Effects of transcutaneous vagus nerve stimulation in individuals aged 55 years or above: potential benefits of daily stimulation

Beatrice Bretherton, Lucy Atkinson, Aaron Murray, Jennifer Clancy, Susan Deuchars, Jim Deuchars, Beatrice Bretherton, Lucy Atkinson, Aaron Murray, Jennifer Clancy, Susan Deuchars, Jim Deuchars

Abstract

Ageing is associated with attenuated autonomic function. Transcutaneous vagal nerve stimulation (tVNS) improved autonomic function in healthy young participants. We therefore investigated the effects of a single session of tVNS (studies 1 and 2) and tVNS administered daily for two weeks (study 3) in volunteers aged ≥ 55 years. tVNS was performed using modified surface electrodes on the tragus and connected to a transcutaneous electrical nerve stimulation (TENS) machine. Study 1: participants (n=14) received a single session of tVNS and sham. Study 2: all participants (n=51) underwent a single session of tVNS. Study 3: participants (n=29) received daily tVNS for two weeks. Heart rate variability and baroreflex sensitivity were derived. Quality of life (QoL), mood and sleep were assessed in study 3. tVNS promoted increases in measures of vagal tone and was associated with greater increases in baroreflex sensitivity than sham. Two weeks of daily tVNS improved measures of autonomic function, and some aspects of QoL, mood and sleep. Importantly, findings showed that improvements in measures of autonomic balance were more pronounced in participants with greater baseline sympathetic prevalence. This suggests it may be possible to identify individuals who are likely to encounter significant benefits from tVNS.

Keywords: autonomic nervous system; mood; neuromodulation; quality of life; vagus nerve stimulation.

Conflict of interest statement

CONFLICTS OF INTEREST: The authors report no conflict of interest.

Figures

Figure 1
Figure 1
Baseline LF/HF ratio significantly predicted response (change) to tVNS.
Figure 2
Figure 2
Baseline LF/HF ratio significantly predicted change in LF/HF during tVNS (Δ LF/HF ratio).
Figure 3
Figure 3
Visit 1 baseline Δ RR (A) and BRS (B) significantly predicted change at visit 2 baseline, where lower baseline Δ RR (A) and BRS (B) in visit 1 were associated with greater increases in baseline Δ RR (A) and BRS (B) in visit 2. In A, Δ Δ RR reflects the difference between maximum and minimum RR intervals (Δ RR) between visit 1 baseline and visit 2 baseline. In B, Δ BRS reflects the difference in BRS between visit 1 baseline and visit 2 baseline.
Figure 4
Figure 4
Δ RR significantly differed both within and between the two visits (p = 0.036); * = significantly different to visit 2 recovery.
Figure 5
Figure 5
Baseline LF/HF ratio in visits 1 (A) and 2 (B) significantly predicted change in LF/HF ratio between baseline and tVNS. Δ refers to the differences between baseline and tVNS.
Figure 6
Figure 6
Baseline LF/HF ratio reduced after 2 weeks of daily tVNS in six responders with three showing an increase in baseline LF/HF ratio following the daily tVNS (indicated by the blue boxes).
Figure 7
Figure 7
LF/HF ratio values during visit 1 (A) and visit 2 (B) for each responder during baseline, tVNS and recovery. Dashed black line indicates the group mean.
Figure 8
Figure 8
Baseline LF/HF ratio reduced after 2 weeks of daily tVNS in seven non-responders with ten showing an increase in baseline LF/HF ratio following the daily tVNS (indicated by the blue boxes).
Figure 9
Figure 9
LF/HF ratio values during visit 1 (A) and visit 2 (B) for each non-responder during baseline, tVNS and recovery. Dashed black line indicates the group mean.
Figure 10
Figure 10
Visit 1 SF-36 energy score significantly predicted change at visit 2.
Figure 11
Figure 11
Visit 1 tension (A), depression (B), anger (C) and confusion (D) scores significantly predicted change at visit 2.
Figure 12
Figure 12
Visit 1 ease of falling asleep (A), time taken to fall sleep (B), sleep quality (C) and ease of waking up (D) significantly predicted change at visit 2.
Figure 13
Figure 13
Procedure for study 1.
Figure 14
Figure 14
Procedure for study 2.
Figure 15
Figure 15
Procedure for study 3.

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