Transcutaneous vagus nerve stimulation
The transcutaneous vagus nerve stimulation is a further development of the conventional vagus nerve stimulation , in which no surgery and no hospital stay are necessary, but a significantly lower effectiveness is to be expected.
A branch of the vagus nerve , which runs in a certain area of the auricle, is stimulated through the skin via a special ear electrode. The ear electrode is worn like an earphone. This is connected to a stimulator that generates electrical impulses and is similar in size and shape to a conventional smartphone .
The therapy is carried out by the patient independently and can be easily integrated into everyday life. The stimulation strength is adjusted so that a pleasant tingling or pulsing sensation can be felt at the location of the stimulation. It should be used daily.
Application area epilepsy
Medicines play the most important role in the treatment of epilepsy . However, the goal of being seizure-free is only achieved in around two thirds of those affected.
The remaining third of the patients suffer from so-called drug -resistant epilepsy, epilepsy in which suitable treatment attempts with at least two well-tolerated and appropriately selected and used anticonvulsants do not achieve lasting freedom from seizures. In addition to developing new drugs, research must also focus on alternative treatment methods.
A randomized, controlled clinical multicenter study on the effectiveness of transcutaneous vagus nerve stimulation (t-VNS) in drug-resistant epilepsy, carried out at epilepsy centers in Germany and Austria, showed that the patients tolerated the therapy well and were able to integrate it into their everyday lives. The frequency of seizures had decreased by an average of 23% after 5 months, and the patients also reported an improvement in their quality of life. In this study with tVNS, however, neither a dose-response relationship nor a difference in the responder rates between the active and control group could be shown, which indicates a placebo effect. However, case reports show that freedom from seizures can also be achieved in individual patients.
Application area migraine
In the treatment of migraines , drugs initially play a major role. If the effectiveness is insufficient or side effects occur, patients look for alternative therapy options.
Results of a study on the use of transcutaneous vagus nerve stimulation (t-VNS) in chronic migraines at the Upper Bavarian Headache Center of the Neurological Clinic at Großhadern Clinic show a reduction in migraine days by more than 4 days after just one month. With daily use there is a significant reduction in migraine days by up to 7 days per month after three months. Thus the effectiveness is comparable to topiramate and Onabotulinumtoxin A .
Therapy by means of transcutaneous vagus nerve stimulation can be used for all forms and degrees of severity of migraines.
Individual evidence
- ↑ NEMOS® for epilepsy. (No longer available online.) In: www.cerbomed.de. Archived from the original on April 14, 2016 ; accessed on April 14, 2016 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Difficult-to-treat epilepsy. Retrieved April 14, 2016 .
- ↑ References in Transcutaneous Vagus Nerve Stimulation (tVNS) for Treatment of Drug-Resistant Epilepsy: A Randomized, Double-Blind Clinical Trial (cMPsE02) - Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation. In: www.brainstimjrnl.com. Retrieved April 14, 2016 .
- ↑ Epicurians: When drugs reach their limits. (No longer available online.) In: www.epikurier.de. Archived from the original on April 14, 2016 ; accessed on April 14, 2016 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ^ Andreas Straube, J. Ellrich, O. Eren, B. Blum, R. Ruscheweyh: Treatment of chronic migraine with transcutaneous stimulation of the auricular branch of the vagal nerve (auricular t-VNS): a randomized, monocentric clinical trial . In: The Journal of Headache and Pain . tape 16 , no. 1 , July 9, 2015, ISSN 1129-2369 , p. 1–9 , doi : 10.1186 / s10194-015-0543-3 , PMID 26156114 , PMC 4496420 (free full text).
