Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Pain and Headache Reports
Erschienen in: Current Pain and Headache Reports 12/2015

01.12.2015 | Neuromodulation (M Gofeld, Section Editor)

Review of the Uses of Vagal Nerve Stimulation in Chronic Pain Management

verfasst von: Krishnan Chakravarthy, Hira Chaudhry, Kayode Williams, Paul J. Christo

Erschienen in: Current Pain and Headache Reports | Ausgabe 12/2015

Einloggen, um Zugang zu erhalten

Abstract

Recent human and animal studies provide growing evidence that vagal nerve stimulation (VNS) can deliver strong analgesic effects in addition to providing therapeutic efficacy in the treatment of refractory epilepsy and depression. Analgesia is potentially mediated by vagal afferents that inhibit spinal nociceptive reflexes and transmission and have strong anti-inflammatory properties. The purpose of this review is to provide pain practitioners with an overview of VNS technology and limitations. It specifically focuses on clinical indications of VNS for various chronic pain syndromes, including fibromyalgia, pelvic pain, and headaches. We also present potential mechanisms for VNS modulation of chronic pain by reviewing both animal and human studies.
Literatur
1.
Randich A, Gebhart GF. Vagal afferent modulation of nociception. Brain Res Brain Res Rev. 1992;17:77–99.CrossRefPubMed
2.
Ren K, Zhuo M, Randich A, Gebhart GF. Vagal afferent stimulation-produced effects on nociception in capsaicin-treated rats. J Neurophysiol. 1993;69:1530–40.PubMed
3.
Sylvie M, Schoenen J. Pain control by vagus nerve stimulation: from animal to man…and back. Acta Neurol Belg. 2005;105:62–7.
4.
Kirchner A, Birklein F, Stefan H, Handwerker HO. Left vagus nerve stimulation suppresses experimentally induced pain. Neurology. 2000;55:1167–71.CrossRefPubMed
5.
Ness TJ, Fillingim RB, Randich A, Backensto EM, Faught E. Low intensity vagal nerve stimulation lowers human thermal pain thresholds. Pain. 2000;86:81–5.CrossRefPubMed
6.
Ness TJ, Randich A, Fillingim RB, Faught E, Backensto EM. Left vagus nerve stimulation suppresses experimentally induced pain. Neurology. 2001;56:985–6.CrossRefPubMed
7.
Sedan O, Sprecher E, Yarnitsky D. Vagal stomach afferents inhibit somatic pain perception. Pain. 2005;113:354–9.CrossRefPubMed
8.••
Ben-Menachem E, Revesz D, Simon BJ, Silberstein S. Surgically implanted and non-invasive vagus nerve stimulation: a review of efficacy, safety and tolerability. Eur J Neurol. 2015;22:1260–8. Excellent review on vagal nerve stimulators and their clinical utility.CrossRefPubMed
9.
Hatton KW, McLarney JT, Pittman T, Fahy BG. Vagal nerve stimulation: overview and implications for anesthesiologists. Anesth Analg. 2006;103:1241–9.CrossRefPubMed
10.
11.
Foley JO, Dubois F. Quantitative studies of the vagus nerve in the cat, I. The ratio of sensory and motor studies. J Comp Neurol. 1937;67:49–67.CrossRef
12.
Ricardo JA, Koh ET. Anatomical evidence of direct projections from the nucleus of the solitary tract to the hypothalamus, amygdala, and other forebrain structures in the rat. Brain Res. 1978;153:1–26.CrossRefPubMed
13.
Morest DK. Experimental study of the projections of the nucleus of the tractus solitarius and the area postrema in the cat. J Comp Neurol. 1967;130:277–300.CrossRefPubMed
14.
Cecheto DF. Central representation of visceral function. Fed Proc. 1987;46:17–23.
15.
Krahl SE, Clark KB, Smith DC, Browning RA. Locus coeruleus lesions suppress the seizure-attenuating effects of vagus nerve stimulation. Epilepsia. 1998;39:709–14.CrossRefPubMed
