节OA患者的膝关节疼痛。clinicaltrials .gov （NCT05625178）。

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来源期刊

Osteoarthritis and cartilage open Orthopedics, Sports Medicine and Rehabilitation

CiteScore

3.30

自引率

0.00%

发文量