Laboratory Administration of Transcutaneous Auricular Vagus Nerve Stimulation (taVNS): Technique, Targeting, and Considerations

Bashar W Badran, Alfred B Yu, Devin Adair, Georgia Mappin, William H DeVries, Dorothea D Jenkins, Mark S George, Marom Bikson, Bashar W Badran, Alfred B Yu, Devin Adair, Georgia Mappin, William H DeVries, Dorothea D Jenkins, Mark S George, Marom Bikson

Abstract

Non-invasive vagus nerve stimulation (VNS) may be administered via a novel, emerging neuromodulatory technique known as transcutaneous auricular vagus nerve stimulation (taVNS). Unlike cervically-implanted VNS, taVNS is an inexpensive and non-surgical method used to modulate the vagus system. taVNS is appealing as it allows for rapid translation of basic VNS research and serves as a safe, inexpensive, and portable neurostimulation system for the future treatment of central and peripheral disease. The background and rationale for taVNS is described, along with electrical and parametric considerations, proper ear targeting and attachment of stimulation electrodes, individual dosing via determination of perception threshold (PT), and safe administration of taVNS.

Figures

Figure 1:. Vagus Nerve Efferent Projections and…
Figure 1:. Vagus Nerve Efferent Projections and Cross-section.
(A) Efferent projections of the vagus nerve target every major organ on the body with wide effects on bodily function (B) Cross-section of the vagus nerve, demonstrating the inside anatomy of the nerve as a series of bundles of nerves all contained within one major pathway.
Figure 2:. taVNS Ear Targets.
Figure 2:. taVNS Ear Targets.
Targeting the ABVN can be accomplished by stimulating the anterior wall of the outer ear canal, landmarked notably by the tragus (A1), or cymba conchae (A2). Sham stimulation is administered to the earlobe (S).
Figure 3:. Key Components.
Figure 3:. Key Components.
The minimum required components for proper administration of taVNS are the following (A) ear stimulation electrodes, (B) conductive gel and alcohol prep pads, (C) computer capable of sending and receiving TTL pulses to a (D) constant current stimulator to trigger stimulation.
Figure 4:. Example Setup.
Figure 4:. Example Setup.
This photo shows an individual receiving taVNS of the left ear while in position to undergo an experimental paradigm.
Figure 5:
Figure 5:
Screenshot of the GUI used for stimulation.
Figure 6:. Electrical Stimulation Waveform Manipulations.
Figure 6:. Electrical Stimulation Waveform Manipulations.
Direct square wave electrical current can be delivered at various parameters. This figure demonstrates key properties of the waveform that can be changed in order to achieve desired biologic effects.
Figure 7:. Perceptual Threshold Values at Increasing…
Figure 7:. Perceptual Threshold Values at Increasing Pulse Widths.
As pulse width increases, perceptual threshold (PT) decreases. Most healthy individuals will have a PT within 2 standard deviations (SD) of these mean values.

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