16.
Matheny RG, Shaar CJ. Vagus nerve stimulation as a method to temporarily slow or arrest the heart. Ann Thorac Surg. 1997;63(6 Suppl):S28–9.CrossRefPubMed
17.
Ardell JL, Randall WC. Selective vagal innervation of sinoatrial and atrioventricular nodes in canine heart. Am J Physiol. 1986;251(4 Pt 2):H764–73.PubMed
18.
Ruffoli R, Giorgi FS, Pizzanelli C, Murri L, Paparelli A, Fornai F. The chemical neuroanatomy of vagus nerve stimulation. J Chem Neuroanat. 2011;42:288–96.CrossRefPubMed
19.
Berthoud HR, Neuhuber WL. Functional and chemical anatomy of the afferent vagal system. Auton Neurosci. 2000;85:1–17.CrossRefPubMed
20.••
Fahy BG. Intraoperative and perioperative complications with a vagus nerve stimulation device. J Clin Anesth. 2010;22:213–22. Excellent evidence based review on vagus nerve stimulation devices and their intraoperative and perioperative complications.CrossRefPubMed
21.
Bauman JA, Ridgway EB, Devinsky O, Doyle WK. Subpectoral implantation of the vagus nerve stimulator. Neurosurgery. 2006;58(4 Suppl 2):ONS-322–5.
22.
Milby AH, Halpern CH, Baltuch GH. Vagus nerve stimulation for epilepsy and depression. Neurotherapeutics. 2008;5:75–85.CrossRefPubMed
23.
Ben-Menachem E, Mañon-Espaillat R, Ristanovic R, et al. Vagus nerve stimulation for treatment of partial seizures: a controlled study of effect on seizures. First International Vagus Nerve Stimulation Study Group. Epilepsia. 1994;35:616–26.CrossRefPubMed
24.
25.
26.
Vagus Nerve Stimulation Study Group. A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. Neurology. 1995;45:224–30.CrossRef
27.
Uthman BM, Wilder BJ, Penry JK, et al. Treatment of epilepsy by stimulation of the vagus nerve. Neurology. 1993;43:1338–45.CrossRefPubMed
28.
Rush AJ, Marangell LB, Sackeim HA, et al. Vagus nerve stimulation for treatment-resistant depression: a randomized, controlled acute phase trial. Biol Psychiatry. 2005;58:347–54.CrossRefPubMed
29.
Rush AJ, Sackeim HA, Marangell LB, et al. Effects of 12 months of vagus nerve stimulation in treatment-resistant depression: a naturalistic study. Biol Psychiatry. 2005;58:355–63.CrossRefPubMed
30.
31.
Sadler RM, Purdy RA, Rahey S. Vagal nerve stimulation aborts migraine in patient with intractable epilepsy. Cephalalgia. 2002;22:482–4.CrossRefPubMed
32.
Mauskop A. Vagus nerve stimulation relieves chronic refractory migraine and cluster headaches. Cephalalgia. 2005;25:82–6.CrossRefPubMed
33.
Schwartz PJ, De Ferrari GM, Sanzo A, et al. Long term vagal stimulation in patients with advanced heart failure: first experience in man. Eur J Heart Fail. 2008;10:884–91.CrossRefPubMed
34.
Merrill CA, Jonsson MA, Minthon L, et al. Vagus nerve stimulation in patients with Alzheimer’s disease: additional follow-up results of a pilot study through 1 year. J Clin Psychiatry. 2006;67:1171–8.CrossRefPubMed
35.
Sjogren MJ, Hellstrom PT, Jonsson MA, Runnerstam M, Silander HC, Ben-Menachem E. Cognition-enhancing effect of vagus nerve stimulation in patients with Alzheimer’s disease: a pilot study. J Clin Psychiatry. 2002;63:972–80.CrossRefPubMed
36.
George MS, Ward Jr HE, Ninan PT, et al. A pilot study of vagus nerve stimulation (VNS) for treatment-resistant anxiety disorders. Brain Stimul. 2008;1:112–21.CrossRefPubMed
37.
Roslin M, Kurian M. VNS in the treatment of morbid obesity. In: Schacter SC, Schmidt D, editors. VNS. London: Martin-Dunitz; 2012. p. 113–21.
38.
Ben-Menachem E. Vagus-nerve stimulation for the treatment of epilepsy. Lancet Neurol. 2002;1:477–82.CrossRefPubMed
