The effects of daily transcutaneous vagus nerve stimulation on autonomic tone

Physiology 2019 (Aberdeen, UK) (2019) Proc Physiol Soc 43, C100

Oral Communications: The effects of daily transcutaneous vagus nerve stimulation on autonomic tone

B. Bretherton1,2, L. Atkinson1, S. Deuchars1, J. Deuchars1

1. School of Biomedical Sciences, University of Leeds, Leeds, United Kingdom. 2. Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.

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Aging is associated with increases in sympathetic and decreases in parasympathetic nervous activity, potentially contributing to age related disorders1. In young, healthy adults, non-invasive, transcutaneous electrical stimulation of the vagus nerve (tVNS) promoted parasympathetic and reduced sympathetic activity2. Since the magnitude of change was linked to the starting levels of autonomic activity2, here we tested if daily tVNS for 14 days promoted increases in parasympathetic and decreases in sympathetic activity in volunteers aged ≥ 55 years. Twenty-nine healthy participants (11 males) attended on two occasions. During both visits, participants underwent a 10 minute baseline period, 15 minutes of tVNS (administered via a TENS machine bilaterally to the tragus) and a 10 minute recovery period. Heart rate variability (HRV) and baroreflex sensitivity (BRS, responsiveness of changes in RR interval following changes in blood pressure) were derived. Participants self-administered tVNS at home once daily for 15 minutes over 14 days following visit 1. Data were analysed by repeated measure ANOVA, paired t-test and linear regression, values are the mean ± 1 S.E.M. In the first lab-visit, tVNS was associated with significantly higher values for measures reflecting parasympathetic activity (nSD2: 59 ± 5, p = 0.001) and overall variability in heart rate (SDRR: 47 ± 5 ms, p = 0.001) compared to baseline (nSD2: 46 ± 3; SDRR: 36 ± 3 ms). A measure of baseline parasympathetic outflow tended to be improved after two weeks of daily tVNS (pRR50: visit 1: 10 ± 3%, visit 2: 14 ± 4%, p = 0.053). Resting BRS in visit 1 significantly predicted change at visit 2 (R2 = 0.330, p = 0.002): low visit 1 values were linked with greater increases after 14 days of tVNS. Baseline autonomic balance (LF/HF) significantly predicted change to tVNS both before and after two weeks of daily tVNS (visit 1: R2 = 0.352, p = 0.001; visit 2: R2 = 0.697, p < 0.001): imbalance during visit 1 was related to greater improvements following 14 days of daily tVNS. For those who responded to tVNS in visit 1 (n = 9), most encountered improvements in autonomic balance at visit 2 (n= 6). This was even the case for seven participants who did not respond to tVNS in visit 1. Findings show that daily tVNS for 14 days confers autonomic benefits in individuals aged ≥ 55 years. Importantly, baseline autonomic tone seems to influence the direction and magnitude of change after 14 days of daily tVNS: low initial autonomic function is associated with greater improvements following daily tVNS for 14 days. Therefore, daily tVNS appears to help attenuate autonomic changes that occur with ageing, having the most pronounced effects in individuals with impaired autonomic balance. This means that tVNS is a simple and effective tool that can temporarily halt age-related changes in autonomic function and boost the period of healthy aging.



Where applicable, experiments conform with Society ethical requirements.

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