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J. Clin. Med. 2019, 8(4), 496; https://doi.org/10.3390/jcm8040496

Cardiac and Peripheral Autonomic Responses to Orthostatic Stress During Transcutaneous Vagus Nerve Stimulation in Healthy Subjects

1
Department of Internal Medicine, Fondazione IRCSS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
2
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
3
Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo 01246-903, Brazil
4
Institute of Cardiology of Rio Grande do Sul, Porto Alegre 90040-060, Brazil
5
Institute of Science and Technology, Federal University of Sao Paulo, Sao Paulo 04021-001, Brazil
6
Department of Cardiology, Fondazione IRCSS Ca’ Granda, Ospedale Maggiore Policlínico, 20122 Milan, Italy
7
Department of Internal Medicine, ASST Fatebenefratelli-Sacco, 20131 Milan, Italy
8
Department of Cardiology and Biomedical Engineering, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto di Montescano, 27040 Pavia, Italy
*
Author to whom correspondence should be addressed.
Both authors equally contributed to the manuscript.
Received: 20 February 2019 / Revised: 1 April 2019 / Accepted: 8 April 2019 / Published: 11 April 2019
(This article belongs to the Special Issue Autonomic Nervous System: From Bench to Bedside)
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Abstract

Previous studies showed that transcutaneous vagus nerve stimulation (tVNS) modulates the autonomic nervous system (ANS) in resting condition. However, the autonomic regulation in response to an orthostatic challenge during tVNS in healthy subjects remains unknown. We tested the hypothesis that tVNS reduces heart rate (HR) and alters the responsivity of ANS to orthostatic stress in healthy subjects. In a randomized and cross-over trial, thirteen healthy subjects underwent two experimental sessions on different days: (1) tVNS and (2) control. Using a tVNS device, an auricular electrode was placed on the left cymba conchae of the external ear; an electric current with a pulse frequency of 25 Hz and amplitude between 1 and 6 mA was applied. For the assessment of ANS, the beat-to-beat HR and systolic arterial pressure (SAP) were analyzed using linear and nonlinear approaches during clinostatic and orthostatic conditions. In clinostatic conditions, tVNS reduced HR (p < 0.01), SAP variability (p < 0.01), and cardiac and peripheral sympathetic modulation (p < 0.01). The responsivity of the peripheral sympathetic modulation to orthostatic stress during tVNS was significantly higher when compared to the control session (p = 0.03). In conclusion, tVNS reduces the HR and affects cardiac and peripheral autonomic control and increases the responses of peripheral autonomic control to orthostatic stress in healthy subjects. View Full-Text
Keywords: transcutaneous vagus nerve stimulation (tVNS); neuromodulation; cardiac autonomic control; orthostatic stress; symbolic analysis transcutaneous vagus nerve stimulation (tVNS); neuromodulation; cardiac autonomic control; orthostatic stress; symbolic analysis
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MDPI and ACS Style

Tobaldini, E.; Toschi-Dias, E.; Appratto de Souza, L.; Rabello Casali, K.; Vicenzi, M.; Sandrone, G.; Cogliati, C.; La Rovere, M.T.; Pinna, G.D.; Montano, N. Cardiac and Peripheral Autonomic Responses to Orthostatic Stress During Transcutaneous Vagus Nerve Stimulation in Healthy Subjects. J. Clin. Med. 2019, 8, 496.

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