39.
Tatum WO, Moore DB, Stecker MM, et al. Ventricular asystole during vagus nerve stimulation for epilepsy in humans. Neurology. 1999;52:1267–9.CrossRefPubMed
40.
Ali II, Pirzada NA, Kanjwal Y, et al. Complete heart block with ventricular asystole during left vagus nerve stimulation for epilepsy. Epilepsy Behav. 2004;5:768–71.CrossRefPubMed
41.
Ardesch JJ, Buschman HP, van der Burgh PH, Wagener-Schimmel LJ, van der Aa HE, Hageman G. Cardiac responses of vagus nerve stimulation: intraoperative bradycardia and subsequent chronic stimulation. Clin Neurol Neurosurg. 2007;109:849–52.CrossRefPubMed
42.
Schuurman PR, Beukers RJ. Ventricular asystole during vagal nerve stimulation. Epilepsia. 2009;50:967–8.CrossRefPubMed
43.
Ben-Menachem E, Hellstrom K, Waldton C, Augustinsson LE. Evaluation of refractory epilepsy treated with vagus nerve stimulation for up to 5 years. Neurology. 1999;52:1265–7.CrossRefPubMed
44.
Husain MM, Stegman D, Trevino K. Pregnancy and delivery while receiving vagus nerve stimulation for the treatment of major depression: a case report. Ann Gen Psychiatry. 2005;4:16.PubMedCentralCrossRefPubMed
45.
46.
47.
Busch V, Zeman F, Heckel A, Menne F, Ellrich J, Eichhammer P. The effect of transcutaneous vagus nerve stimulation on pain perception—an experimental study. Brain Stimul. 2013;6:202–9.CrossRefPubMed
48.
Nesbitt AD, Marin JCA, Tomkins E, Ruttledge MH, Goadsby PJ. Non-invasive vagus nerve stimulation for the treatment of cluster headache: a cohort series with extended follow-up. Presented at Biennial World Congress of the International Neuromodulation Society, 8–13 June 2013, Berlin, Germany.
49.
Goadsby P, Lipton R, Cady R, Mauskop A, Grosberg B. Non-invasive vagus nerve stimulation (nVNS) for acute treatment of migraine: an open-label pilot study [abstract S40.004]. Presented at Annual Meeting of the American Academy of Neurology, 16–23 March 2013, San Diego, CA.
50.
Nesbitt AD, Marin JCA, Tomkins E, Ruttledge MH, Goadsby PJ. Non-invasive vagus nerve stimulation for the treatment of cluster headache: a cohort study [abstract P141]. Cephalalgia. 2013;33:107.
51.
Goadsby PJ, Grosberg BM, Mauskop A, Cady R, Simmons KA. Effect of noninvasive vagus nerve stimulation on acute migraine: an open-label pilot study. Cephalalgia. 2014;34:986–93.CrossRefPubMed
52.
Moscato D, Moscato FR. Treatment of chronic migraine by means of vagal stimulator [abstract]. J Headache Pain. 2013;14(Suppl):56–7.
53.
Zalvan C, Sulica L, Wolf S, Cohen J, Gonzalez-Yanes O, Blitzer A. Laryngopharyngeal dysfunction from the implant vagal nerve stimulator. Laryngoscope. 2003;113:221–5.CrossRefPubMed
54.
Amark P, Stödberg T, Wallstedt L. Late onset bradyarrhythmia during vagus nerve stimulation. Epilepsia. 2007;48:1023–4.CrossRefPubMed
55.
Iriarte J, Urrestarazu E, Alegre M, et al. Late-onset periodic asystolia during vagus nerve stimulation. Epilepsia. 2009;50:928–32.CrossRefPubMed
56.
Handforth A, DeGiorgio CM, Schachter SC, et al. Vagus nerve stimulation therapy for partial-onset seizures: a randomized active control trial. Neurology. 1998;51:48–55.CrossRefPubMed
57.
Lundy DS, Casiano RR, Landy HJ, Gallo J, Gallo B, Ramsey RE. Effects of vagal nerve stimulation on laryngeal function. J Voice. 1993;7:359–64.CrossRefPubMed
58.
Lundgren J, Ekberg O, Olsson R. Aspiration: a potential complication to vagus nerve stimulation. Epilepsia. 1998;39:998–1000.CrossRefPubMed
59.
