Cerebral Hemodynamic Correlates of Transcutaneous Auricular Vagal Nerve Stimulation in Consciousness Restoration: An Open-Label Pilot Study

Yutian Yu; Yi Yang; Shuoqiu Gan; Shengnan Guo; Jiliang Fang; Shouyan Wang; Chunzhi Tang; Lijun Bai; Jianghong He; Peijing Rong

doi:10.3389/fneur.2021.684791

Cerebral Hemodynamic Correlates of Transcutaneous Auricular Vagal Nerve Stimulation in Consciousness Restoration: An Open-Label Pilot Study

Front Neurol. 2021 Jul 15:12:684791. doi: 10.3389/fneur.2021.684791. eCollection 2021.

Authors

Yutian Yu^{1

2

3}, Yi Yang^{4

5}, Shuoqiu Gan^{6

7}, Shengnan Guo³, Jiliang Fang⁸, Shouyan Wang⁹, Chunzhi Tang¹⁰, Lijun Bai⁶, Jianghong He^{4

5}, Peijing Rong³

Affiliations

¹ Acupuncture Department, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
² Ninth School of Clinical Medicine, Peking University, Beijing, China.
³ Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.
⁴ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁵ Department of Neurosurgery, PLA Army General Hospital, Beijing, China.
⁶ The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China.
⁷ Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
⁸ Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
⁹ Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
¹⁰ Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.

Abstract

This study aimed to preliminarily illustrate the cerebral hemodynamic correlates of transcutaneous auricular vagal nerve stimulation (taVNS) in consciousness restoration. Arterial spin labeling (ASL) was adopted with functional magnetic resonance imaging (fMRI) to measure cerebral blood flow (CBF) changes before and after taVNS in 10 qualified patients with disorders of consciousness (DOC). Before taVNS, five patients responded to auditory stimuli (RtAS), and five did not respond to auditory stimuli (nRtAS). The RtAS DOC patients obtained favorable prognoses after the 4-week taVNS treatment, whereas the nRtAS ones did not. Simultaneously, taVNS increased CBF of multiple brain regions in the RtAS DOC patients, but hardly in the nRtAS ones. In conclusion, the preserved auditory function might be the prior key factor of the taVNS responders in DOC patients, and taVNS might alleviate RtAS DOC by activating the salience network, the limbic system, and the interoceptive system.

Keywords: arterial spin labeling (ASL); cerebral blood flow (CBF); disorders of consciousness (DOC); functional magnetic resonance imaging (fMRI); non-responded to auditory stimuli (nRtAS); responded to auditory stimuli (RtAS); transcutaneous auricular vagal nerve stimulation (taVNS).