Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation

Background Abdominal pain and constipation are 2 main symptoms in patients with constipation-predominant irritable bowel syndrome (IBS-C). This study aimed to investigate the effects and possible mechanisms of transcutaneous auricular vagal nerve stimulation (taVNS) in patients with IBS-C.Methods Fo...

Full description

Bibliographic Details
Main Authors: Xiaodan Shi, Yedong Hu, Bo Zhang, Wenna Li, Jiande DZ Chen, Fei Liu
Format: Article
Language:English
Published: American Society for Clinical investigation 2021-07-01
Series:JCI Insight
Subjects:
Online Access:https://doi.org/10.1172/jci.insight.150052
_version_ 1811329136758620160
author Xiaodan Shi
Yedong Hu
Bo Zhang
Wenna Li
Jiande DZ Chen
Fei Liu
author_facet Xiaodan Shi
Yedong Hu
Bo Zhang
Wenna Li
Jiande DZ Chen
Fei Liu
author_sort Xiaodan Shi
collection DOAJ
description Background Abdominal pain and constipation are 2 main symptoms in patients with constipation-predominant irritable bowel syndrome (IBS-C). This study aimed to investigate the effects and possible mechanisms of transcutaneous auricular vagal nerve stimulation (taVNS) in patients with IBS-C.Methods Forty-two patients with IBS-C were randomized into a 4-week sham-taVNS or taVNS treatment. The primary outcomes were complete spontaneous bowel movements per week (CSBMs/week) and visual analog scale (VAS) for abdominal pain. High-resolution anorectal manometry (HRAM) was performed to evaluate anorectal motor and sensory function. Cytokines and brain gut peptides were analyzed in blood samples. ECG was recorded for the assessment of autonomic function.Results Compared with sham-taVNS, (a) taVNS increased CSBMs/week (P = 0.001) and decreased VAS pain score (P = 0.001); (b) improved quality of life (P = 0.020) and decreased IBS symptom score (P = 0.001); (c) improved rectoanal inhibitory reflex (P = 0.014) and improved rectal sensation (P < 0.04); (d) decreased a number of proinflammatory cytokines and serotonin in circulation; and (e) enhanced vagal activity (P = 0.040). The vagal activity was weakly correlated with the CSBMs/week (r = 0.391; P = 0.010) and the VAS pain score (r = –0.347; P = 0.025).Conclusions Noninvasive taVNS improves both constipation and abdominal pain in patients with IBS-C. The improvement in IBS-C symptoms might be attributed to the integrative effects of taVNS on intestinal functions mediated via the autoimmune mechanisms.Trial registration www.chictr.org.cn, no. ChiCTR2000029644.Funding National Natural Science Foundation of China (grant no. 81970538 for FL).
first_indexed 2024-04-13T15:38:29Z
format Article
id doaj.art-312971cc01204877891b33a99e07aafb
institution Directory Open Access Journal
issn 2379-3708
language English
last_indexed 2024-04-13T15:38:29Z
publishDate 2021-07-01
publisher American Society for Clinical investigation
record_format Article
series JCI Insight
spelling doaj.art-312971cc01204877891b33a99e07aafb2022-12-22T02:41:13ZengAmerican Society for Clinical investigationJCI Insight2379-37082021-07-01614Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipationXiaodan ShiYedong HuBo ZhangWenna LiJiande DZ ChenFei LiuBackground Abdominal pain and constipation are 2 main symptoms in patients with constipation-predominant irritable bowel syndrome (IBS-C). This study aimed to investigate the effects and possible mechanisms of transcutaneous auricular vagal nerve stimulation (taVNS) in patients with IBS-C.Methods Forty-two patients with IBS-C were randomized into a 4-week sham-taVNS or taVNS treatment. The primary outcomes were complete spontaneous bowel movements per week (CSBMs/week) and visual analog scale (VAS) for abdominal pain. High-resolution anorectal manometry (HRAM) was performed to evaluate anorectal motor and sensory function. Cytokines and brain gut peptides were analyzed in blood samples. ECG was recorded for the assessment of autonomic function.Results Compared with sham-taVNS, (a) taVNS increased CSBMs/week (P = 0.001) and decreased VAS pain score (P = 0.001); (b) improved quality of life (P = 0.020) and decreased IBS symptom score (P = 0.001); (c) improved rectoanal inhibitory reflex (P = 0.014) and improved rectal sensation (P < 0.04); (d) decreased a number of proinflammatory cytokines and serotonin in circulation; and (e) enhanced vagal activity (P = 0.040). The vagal activity was weakly correlated with the CSBMs/week (r = 0.391; P = 0.010) and the VAS pain score (r = –0.347; P = 0.025).Conclusions Noninvasive taVNS improves both constipation and abdominal pain in patients with IBS-C. The improvement in IBS-C symptoms might be attributed to the integrative effects of taVNS on intestinal functions mediated via the autoimmune mechanisms.Trial registration www.chictr.org.cn, no. ChiCTR2000029644.Funding National Natural Science Foundation of China (grant no. 81970538 for FL).https://doi.org/10.1172/jci.insight.150052Gastroenterology
spellingShingle Xiaodan Shi
Yedong Hu
Bo Zhang
Wenna Li
Jiande DZ Chen
Fei Liu
Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation
JCI Insight
Gastroenterology
title Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation
title_full Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation
title_fullStr Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation
title_full_unstemmed Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation
title_short Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation
title_sort ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation
topic Gastroenterology
url https://doi.org/10.1172/jci.insight.150052
work_keys_str_mv AT xiaodanshi amelioratingeffectsandmechanismsoftranscutaneousauricularvagalnervestimulationonabdominalpainandconstipation
AT yedonghu amelioratingeffectsandmechanismsoftranscutaneousauricularvagalnervestimulationonabdominalpainandconstipation
AT bozhang amelioratingeffectsandmechanismsoftranscutaneousauricularvagalnervestimulationonabdominalpainandconstipation
AT wennali amelioratingeffectsandmechanismsoftranscutaneousauricularvagalnervestimulationonabdominalpainandconstipation
AT jiandedzchen amelioratingeffectsandmechanismsoftranscutaneousauricularvagalnervestimulationonabdominalpainandconstipation
AT feiliu amelioratingeffectsandmechanismsoftranscutaneousauricularvagalnervestimulationonabdominalpainandconstipation