Matthew T Wittbrodt1, Nil Z Gurel2, Jonathon A Nye3, Stacy Ladd4, Md Mobashir H Shandhi2, Minxuan Huang5, Amit J Shah6, Bradley D Pearce3, Zuhayr S Alam4, Mark H Rapaport4, Nancy Murrah3, Yi-An Ko7, Ammer A Haffer5, Lucy H Shallenberger3, Viola Vaccarino8, Omer T Inan9, J Douglas Bremner10. 1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: mattwittbrodt@emory.edu. 2. Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA. 3. Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA. 4. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA. 5. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 6. Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA. 7. Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 8. Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA; Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA, USA. 9. Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA. 10. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA.
Abstract
BACKGROUND: Traumatic stress can have lasting effects on neurobiology and result in psychiatric conditions such as posttraumatic stress disorder (PTSD). We hypothesize that non-invasive cervical vagal nerve stimulation (nVNS) may alleviate trauma symptoms by reducing stress sympathetic reactivity. This study examined how nVNS alters neural responses to personalized traumatic scripts. METHODS:Nineteen participants who had experienced trauma but did not have the diagnosis of PTSD completed this double-blind sham-controlled study. In three sequential time blocks, personalized traumatic scripts were presented to participants immediately followed by either sham stimulation (n = 8; 0-14 V, 0.2 Hz, pulse width = 5s) or active nVNS (n = 11; 0-30 V, 25 Hz, pulse width = 40 ms). Brain activity during traumatic scripts was assessed using High Resolution Positron Emission Tomography (HR-PET) with radiolabeled water to measure brain blood flow. RESULTS: Traumatic scripts resulted in significant activations within the bilateral medial and orbital prefrontal cortex, premotor cortex, anterior cingulate, thalamus, insula, hippocampus, right amygdala, and right putamen. Greater activation was observed during sham stimulation compared to nVNS within the bilateral prefrontal and orbitofrontal cortex, premotor cortex, temporal lobe, parahippocampal gyrus, insula, and left anterior cingulate. During the first exposure to the trauma scripts, greater activations were found in the motor cortices and ventral visual stream whereas prefrontal cortex and anterior cingulate activations were more predominant with later script presentations for those subjects receiving sham stimulation. CONCLUSION:nVNS decreases neural reactivity to an emotional stressor in limbic and other brain areas involved in stress, with changes over repeated exposures suggesting a shift from scene appraisal to cognitively processing the emotional event.
RCT Entities:
BACKGROUND:Traumatic stress can have lasting effects on neurobiology and result in psychiatric conditions such as posttraumatic stress disorder (PTSD). We hypothesize that non-invasive cervical vagal nerve stimulation (nVNS) may alleviate trauma symptoms by reducing stress sympathetic reactivity. This study examined how nVNS alters neural responses to personalized traumatic scripts. METHODS: Nineteen participants who had experienced trauma but did not have the diagnosis of PTSD completed this double-blind sham-controlled study. In three sequential time blocks, personalized traumatic scripts were presented to participants immediately followed by either sham stimulation (n = 8; 0-14 V, 0.2 Hz, pulse width = 5s) or active nVNS (n = 11; 0-30 V, 25 Hz, pulse width = 40 ms). Brain activity during traumatic scripts was assessed using High Resolution Positron Emission Tomography (HR-PET) with radiolabeled water to measure brain blood flow. RESULTS: Traumatic scripts resulted in significant activations within the bilateral medial and orbital prefrontal cortex, premotor cortex, anterior cingulate, thalamus, insula, hippocampus, right amygdala, and right putamen. Greater activation was observed during sham stimulation compared to nVNS within the bilateral prefrontal and orbitofrontal cortex, premotor cortex, temporal lobe, parahippocampal gyrus, insula, and left anterior cingulate. During the first exposure to the trauma scripts, greater activations were found in the motor cortices and ventral visual stream whereas prefrontal cortex and anterior cingulate activations were more predominant with later script presentations for those subjects receiving sham stimulation. CONCLUSION: nVNS decreases neural reactivity to an emotional stressor in limbic and other brain areas involved in stress, with changes over repeated exposures suggesting a shift from scene appraisal to cognitively processing the emotional event.
Authors: Asim H Gazi; Matthew T Wittbrodt; Anna B Harrison; Srirakshaa Sundararaj; Nil Z Gurel; Jonathon A Nye; Amit J Shah; Viola Vaccarino; J Douglas Bremner; Omer T Inan Journal: IEEE Trans Biomed Eng Date: 2022-01-20 Impact factor: 4.538
Authors: Nil Z Gurel; Matthew T Wittbrodt; Hewon Jung; Md Mobashir H Shandhi; Emily G Driggers; Stacy L Ladd; Minxuan Huang; Yi-An Ko; Lucy Shallenberger; Joy Beckwith; Jonathon A Nye; Bradley D Pearce; Viola Vaccarino; Amit J Shah; Omer T Inan; J Douglas Bremner Journal: Neurobiol Stress Date: 2020-10-20
Authors: J Douglas Bremner; Matthew T Wittbrodt; Nil Z Gurel; MdMobashir H Shandhi; Asim H Gazi; Yunshen Jiao; Oleksiy M Levantsevych; Minxuan Huang; Joy Beckwith; Isaias Herring; Nancy Murrah; Emily G Driggers; Yi-An Ko; MhmtJamil L Alkhalaf; Majd Soudan; Lucy Shallenberger; Allison N Hankus; Jonathon A Nye; Jeanie Park; Anna Woodbury; Puja K Mehta; Mark H Rapaport; Viola Vaccarino; Amit J Shah; Bradley D Pearce; Omer T Inan Journal: J Affect Disord Rep Date: 2021-07-10
Authors: Christopher J Czura; Marom Bikson; Leigh Charvet; Jiande D Z Chen; Manfred Franke; Marat Fudim; Eric Grigsby; Sam Hamner; Jared M Huston; Navid Khodaparast; Elliot Krames; Bruce J Simon; Peter Staats; Kristl Vonck Journal: Front Neurol Date: 2022-07-14 Impact factor: 4.086
Authors: Matthew T Wittbrodt; Nil Z Gurel; Jonathon A Nye; Md Mobashir H Shandhi; Asim H Gazi; Amit J Shah; Bradley D Pearce; Nancy Murrah; Yi-An Ko; Lucy H Shallenberger; Viola Vaccarino; Omer T Inan; J Douglas Bremner Journal: Psychosom Med Date: 2021 Nov-Dec 01 Impact factor: 4.312
Authors: Asim H Gazi; Nil Z Gurel; Kristine L S Richardson; Matthew T Wittbrodt; Amit J Shah; Viola Vaccarino; J Douglas Bremner; Omer T Inan Journal: JMIR Mhealth Uhealth Date: 2020-09-22 Impact factor: 4.773
Authors: James Douglas Bremner; Nil Z Gurel; Matthew T Wittbrodt; Mobashir H Shandhi; Mark H Rapaport; Jonathon A Nye; Bradley D Pearce; Viola Vaccarino; Amit J Shah; Jeanie Park; Marom Bikson; Omer T Inan Journal: J Pers Med Date: 2020-09-09