Table_1_Effect of Non-invasive Vagus Nerve Stimulation on Resting-State Electroencephalography and Laser-Evoked Potentials in Migraine Patients: Mechanistic Insights.DOCX

A recent multicenter trial provided Class I evidence that for patients with an episodic migraine, non-invasive vagus nerve stimulation (nVNS) significantly increases the probability of having mild pain or being pain-free 2 h post-stimulation. Here we aimed to investigate the potential effect of nVNS in the modulation of spontaneous and pain related bioelectrical activity in a subgroup of migraine patients enrolled in the PRESTO trial by using resting-state electroencephalography and trigeminal laser-evoked potentials (LEPs). LEPs were recorded for 27 migraine patients who received active or sham nVNS over the cervical vagus nerve. We measured power values for frequencies between 1–100 Hz in a resting-state condition and the latency and amplitude of N1, N2, and P2 components of LEPs in a basal condition during and after active or sham vagus nerve stimulation (T0, T1, T2). The P2 evoked by the right and the left trigeminal branch was smaller during active nVNS. The sham device also attenuated the P2 amplitude evoked by the left trigeminal branch at T1 and T2, but this attenuation did not reach significance. No changes were observed for N1 amplitude, N1, N2, P2 latency, or pain rating. nVNS induced an increase of EEG power in both slow and fast rhythms, but this effect was not significant as compared to the sham device. These findings suggest that nVNS acts on the cortical areas that are responsible for trigeminal pain control and pave the ground for future studies aimed at confirming the possible correlations with clinical outcomes, including the effect on symptoms that are directly correlated with trigeminal pain processing and modulation.

近期一项多中心试验提供了I类证据，表明对于发作性偏头痛患者，非侵入性迷走神经刺激（non-invasive vagus nerve stimulation, nVNS）可显著提升刺激后2小时出现轻度疼痛或无痛的概率。本研究旨在通过静息态脑电图（resting-state electroencephalography）与三叉神经激光诱发电位（trigeminal laser-evoked potentials, LEPs），探究nVNS对PRESTO试验入组的偏头痛亚组患者自发性及疼痛相关生物电活动调控的潜在效应。本研究对27名接受颈迷走神经部位活性或假刺激nVNS的偏头痛患者进行了LEPs记录，测量了静息状态下1~100 Hz频段的脑电功率值，以及基础状态下、活性或假迷走神经刺激期间及刺激后（T0、T1、T2）LEPs的N1、N2、P2成分的潜伏期与波幅。右侧与左侧三叉神经分支诱发的P2波幅在活性nVNS期间有所降低。假刺激装置在T1与T2时间点也可减弱左侧三叉神经分支诱发的P2波幅，但该减弱未达到统计学显著性。N1波幅、N1、N2及P2的潜伏期，以及疼痛评分均未观察到显著变化。nVNS可提升脑电慢波与快波节律的功率，但该效应与假刺激装置相比未达到统计学显著性。本研究结果提示，nVNS可作用于调控三叉神经痛的皮层区域，为后续验证其与临床结局（包括对与三叉神经痛处理及调控直接相关的症状的影响）的潜在相关性研究奠定了基础。