Neural networks and the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation in depression

Chun-Hong Liu, Ming-Hao Yang, Guang-Zhong Zhang, Xiao-Xu Wang, Bin Li, Meng Li, Marie Woelfer, Martin Walter, Lihong Wang, Chun-Hong Liu, Ming-Hao Yang, Guang-Zhong Zhang, Xiao-Xu Wang, Bin Li, Meng Li, Marie Woelfer, Martin Walter, Lihong Wang

Abstract

Transcutaneous auricular vagus nerve stimulation (taVNS) is a relatively non-invasive alternative treatment for patients suffering from major depressive disorder (MDD). It has been postulated that acupuncture may achieve its treatment effects on MDD through suppression of vagal nerve inflammatory responses. Our previous research established that taVNS significantly increases amygdala-dorsolateral prefrontal cortex connectivity, which is associated with a reduction in depression severity. However, the relationship between taVNS and the central/peripheral functional state of the immune system, as well as changes in brain neural circuits, have not as yet been elucidated. In the present paper, we outline the anatomic foundation of taVNS and emphasize that it significantly modulates the activity and connectivity of a wide range of neural networks, including the default mode network, executive network, and networks involved in emotional and reward circuits. In addition, we present the inflammatory mechanism of MDD and describe how taVNS inhibits central and peripheral inflammation, which is possibly related to the effectiveness of taVNS in reducing depression severity. Our review suggests a link between the suppression of inflammation and changes in brain regions/circuits post taVNS.

Keywords: Anti-inflammation; Brain network; Depression; Transcutaneous auricular vagus nerve stimulation; Vagus nerve.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Innervation of the human auricle, including the auricular branch of the vagus nerve (blue shading); the black areas show the specific auricular acupoints. TF4 and CO10–12 are used to stimulate the auricular branch of the vagus nerve
Fig. 2
Fig. 2
Proposed model of the mechanism of taVNS in the central nervous system (schematic). Anterior DMN = anterior default mode network; CEN = central executive network; dlPFC = dorsolateral prefrontal cortex; dmPFC = dorsomedial prefrontal cortex; DS = dorsal striatum; LC = locus coeruleus; mPFC = medial prefrontal cortex; NTS = nucleus tractus solitarius; PCC = posterior cingulate cortex; posterior DMN = posterior default mode network; rACC = rostral anterior cingulate cortex; VS = ventral striatum.
Fig. 3
Fig. 3
Hypothesized mechanisms of taVNS in the treatment of depression: direct and indirect modulation of the activity and connectivity of the key brain regions involved in depression, reducing neuroinflammatory sensitization and modulating the autonomic nervous system. ACh = acetylcholine; CRP = C-reactive protein; IL = interleukin; LC = locus coeruleus; NE = norepinephrine; NTS = nucleus tractus solitarius; TNF-α = tumor necrosis factor-α.

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Source: PubMed

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