Transcutaneous Auricular Vagus Nerve Stimulation to Improve Emotional State

Overview

Journal Biomedicines

Specialty Biomedical Engineering

Date 2024 Feb 24

PMID 38398009

Authors

Ainara Aranberri Ruiz

Affiliations

Soon will be listed here.

Abstract

Emotional experiences are a part of our lives. The maladaptive functioning of an individual's emotional field can lead to emotional disturbances of various kinds, such as anxiety and depression. Currently, there is an increasing prevalence of emotional disorders that cause great human suffering and high socioeconomic costs. Emotional processing has a biological basis. The major neuroscientific theories of emotion are based on biological functioning, and all of them take into account the anatomy and function of the tenth cranial nerve: the vagus nerve. The vagus nerve connects the subdiaphragmatic and supradiaphragmatic areas and modulates emotional processing as the basis of interoceptive functioning. Auricular vagus nerve stimulation is a new and innovative neuromodulation technique based on the function of the vagus nerve. Several interventions have shown that this new neurostimulation technique is a very promising resource for treating emotional disorders. In this paper, we summarise three neuroscientific theories of emotion, explain what transcutaneous auricular nerve stimulation is, and present arguments for its use and continued research.

Citing Articles

Effect of long-term transcutaneous auricular vagus nerve stimulation in multiple system atrophy-cerebellar subtype: a case report.

Wang Z, Cheng X, Liu Z, Wu D, Ni J, Chen C Front Neurosci. 2025; 18:1499793.

PMID: 39881809 PMC: 11774832. DOI: 10.3389/fnins.2024.1499793.

Transcutaneous vagus nerve stimulation for Parkinson's disease: a systematic review and meta-analysis.

Shan J, Li Z, Ji M, Zhang M, Zhang C, Zhu Y Front Aging Neurosci. 2025; 16:1498176.

PMID: 39877075 PMC: 11772336. DOI: 10.3389/fnagi.2024.1498176.

Neuromodulation Strategies in Lifelong Bipolar Disorder: A Narrative Review.

Bernabei L, Leone B, Hirsch D, Mentuccia V, Panzera A, Riggio F Behav Sci (Basel). 2025; 14(12.

PMID: 39767317 PMC: 11674029. DOI: 10.3390/bs14121176.

Comparative Analysis of High-Frequency and Low-Frequency Transcutaneous Electrical Stimulation of the Right Median Nerve in the Regression of Clinical and Neurophysiological Manifestations of Generalized Anxiety Disorder.

Al-Zamil M, Kulikova N, Minenko I, Shurygina I, Petrova M, Mansur N J Clin Med. 2024; 13(11).

PMID: 38892737 PMC: 11172620. DOI: 10.3390/jcm13113026.

References

Assenza G, Campana C, Colicchio G, Tombini M, Assenza F, Pino G . Transcutaneous and invasive vagal nerve stimulations engage the same neural pathways: In-vivo human evidence. Brain Stimul. 2017; 10(4):853-854. DOI: 10.1016/j.brs.2017.03.005. View

Kurtin D, Giunchiglia V, Vohryzek J, Cabral J, Skeldon A, Violante I . Moving from phenomenological to predictive modelling: Progress and pitfalls of modelling brain stimulation in-silico. Neuroimage. 2023; 272:120042. DOI: 10.1016/j.neuroimage.2023.120042. View

Hagihara K, Bukalo O, Zeller M, Aksoy-Aksel A, Karalis N, Limoges A . Intercalated amygdala clusters orchestrate a switch in fear state. Nature. 2021; 594(7863):403-407. PMC: 8402941. DOI: 10.1038/s41586-021-03593-1. View

Rong P, Fang J, Wang L, Meng H, Liu J, Ma Y . Transcutaneous vagus nerve stimulation for the treatment of depression: a study protocol for a double blinded randomized clinical trial. BMC Complement Altern Med. 2012; 12:255. PMC: 3537743. DOI: 10.1186/1472-6882-12-255. View

Berboth S, Morawetz C . Amygdala-prefrontal connectivity during emotion regulation: A meta-analysis of psychophysiological interactions. Neuropsychologia. 2021; 153:107767. DOI: 10.1016/j.neuropsychologia.2021.107767. View

