Trigeminal nerve stimulation: a current state-of-the-art review
Abstract Nearly 5 decades ago, the effect of trigeminal nerve stimulation (TNS) on cerebral blood flow was observed for the first time. This implication directly led to further investigations and TNS’ success as a therapeutic intervention. Possessing unique connections with key brain and brainstem r...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Bioelectronic Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42234-023-00128-z |
| _version_ | 1797388167840530432 |
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| author | Keren Powell Kanheng Lin Willians Tambo Andrea Palomo Saavedra Daniel Sciubba Yousef Al Abed Chunyan Li |
| author_facet | Keren Powell Kanheng Lin Willians Tambo Andrea Palomo Saavedra Daniel Sciubba Yousef Al Abed Chunyan Li |
| author_sort | Keren Powell |
| collection | DOAJ |
| description | Abstract Nearly 5 decades ago, the effect of trigeminal nerve stimulation (TNS) on cerebral blood flow was observed for the first time. This implication directly led to further investigations and TNS’ success as a therapeutic intervention. Possessing unique connections with key brain and brainstem regions, TNS has been observed to modulate cerebral vasodilation, brain metabolism, cerebral autoregulation, cerebral and systemic inflammation, and the autonomic nervous system. The unique range of effects make it a prime therapeutic modality and have led to its clinical usage in chronic conditions such as migraine, prolonged disorders of consciousness, and depression. This review aims to present a comprehensive overview of TNS research and its broader therapeutic potentialities. For the purpose of this review, PubMed and Google Scholar were searched from inception to August 28, 2023 to identify a total of 89 relevant studies, both clinical and pre-clinical. TNS harnesses the release of vasoactive neuropeptides, modulation of neurotransmission, and direct action upon the autonomic nervous system to generate a suite of powerful multitarget therapeutic effects. While TNS has been applied clinically to chronic pathological conditions, these powerful effects have recently shown great potential in a number of acute/traumatic pathologies. However, there are still key mechanistic and methodologic knowledge gaps to be solved to make TNS a viable therapeutic option in wider clinical settings. These include bimodal or paradoxical effects and mechanisms, questions regarding its safety in acute/traumatic conditions, the development of more selective stimulation methods to avoid potential maladaptive effects, and its connection to the diving reflex, a trigeminally-mediated protective endogenous reflex. The address of these questions could overcome the current limitations and allow TNS to be applied therapeutically to an innumerable number of pathologies, such that it now stands at the precipice of becoming a ground-breaking therapeutic modality. |
| first_indexed | 2024-03-08T22:36:56Z |
| format | Article |
| id | doaj.art-f4d6fa2f74ba4128bb4448618a170ad4 |
| institution | Directory Open Access Journal |
| issn | 2332-8886 |
| language | English |
| last_indexed | 2024-03-08T22:36:56Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Bioelectronic Medicine |
| spelling | doaj.art-f4d6fa2f74ba4128bb4448618a170ad42023-12-17T12:25:15ZengBMCBioelectronic Medicine2332-88862023-12-019113010.1186/s42234-023-00128-zTrigeminal nerve stimulation: a current state-of-the-art reviewKeren Powell0Kanheng Lin1Willians Tambo2Andrea Palomo Saavedra3Daniel Sciubba4Yousef Al Abed5Chunyan Li6Translational Brain Research Laboratory, The Feinstein Institutes for Medical ResearchTranslational Brain Research Laboratory, The Feinstein Institutes for Medical ResearchTranslational Brain Research Laboratory, The Feinstein Institutes for Medical ResearchUniversity of Notre Dame du Lac, Notre DameDepartment of Neurosurgery, Zucker School of Medicine at Hofstra/NorthwellInstitute for Bioelectronic Medicine, The Feinstein Institutes for Medical ResearchTranslational Brain Research Laboratory, The Feinstein Institutes for Medical ResearchAbstract Nearly 5 decades ago, the effect of trigeminal nerve stimulation (TNS) on cerebral blood flow was observed for the first time. This implication directly led to further investigations and TNS’ success as a therapeutic intervention. Possessing unique connections with key brain and brainstem regions, TNS has been observed to modulate cerebral vasodilation, brain metabolism, cerebral autoregulation, cerebral and systemic inflammation, and the autonomic nervous system. The unique range of effects make it a prime therapeutic modality and have led to its clinical usage in chronic conditions such as migraine, prolonged disorders of consciousness, and depression. This review aims to present a comprehensive overview of TNS research and its broader therapeutic potentialities. For the purpose of this review, PubMed and Google Scholar were searched from inception to August 28, 2023 to identify a total of 89 relevant studies, both clinical and pre-clinical. TNS harnesses the release of vasoactive neuropeptides, modulation of neurotransmission, and direct action upon the autonomic nervous system to generate a suite of powerful multitarget therapeutic effects. While TNS has been applied clinically to chronic pathological conditions, these powerful effects have recently shown great potential in a number of acute/traumatic pathologies. However, there are still key mechanistic and methodologic knowledge gaps to be solved to make TNS a viable therapeutic option in wider clinical settings. These include bimodal or paradoxical effects and mechanisms, questions regarding its safety in acute/traumatic conditions, the development of more selective stimulation methods to avoid potential maladaptive effects, and its connection to the diving reflex, a trigeminally-mediated protective endogenous reflex. The address of these questions could overcome the current limitations and allow TNS to be applied therapeutically to an innumerable number of pathologies, such that it now stands at the precipice of becoming a ground-breaking therapeutic modality.https://doi.org/10.1186/s42234-023-00128-zTrigeminal nerve stimulationTrigeminal nerveVasoactive neuropeptideNeurotransmissionAutonomic nervous systemCerebral vasodilation |
| spellingShingle | Keren Powell Kanheng Lin Willians Tambo Andrea Palomo Saavedra Daniel Sciubba Yousef Al Abed Chunyan Li Trigeminal nerve stimulation: a current state-of-the-art review Bioelectronic Medicine Trigeminal nerve stimulation Trigeminal nerve Vasoactive neuropeptide Neurotransmission Autonomic nervous system Cerebral vasodilation |
| title | Trigeminal nerve stimulation: a current state-of-the-art review |
| title_full | Trigeminal nerve stimulation: a current state-of-the-art review |
| title_fullStr | Trigeminal nerve stimulation: a current state-of-the-art review |
| title_full_unstemmed | Trigeminal nerve stimulation: a current state-of-the-art review |
| title_short | Trigeminal nerve stimulation: a current state-of-the-art review |
| title_sort | trigeminal nerve stimulation a current state of the art review |
| topic | Trigeminal nerve stimulation Trigeminal nerve Vasoactive neuropeptide Neurotransmission Autonomic nervous system Cerebral vasodilation |
| url | https://doi.org/10.1186/s42234-023-00128-z |
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