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Observational Study
. 2015 Apr 7;10(4):e0120786.
doi: 10.1371/journal.pone.0120786. eCollection 2015.

Assessment of brainstem function with auricular branch of vagus nerve stimulation in Parkinson's disease

David Weise  1 , Melanie Adamidis  1 , Fabio Pizzolato  2 , Jost-Julian Rumpf  1 , Christopher Fricke  1 , Joseph Classen  1
Affiliations
Observational Study

Assessment of brainstem function with auricular branch of vagus nerve stimulation in Parkinson's disease

David Weise et al. PLoS One. .

Abstract

Background: The efferent dorsal motor nucleus of the vagal nuclei complex may degenerate early in the course of Parkinson's disease (PD), while efferent nucleus ambiguous, the principal source of parasympathetic vagal neurons innervating the heart, and afferent somatosensory nuclei remain intact.

Objective: To obtain neurophysiological evidence related to this pattern, we tested processing of afferent sensory information transmitted via the auricular branch of the vagus nerve (ABVN) which is known to be connected to autonomic regulation of cardiac rhythm.

Methods: In this cross-sectional observational study, we recorded (i) somatosensory evoked potentials (ABVN-SEP) and (ii) cutaneo-cardioautonomic response elicited by stimulation of the ABVN (modulation of heart-rate variability (HRV index; low frequency power, ln(LF), high frequency power, ln(HF); ln(LF/HF) ratio)) in 50 PD patients and 50 age and sex matched healthy controls. Additionally, auditory evoked potentials and trigeminal nerve SEP were assessed.

Results: Neither ABVN-SEP nor any of the other functional brainstem parameters differed between patients and controls. Although HRV index was decreased in PD patients, modulation of ln(LF/HF) by ABVN-stimulation, likely indicating cardiac parasympathetic activation, did not differ between both groups.

Conclusions: Findings do not point to prominent dysfunction of processing afferent information from ABVN and its connected parasympathetic cardiac pathway in PD. They are consistent with the known pattern of degeneration of the vagal nuclei complex of the brainstem.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Schematic illustration of the vagal nuclei complex and its afferents and efferents.
Fig 2
Fig 2. Schematic illustration of bipolar recordings from the scalp (10–20 system).
Fig 3
Fig 3. ABVN-SEP recorded at the electrode position A1-Cz after electric stimulation of the auricular branch of the left vagus nerve in a healthy control subject (dashed line) and a patient with Parkinson’s disease (continuous line).
P1 first positive peak, N1 first negative peak, P2 second positive peak.
See this image and copyright information in PMC

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