The Short-Term Effects of Transcutaneous Auricular Vagus Nerve Stimulation in Female Patients with Functional Constipation and Myofascial Pain Syndrome: A Randomized Clinical Trial

IF 3.7 3区医学 Q2 CLINICAL NEUROLOGY

Neuromodulation Pub Date : 2026-10-01 Epub Date: 2026-05-28 DOI:10.1016/j.neurom.2026.05.003

Fariba Khosravi PhD, Siyavash Joukar PhD, Mohammad Reza Nourbakhsh PhD, Mahboobeh Abdolalizadeh PhD, Amir Massoud Arab PhD

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引用次数: 0

Abstract

Introduction

The management of chronic constipation when it coexists with chronic pain syndrome is challenging because of complex pathophysiologic and constipating analgesic side effects. Transcutaneous auricular vagus nerve stimulation (taVNS) is an effective neuromodulation method to modulate gastrointestinal function and pain processing by targeting vagal pathways. Accordingly, this study evaluated the short-term effects of taVNS in patients with functional constipation (FC) comorbid with myofascial pain syndrome (MPS).

Materials and Methods

A total of 38 female participants with FC and MPS (aged 20–50 years) were randomly allocated (1:1) using a computer-generated randomization to either taVNS or sham-taVNS groups. Participants received the intervention for 30 minutes, five days a week for two weeks. The complete spontaneous bowel movements per week (CSBMs/week) as the primary outcome was assessed at baseline and after the treatment. Secondary outcomes were Wexner constipation scores (WCS), patient assessment of constipation quality of life (PAC-QoL) score, visual analogue scale (VAS), pressure pain threshold (PPT), and heart rate variability (HRV).

Results

The result of analysis of covariance (ANCOVA) showed that taVNS significantly and clinically improved CSBMs/week compared with the sham-taVNS (p = 0.007; Cohen d = 0.97, 95% CI 0.26 – 1.66). The mean increase of CSBMs/week was 1.65 times compared with the baseline and 1.37 times compared with the sham-taVNS (MCID = 1.3 times). Moreover, the taVNS group had greater reduction in WCS and VAS compared with the sham group. In the HRV analysis, the taVNS enhanced high frequency (HF) and decreased low frequency (LF) and the LF/HF ratio compared with the sham-taVNS. However, there was no substantial difference in the PPT and PAC-QoL between groups.

Conclusions

These promising findings provide preliminary evidence that taVNS may be an effective nonpharmacologic intervention in female patients with FC coexisting with chronic pain conditions, particularly MPS. Further large-scale studies with longer follow-up and mechanistic assessments are warranted.

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经皮耳迷走神经刺激治疗女性功能性便秘和肌筋膜疼痛综合征的短期疗效：一项随机临床试验。

慢性便秘与慢性疼痛综合征共存时，由于其复杂的病理生理和便秘镇痛副作用，治疗具有挑战性。经皮耳迷走神经刺激（taVNS）是一种有效的神经调节方法，通过靶向迷走神经通路来调节胃肠道功能和疼痛加工。因此，本研究评估了taVNS对功能性便秘（FC）合并肌筋膜疼痛综合征（MPS）患者的短期效果。材料和方法：38名女性FC和MPS参与者（年龄20-50岁）使用计算机生成的随机化随机分配（1:1）到taVNS组或假taVNS组。参与者接受30分钟的干预，每周五天，持续两周。在基线和治疗后评估每周完全自发排便量（CSBMs/week）作为主要结局。次要结果为Wexner便秘评分（WCS）、患者便秘生活质量评估（PAC-QoL）评分、视觉模拟量表（VAS）、压痛阈值（PPT）和心率变异性（HRV）。结果：协方差分析（ANCOVA）结果显示，与sham-taVNS相比，taVNS显著改善临床CSBMs/week （p = 0.007; Cohen d = 0.97, 95% CI 0.26 ~ 1.66）。与基线相比，CSBMs/周平均增加1.65倍，与sham-taVNS相比，平均增加1.37倍（MCID = 1.3倍）。此外，taVNS组WCS和VAS较sham组有更大的降低。在HRV分析中，与假taVNS相比，taVNS增强了高频（HF），降低了低频（LF）和LF/HF比值。但两组间PPT和PAC-QoL无显著差异。结论：这些有希望的发现提供了初步证据，taVNS可能是一种有效的非药物干预女性FC合并慢性疼痛疾病，特别是MPS。有必要进行进一步的大规模研究，进行更长时间的随访和机制评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuromodulation 医学-临床神经学

CiteScore

6.40

自引率

3.60%

发文量

978

审稿时长

54 days

期刊介绍： Neuromodulation: Technology at the Neural Interface is the preeminent journal in the area of neuromodulation, providing our readership with the state of the art clinical, translational, and basic science research in the field. For clinicians, engineers, scientists and members of the biotechnology industry alike, Neuromodulation provides timely and rigorously peer-reviewed articles on the technology, science, and clinical application of devices that interface with the nervous system to treat disease and improve function.