Press C, Kok P, Yon D . The Perceptual Prediction Paradox. Trends Cogn Sci. 2019; 24(1):13-24. DOI: 10.1016/j.tics.2019.11.003. View

Vanderhasselt M, Baeken C, Van Schuerbeek P, Luypaert R, De Raedt R . Inter-individual differences in the habitual use of cognitive reappraisal and expressive suppression are associated with variations in prefrontal cognitive control for emotional information: an event related fMRI study. Biol Psychol. 2012; 92(3):433-9. DOI: 10.1016/j.biopsycho.2012.03.005. View

Messina I, Grecucci A, Viviani R . Neurobiological models of emotion regulation: a meta-analysis of neuroimaging studies of acceptance as an emotion regulation strategy. Soc Cogn Affect Neurosci. 2021; 16(3):257-267. PMC: 7943364. DOI: 10.1093/scan/nsab007. View

Kong J, Fang J, Park J, Li S, Rong P . Treating Depression with Transcutaneous Auricular Vagus Nerve Stimulation: State of the Art and Future Perspectives. Front Psychiatry. 2018; 9:20. PMC: 5807379. DOI: 10.3389/fpsyt.2018.00020. View

10.

Mather M, Thayer J . How heart rate variability affects emotion regulation brain networks. Curr Opin Behav Sci. 2018; 19:98-104. PMC: 5761738. DOI: 10.1016/j.cobeha.2017.12.017. View

11.

Clark J, Watson S, Friston K . What is mood? A computational perspective. Psychol Med. 2018; 48(14):2277-2284. PMC: 6340107. DOI: 10.1017/S0033291718000430. View

12.

Barrett L, Satpute A . Large-scale brain networks in affective and social neuroscience: towards an integrative functional architecture of the brain. Curr Opin Neurobiol. 2013; 23(3):361-72. PMC: 4119963. DOI: 10.1016/j.conb.2012.12.012. View

13.

Banks S, Eddy K, Angstadt M, Nathan P, Phan K . Amygdala-frontal connectivity during emotion regulation. Soc Cogn Affect Neurosci. 2008; 2(4):303-12. PMC: 2566753. DOI: 10.1093/scan/nsm029. View

14.

Shipp S, Adams R, Friston K . Reflections on agranular architecture: predictive coding in the motor cortex. Trends Neurosci. 2013; 36(12):706-16. PMC: 3858810. DOI: 10.1016/j.tins.2013.09.004. View

15.

Porges S . The polyvagal perspective. Biol Psychol. 2006; 74(2):116-43. PMC: 1868418. DOI: 10.1016/j.biopsycho.2006.06.009. View

16.

Panaro M, Benameur T, Porro C . Hypothalamic Neuropeptide Brain Protection: Focus on Oxytocin. J Clin Med. 2020; 9(5). PMC: 7290962. DOI: 10.3390/jcm9051534. View

17.

Borgmann D, Rigoux L, Kuzmanovic B, Edwin Thanarajah S, Munte T, Fenselau H . Technical Note: Modulation of fMRI brainstem responses by transcutaneous vagus nerve stimulation. Neuroimage. 2021; 244:118566. DOI: 10.1016/j.neuroimage.2021.118566. View

18.

Kuppens P, Tuerlinckx F, Russell J, Barrett L . The relation between valence and arousal in subjective experience. Psychol Bull. 2012; 139(4):917-40. DOI: 10.1037/a0030811. View

19.

Kohn N, Eickhoff S, Scheller M, Laird A, Fox P, Habel U . Neural network of cognitive emotion regulation--an ALE meta-analysis and MACM analysis. Neuroimage. 2013; 87:345-55. PMC: 4801480. DOI: 10.1016/j.neuroimage.2013.11.001. View

20.

Wienke C, Grueschow M, Haghikia A, Zaehle T . Phasic, Event-Related Transcutaneous Auricular Vagus Nerve Stimulation Modifies Behavioral, Pupillary, and Low-Frequency Oscillatory Power Responses. J Neurosci. 2023; 43(36):6306-6319. PMC: 10490471. DOI: 10.1523/JNEUROSCI.0452-23.2023. View