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Mechanisms underpinning sympathetic nervous activity and its modulation using transcutaneous vagus nerve stimulation
Author(s) -
Deuchars Susan A.,
Lall Varinder K.,
Clancy Jennifer,
Mahadi Mohd,
Murray Aaron,
Peers Lucy,
Deuchars Jim
Publication year - 2017
Publication title -
experimental physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.925
H-Index - 101
eISSN - 1469-445X
pISSN - 0958-0670
DOI - 10.1113/ep086433
Subject(s) - vagus nerve , vagus nerve stimulation , neuromodulation , stimulation , medicine , autonomic nervous system , neuroscience , parasympathetic nervous system , heart rate variability , vagal tone , sympathetic nervous system , autonomic nerve , balance (ability) , pathological , heart rate , psychology , physical medicine and rehabilitation , blood pressure
New FindingsWhat is the topic of this review? This review briefly considers what modulates sympathetic nerve activity and how it may change as we age or in pathological conditions. It then focuses on transcutaneous vagus nerve stimulation, a method of neuromodulation in autonomic cardiovascular control.What advances does it highlight? The review considers the pathways involved in eliciting the changes in autonomic balance seen with transcutaneous vagus nerve stimulation in relationship to other neuromodulatory techniques.The autonomic nervous system, consisting of the sympathetic and parasympathetic branches, is a major contributor to the maintenance of cardiovascular variables within homeostatic limits. As we age or in certain pathological conditions, the balance between the two branches changes such that sympathetic activity is more dominant, and this change in dominance is negatively correlated with prognosis in conditions such as heart failure. We have shown that non‐invasive stimulation of the tragus of the ear increases parasympathetic activity and reduces sympathetic activity and that the extent of this effect is correlated with the baseline cardiovascular parameters of different subjects. The effects could be attributable to activation of the afferent branch of the vagus and, potentially, other sensory nerves in that region. This indicates that tragus stimulation may be a viable treatment in disorders where autonomic activity to the heart is compromised.

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