title: BOLD fMRI deactivation of limbic and temporal brain structures and mood enhancing effect by transcutaneous vagus nerve stimulation.
abstract: Direct vagus nerve stimulation (VNS) has proved to be an effective treatment for seizure disorder and major depression. However, since this invasive technique implies surgery, with its side-effects and relatively high financial costs, a non-invasive method to stimulate vagal afferences would be a great step forward. We studied effects of non-invasive electrical stimulation of the nerves in the left outer auditory canal in healthy subjects (n = 22), aiming to activate vagal afferences transcutaneously (t-VNS). Short-term changes in brain activation and subjective well-being induced by t-VNS were investigated by functional magnetic resonance imaging (fMRI) and psychometric assessment using the Adjective Mood Scale (AMS), a self-rating scale for current subjective feeling. Stimulation of the ear lobe served as a sham control. fMRI showed that robust t-VNS induced BOLD-signal decreases in limbic brain areas, including the amygdala, hippocampus, parahippocampal gyrus and the middle and superior temporal gyrus. Increased activation was seen in the insula, precentral gyrus and the thalamus. Psychometric assessment revealed significant improvement of well-being after t-VNS. Ear lobe stimulation as a sham control intervention did not show similar effects in either fMRI or psychometric assessment. No significant effects on heart rate, blood pressure or peripheral microcirculation could be detected during the stimulation procedure.
  
  
  CONCLUSIONS
  Our study shows the feasibility and beneficial effects of transcutaneous nerve stimulation in the left auditory canal of healthy subjects. Brain activation patterns clearly share features with changes observed during invasive vagus nerve stimulation.
authors.affiliation: Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany. mail@thomaskraus.de
authors.forename: T
authors.initials: T
authors.lastname: Kraus
authors.forename: K
authors.initials: K
authors.lastname: Hösl
authors.forename: O
authors.initials: O
authors.lastname: Kiess
authors.forename: A
authors.initials: A
authors.lastname: Schanze
authors.forename: J
authors.initials: J
authors.lastname: Kornhuber
authors.forename: C
authors.initials: C
authors.lastname: Forster
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D004424:Ear Canal / Q000502:physiology; D004431:Ear, External / Q000502:physiology; D004562:Electrocardiography; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008032:Limbic System / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000097:blood*; D011594:Psychometrics; D013702:Temporal Lobe / Q000378:metabolism*; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects; D014630:Vagus Nerve / Q000502:physiology*
chemical_list: D010100:Oxygen