Lundgren J, Amark P, Blennow G, Strömblad LG, Wallstedt L. Vagus nerve stimulation in 16 children with refractory epilepsy. Epilepsia. 1998;39:809–13.CrossRefPubMed
60.
Marzec M, Edwards J, Sagher O, Fromes G, Malow BA. Effects of vagus nerve stimulation on sleep-related breathing in epilepsy patients. Epilepsia. 2003;44:930–5.CrossRefPubMed
61.
Khurana DS, Reumann M, Hobdell EF, et al. Vagus nerve stimulation in children with refractory epilepsy: unusual complications and relationship to sleep-disordered breathing. Childs Nerv Syst. 2007;23:1309–12.CrossRefPubMed
62.
Malow BA, Levy K, Maturen K, Bowes R. Obstructive sleep apnea is common in medically refractory epilepsy patients. Neurology. 2000;55:1002–7.CrossRefPubMed
63.
Malow BA, Edwards J, Marzec M, Sagher O, Fromes G. Effects of vagus nerve stimulation on respiration during sleep: a pilot study. Neurology. 2000;55:1450–4.CrossRefPubMed
64.
Ebben MR, Sethi NK, Conte M, Pollak CP, Labar D. Vagus nerve stimulation, sleep apnea, and CPAP titration. J Clin Sleep Med. 2008;4:471–3.PubMedCentralPubMed
65.
Oshinsky ML, Murphy AL, Hekierski Jr H, Cooper M, Simon BJ. Noninvasive vagus nerve stimulation as treatment for trigeminal allodynia. Pain. 2014;155(5):1037–42.PubMedCentralCrossRefPubMed
66.
Lange G, Janal MN, Maniker A, Fitzgibbons J, Fobler M, Cook D, et al. Safety and efficacy of vagus nerve stimulation in fibromyalgia: a phase I/II proof of concept trial. Pain Med. 2011;12(9):1406–13.PubMedCentralCrossRefPubMed
67.
Napadow V, Edwards RR, Cahalan CM, Mensing G, Greenbaum S, Valovska A, et al. Evoked pain analgesia in chronic pelvic pain patients using respiratory-gated auricular vagal afferent nerve stimulation. Pain Med. 2012;13(6):777–89.PubMedCentralCrossRefPubMed
68.
Barbanti P, Grazzi L, Egeo G, Padovan AM, Liebler E, Bussone G. Non-invasive vagus nerve stimulation for acute treatment of high-frequency and chronic migraine: an open label study. J Headache Pain. 2015;16:61. doi:10.​1186/​s10194-015-0542-4.
69.
Straube A, Ellrich J, Eren O, Blum B, Ruscheweyh R. Treatment of chronic migraine with transcutaneous stimulation of the auricular branch of the vagal nerve (auricular t-VNS): a randomized, monocentric clinical trial. J Headache Pain. 2015;16(1):543.CrossRefPubMed
70.
Chandler MJ, Zhang J, Qin C, Foreman RD. Spinal inhibitory effects of cardiopulmonary afferent inputs in monkeys: neuronal processing in high cervical segments. J Neurophysiol. 2002;87:1290–302.PubMed
71.
Zhang J, Chandler MJ, Foreman RD. Thoracic visceral inputs use upper cervical segments to inhibit lumbar spinal neurons in rats. Brain Res. 1996;709:337–42.CrossRefPubMed
72.
Zhang J, Chandler MJ, Foreman RD. Cardio-pulmonary sympathetic and vagal afferents excite C1-C2 propriospinal cells in rats. Brain Res. 2003;969:53–8.CrossRefPubMed
73.
Ammons WS, Blair RWFRD. Vagal afferent inhibition of primate thoracic spinothalamic neurons. J Neurophysiol. 1983;50:926–40.PubMed
74.
Ren K, Randich A, Gebhart GF. Spinal serotonergic and kappa opioid receptors mediate facilitation of the tail flick reflex produced by afferent stimulation. Pain. 1991;45:321–9.CrossRefPubMed
75.
Ren K, Randich A, Gebhart GF. Vagal afferent modulation of a nociceptive reflex in rats: involvement of spinal opioid and monoamine receptors. Brain Res. 1988;446:285–94.CrossRefPubMed
76.
Thies R, Foreman RD. Inhibition and excitation of thoracic spinoreticular neurons by electrical stimulation of vagal afferent nerves. Exp Neurol. 1983;82:1–16.CrossRefPubMed
77.
