Transcutaneous auricular Vagus Nerve Stimulation and Median Nerve Stimulation reduce acute stress in young healthy adults: a single-blind sham-controlled crossover study

Jesus Antonio Sanchez-Perez; Asim H Gazi; Farhan N Rahman; Alexis Seith; Georgia Saks; Srirakshaa Sundararaj; Rachel Erbrick; Anna B Harrison; Christopher J Nichols; Mihir Modak; Yekanth R Chalumuri; Teresa K Snow; Jin-Oh Hahn; Omer T Inan

doi:10.3389/fnins.2023.1213982

Transcutaneous auricular Vagus Nerve Stimulation and Median Nerve Stimulation reduce acute stress in young healthy adults: a single-blind sham-controlled crossover study

Front Neurosci. 2023 Sep 7:17:1213982. doi: 10.3389/fnins.2023.1213982. eCollection 2023.

Affiliations

¹ School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States.
² Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States.
³ College of Sciences, Georgia Institute of Technology, Atlanta, GA, United States.
⁴ Department of Bioengineering, University of Maryland, College Park, MD, United States.
⁵ Department of Mechanical Engineering, University of Maryland, College Park, MD, United States.
⁶ School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States.

Abstract

Stress is a major determinant of health and wellbeing. Conventional stress management approaches do not account for the daily-living acute changes in stress that affect quality of life. The combination of physiological monitoring and non-invasive Peripheral Nerve Stimulation (PNS) represents a promising technological approach to quantify stress-induced physiological manifestations and reduce stress during everyday life. This study aimed to evaluate the effectiveness of three well-established transcutaneous PNS modalities in reducing physiological manifestations of stress compared to a sham: auricular and cervical Vagus Nerve Stimulation (taVNS and tcVNS), and Median Nerve Stimulation (tMNS). Using a single-blind sham-controlled crossover study with four visits, we compared the stress mitigation effectiveness of taVNS, tcVNS, and tMNS, quantified through physiological markers derived from five physiological signals peripherally measured on 19 young healthy volunteers. Participants underwent three acute mental and physiological stressors while receiving stimulation. Blinding effectiveness was assessed via subjective survey. taVNS and tMNS relative to sham resulted in significant changes that suggest a reduction in sympathetic outflow following the acute stressors: Left Ventricular Ejection Time Index (LVETI) shortening (tMNS: p = 0.007, taVNS: p = 0.015) and Pre-Ejection Period (PEP)-to-LVET ratio (PEP/LVET) increase (tMNS: p = 0.044, taVNS: p = 0.029). tMNS relative to sham also reduced Pulse Pressure (PP; p = 0.032) and tonic EDA activity (tonicMean; p = 0.025). The nonsignificant blinding survey results suggest these effects were not influenced by placebo. taVNS and tMNS effectively reduced stress-induced sympathetic arousal in wearable-compatible physiological signals, motivating their future use in novel personalized stress therapies to improve quality of life.

Keywords: Median Nerve Stimulation; Vagus Nerve Stimulation; multimodal sensing; non-invasive; physiological signals; stress.

Grants and funding

The work of AG was supported by a National Science Foundation (NSF) Graduate Research Fellowship (DGE2039655). FR was supported by an National Institutes of Health T32 Fellowship (T32EB025816). This research was supported by the Office of Naval Research (N00014-21-1-2031). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NSF or ONR.