@article{8732994,
  abstract     = {{Background: There is active interest in biomarker discovery for transcutaneous auricular vagus nerve
stimulation (taVNS). However, greater understanding of the neurobiological mechanisms is needed to
identify candidate markers. Accumulating evidence suggests that taVNS influences activity in solitary
and parabrachial nuclei, the primary brainstem relays for the transmission of visceral sensory afferents to
the insula. The insula mediates interoception, which concerns the representation and regulation of
homeostatic bodily states. Consequently, interoceptive pathways may be relevant to taVNS mechanisms
of action.
Hypotheses: We hypothesized that taVNS would modulate an EEG-derived marker of interoceptive
processing known as the heart-evoked potential (HEP). We also hypothesized that taVNS-induced HEP
effects would be localizable to the insula.
Methods: Using a within-subject, sham-controlled design, we recorded EEG and ECG concurrent to
taVNS in 43 healthy adults. Using ECG and EEG data, we extracted HEPs. Estimation of the cortical
sources of the taVNS-dependent HEP responses observed at the scalp were computed using the
Boundary Element Method and weighted Minimum Norm Estimation. Statistics were calculated using
cluster-based permutation methods.
Results: taVNS altered HEP amplitudes at frontocentral and centroparietal electrode sites at various la-
tencies. The taVNS-dependent HEP effect was localized to the insula, operculum, somatosensory cortex,
and orbital and ventromedial prefrontal regions.
Conclusion: The results support the hypothesis that taVNS can access the insula as well as functionally
and anatomically connected brain regions. HEPs may serve as an objective, non-invasive outcome
parameter for the cortical effects of taVNS.
© 2021 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://
creativecommons.org/licenses/by-nc-nd/4.0/).}},
  author       = {{Poppa, Tasha and Benschop, Lars and Horczak, Paula and Vanderhasselt, Marie-Anne and Carrette, Evelien and Bechara, Antoine and Baeken, Chris and Vonck, Kristl}},
  issn         = {{1935-861X}},
  journal      = {{BRAIN STIMULATION}},
  keywords     = {{Neurology (clinical),Biophysics,General Neuroscience,Transcutaneous,Auricular,Vagu nerve stimulation,Insula,Interoception,Heart-evoked potential,Electroencephalography,Source-localization,Central autonomic network,BRAIN-STEM,ELECTRICAL-STIMULATION,CENTRAL PROJECTIONS,NEURAL RESPONSES,EXTERNAL EAR,CONNECTIVITY,PERCEPTION,STRESS,FMRI,INTEROCEPTION}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{260--269}},
  title        = {{Auricular transcutaneous vagus nerve stimulation modulates the heart-evoked potential}},
  url          = {{http://dx.doi.org/10.1016/j.brs.2021.12.004}},
  volume       = {{15}},
  year         = {{2022}},
}

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