Chandler MJ, Hobbs SF, Bolser DC, Foreman RD. Effects of vagal afferent stimulation on cervical spinothalamic tract neurons in monkeys. Pain. 1991;44:81–7.CrossRefPubMed
78.
Nishikawa Y, Koyama N, Yoshida Y, Yokota T. Activation of ascending antinociceptive system by vagal afferent input as revealed in the nucleus ventralis posteromedialis. Brain Res. 1999;833:108–11.CrossRefPubMed
79.
Randich A, Aicher A. Medullary substrates mediating antinociception produced by electrical stimulation of the vagus. Brain Res. 1988;445:68–76.CrossRefPubMed
80.
Randich A, Ren K, Gebhart GF. Electrical stimulation of cervical vagal afferents. II. Central relays for behavioral antinociception and arterial blood pressure decreases. J Neurophysiol. 1990;64:1115–24.PubMed
81.
Ren K, Randcih A, Gebhart GF. Electrical stimulation of cervical vagal afferents. I. Central relays for modulation of spinal nociceptive transmission. J Neurophysiol. 1990;64:1098–114.PubMed
82.
Ring HA, White S, Costa DC, Pottinger R, Dick JP, Koeze T, et al. A SPECT study of the effect of vagal nerve stimulation on thalamic activity in patients with epilepsy. Seizure. 2000;9(6):380–4.CrossRefPubMed
83.
Van Laere K, Vonck K, Boon P, Brans B, Vandekerckhove T, Dierckx R. Vagus nerve stimulation in refractory epilepsy: SPECT activation study. J Nucl Med. 2000;41(7):1145–54.PubMed
84.
Vonck K, Boon P, Van Laere K, D’Havé M, Vandekerckhove T, O’Connor S, et al. Acute single photon emission computed tomographic study of vagus nerve stimulation in refractory epilepsy. Epilepsia. 2000;41(5):601–9.CrossRefPubMed
85.
Meller ST, Lewis SJ, Ness TJ, Brody MJ, Genhart GF. Vagal afferent-mediated inhibition of a nociceptive reflex by intravenous serotonin in the rat. I. Characterization. Brain Res. 1990;524:90–100.CrossRefPubMed
86.
Takeda M, Tanimoto T, Ojima K, Matsumoto S. Suppressive effect of vagal afferents on the activity of the trigeminal spinal neurons related to the jaw-opening reflex in rats: involvement of the endogenous opioid system. Brain Res Bull. 1998;47:49–56.CrossRefPubMed
87.
Ben-Menachem E, Hamberger A, Hedner T, Hammond EJ, Uthman BM, Slater J, et al. Effects of vagus nerve stimulation on amino acids and other metabolites in the CSF of patients with partial seizures. Epilepsy Res. 1995;20:221–7.CrossRefPubMed
88.
Hosoi T, Okuma Y, Nomura Y. Electrical stimulation of afferent vagus nerve induces Il-1 beta expression in the brain and activates HPA axis. Am J Physiol Regul Integr Comp Physiol. 2000;279:R141–7.PubMed
89.
Khasar SG, Green PG, Miao FJ, Levine JD. Vagal modulation of nociception is mediated by adrenomedullary epinephrine in the rat. Eur J Neurosci. 2003;17:909–15.CrossRefPubMed
90.
Metadaten
Titel
Review of the Uses of Vagal Nerve Stimulation in Chronic Pain Management
verfasst von
Krishnan Chakravarthy
Hira Chaudhry
Kayode Williams
Paul J. Christo
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
Current Pain and Headache Reports / Ausgabe 12/2015
Print ISSN: 1531-3433
Elektronische ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-015-0528-6

Neu im Fachgebiet AINS

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Häufigste Gründe für Brustschmerzen bei Kindern

06.05.2024 Pädiatrische Diagnostik Nachrichten

Akute Brustschmerzen sind ein Alarmsymptom par exellence, schließlich sind manche Auslöser lebensbedrohlich. Auch Kinder klagen oft über Schmerzen in der Brust. Ein Studienteam ist den Ursachen nachgegangen.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

hier abonnieren
Bildnachweise