Response of the Autonomic Nervous System to Auricular Stimulation of the Vagus Nerve (x)

2019-10-24 12:49:55 | BioPortfolio


While invasive vagal stimulation has proven its therapeutic effectiveness over the past 20 years, particularly in the treatment of epilepsy or depression, its implementation is hampered by the high cost, high technicality and sometimes significant side effects. Non-invasive vagal stimulation, most often electric, is a less expensive therapeutic alternative and easier to implement, although the level of evidence is lower than that of invasive stimulation.

Some so-called traditional therapies, such as acupuncture, also stimulate certain parts of the ear by mechanical means, most often by puncturing the ear or the concha. In these traditional therapies, about a hundred stimulation points have been described, each precisely positioned according to an empirical topography.

However, electrical non-invasive stimulation recognizes only three areas of interest on the ear, which are the areas of sensitive innervation, namely the afferences of the vagus nerve in the concha, which is the only one used in practice, the large occipital nerve on the lobe and part of the helix, and the auriculotemporal nerve on the rest of the auricular flag.

In this study, we would like to explore the justification for the topographic precision, adopted by traditional therapies, for non-invasive vagal stimulation on the concha, and try to understand why this type of stimulation leads to a lower efficacy compared to invasive stimulation


Main objective: to measure the physiological impact of two auricular stimuli on the same innervation territory but with opposite actions according to traditional therapies.

An identical physiological response on both stimulation points would be an argument against the topographical precision adopted by traditional therapies; conversely, a different physiological response would suggest the existence of a somatotopy nestled in the same innervation territory.

Secondary objectives:

- Determine, by sinus variability analysis (SV), the intensity of the sympathetic and parasympathetic cardiac response of mechanical stimulation of the ear concha.

- Determine the existence of a blockage of the sympathetic reaction on cutaneous vasoconstriction after mechanical stimulation of the ear concha.

- Measure the relationship between sinus variability and paradoxical skin vasodilation after exposure to cold, as considered in the protocol.

To explore the justification for the topographical precision adopted by traditional therapies, we designed an experiment that consists of studying the autonomous, sympathetic and parasympathetic response to two stimuli performed over two different times.

The sympathetic stimulation will be done by immersing the right hand up to the wrist in a tub of cold water maintained at 5°C Mechanical parasympathetic stimulation will be performed on the ear in two different locations, by placing an adapted needle through an introducer to respect a standardized insertion depth.

The autonomous response will be measured by sinus variability, which responds to a double innervation, sympathetic and parasympathetic, and by the capillary skin response, which responds only to a sympathetic innervation.

The capillary skin response is measured by the amplitude and latency of the paradoxical vasodilation reflex following thermal stimulation, in this case the immersion of a limb's tip in cold water.

The study will consist of 3 sessions, as shown in the figure below. This is a prospective crossover study.

During the first session, the inclusion and non-inclusion criteria will be checked, then a water immersion test will be carried out to ensure the good tolerance of this test and then determine the basic values.

In the absence of acclimatization, the paradoxical vasodilation reflex is highly reproducible. During the second and third sessions, a mechanical stimulation will be done to the ear during the skin immersion test.

Study Design


Vasoconstriction Disorder of Extremities


stimulation of G13 then G15, stimulation of G15 then G13


Hôpital Européen Marseille




Hôpital Européen Marseille

Results (where available)

View Results


Published on BioPortfolio: 2019-10-24T12:49:55-0400

Clinical Trials [4230 Associated Clinical Trials listed on BioPortfolio]

Electrical Stimulation in Denervated Muscles of the Upper Limbs

In the last decade the stimulation of denervated muscles got more attention. Not at least because of the promising results of the RISE project (Use of electrical stimulation to restore sta...

Study of the Effectiveness of Vestibular Stimulation Treatment in the Depressive Phase of Bipolar Disorder

Vestibular stimulation has been shown to be a very effective noninvasive treatment for major depression. Bipolar disorder is a mental illness that presents cyclic sequences of depressive a...

Spinal Cord Stimulation for Refractory Pain in Erythromelalgia

Erythromelalgia is a rare disorder characterized by red, warm, and painful extremities, which is often precipitated by warm conditions. The pathophysiology is incompletely understood. The ...

Effects of Lower Extremities Cycling Functional Electrıcal Stimulation Training in Cerebral Palsy

The aim of this study was to investigate the effects of cycling functional electrical stimulation applied to the lower extremities of children with spastic diplegic cerebral palsy (CP) on ...

Evaluating Unilateral Deep Brain Stimulation in Patients With Obsessive Compulsive Disorder

The investigators previously showed that deep brain stimulation (DBS) in the bed nucleus of the stria terminalis (BNST) reduces symptoms in patients with severe obsessive-compulsive disord...

PubMed Articles [7305 Associated PubMed Articles listed on BioPortfolio]

Static and dynamic network properties of the repetitive transcranial magnetic stimulation target predict changes in emotion regulation in obsessive-compulsive disorder.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique to treat psychiatric disorders, such as obsessive-compulsive disorder (OCD). However, the rTMS response ...

Stimulation Pattern Efficiency in Percutaneous Auricular Vagus Nerve Stimulation: Experimental versus Numerical data.

Percutaneous electrical stimulation of the auricular vagus nerve (pVNS) is an electroceutical technology. The selection of stimulation patterns is empirical, which may lead to under-stimulation or ove...

Transcranial direct current stimulation for the treatment of generalized anxiety disorder: A randomized clinical trial.

Generalized anxiety disorder (GAD) is a common condition with current treatments being only moderately effective. Non-invasive brain stimulation techniques might provide a novel approach for treating ...

Interleaving stimulation in Parkinson's disease: interesting to whom?

Interleaving stimulation (ILS) is an available stimulation strategy that can help the physician manage more challenging cases of patients with deep brain stimulation (DBS) for Parkinson's disease. (PD...

Habenula deep brain stimulation for refractory bipolar disorder.

Medical and Biotech [MESH] Definitions

Stimulation of the brain, which is self-administered. The stimulation may result in negative or positive reinforcement.

Stimulation at an intensity below that where a differentiated response can be elicited.

The electrical response evoked in a muscle or motor nerve by electrical or magnetic stimulation. Common methods of stimulation are by transcranial electrical and TRANSCRANIAL MAGNETIC STIMULATION. It is often used for monitoring during neurosurgery.

A technique of brain electric stimulation therapy which uses constant, low current delivered via ELECTRODES placed on various locations on the scalp.

The electric response evoked in the CEREBRAL CORTEX by ACOUSTIC STIMULATION or stimulation of the AUDITORY PATHWAYS.

More From BioPortfolio on "Response of the Autonomic Nervous System to Auricular Stimulation of the Vagus Nerve (x)"

Quick Search

Relevant Topics

Epilepsy is defined as a disorder of brain function characterized by recurrent seizures that have a sudden onset.  (Oxford Medical Dictionary).  A seizure is caused by a sudden burst of excess electrical activity in the brain, causing a tempora...

Women's Health
Women's Health - key topics include breast cancer, pregnancy, menopause, stroke Follow and track Women's Health News on BioPortfolio: Women's Health News RSS Women'...

Searches Linking to this Trial