Transdermal auricular vagus stimulation for the treatment of postural tachycardia syndrome

André Diedrich; Vasile Urechie; Dana Shiffer; Stefano Rigo; Maura Minonzio; Beatrice Cairo; Emily C Smith; Luis E Okamoto; Franca Barbic; Andrea Bisoglio; Alberto Porta; Italo Biaggioni; Raffaello Furlan

doi:10.1016/j.autneu.2021.102886

Transdermal auricular vagus stimulation for the treatment of postural tachycardia syndrome

Auton Neurosci. 2021 Dec:236:102886. doi: 10.1016/j.autneu.2021.102886. Epub 2021 Sep 29.

Authors

Affiliations

¹ Vanderbilt Autonomic Dysfunction Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA. Electronic address: andre.diedrich@vumc.org.
² Vanderbilt Autonomic Dysfunction Center, Vanderbilt University Medical Center, Nashville, TN, USA.
³ Department of Biomedical Sciences, Humanitas University, Internal Medicine, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy.
⁴ Humanitas University School of Medicine, Rozzano, Italy; Virgilio Research Project, Pieve Emanuele, Milan, Italy.
⁵ Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
⁶ Department of Biomedical Sciences, Humanitas University, Internal Medicine, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy; Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy.

Abstract

Postural Tachycardia Syndrome (POTS) is a chronic disorder characterized by symptoms of orthostatic intolerance such as fatigue, lightheadedness, dizziness, palpitations, dyspnea, chest discomfort and remarkable tachycardia upon standing. Non-invasive transdermal vagal stimulators have been applied for the treatment of epilepsy, anxiety, depression, headache, and chronic pain syndromes. Anti-inflammatory and immunomodulating effects after transdermal vagal stimulation raised interest for applications in other diseases. Patients with sympathetic overactivity, reduced cardiac vagal drive and presence of systemic inflammation like POTS may benefit from tVNS. This article will address crucial methodological aspects of tVNS and provide preliminary results of its acute and chronic use in POTS, with regards to its potential effectiveness on autonomic symptoms reduction and heart rate modulation.

Keywords: Autonomic function; Postural tachycardia syndrome; Vagal stimulation.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Fatigue Syndrome, Chronic*
Heart Rate
Humans
Orthostatic Intolerance*
Postural Orthostatic Tachycardia Syndrome* / therapy
Tachycardia

Abstract

Publication types

MeSH terms

Grants and funding