Researcher ORCID Identifier

0009-0003-9922-787X

Graduation Year

2023

Date of Submission

12-2023

Document Type

Open Access Senior Thesis

Degree Name

Bachelor of Arts

Department

W.M. Keck Science Department

Second Department

Neuroscience

Reader 1

Rustin Berlow

Reader 2

Tessa Solomon-Lane

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Rights Information

© 2023 Rhea N Gandhi

Abstract

Surgical vagus nerve stimulation (VNS) was FDA cleared for depression (2005) and epilepsy. (1997). In the surgical procedure, a pacemaker is implanted below the collarbone (clavicle) and connected to the vagus nerve in the neck. Transcutaneous vagus nerve stimulation (tVNS) is a non-surgical alternative to VNS and there is evidence supporting its effectiveness for several conditions. Advantages include lower cost and fewer adverse side effects.

Anxiety is tied to excess or unopposed sympathetic nervous system activity, while the parasympathetic nervous system, especially the vagus nerve, is relatively underactive. This study aimed to investigate a potential impact of regular tVNS stimulation on anxiety patients’ symptoms. Retrospective chart analysis was performed on 18 patients with high levels of anxiety (5 or higher on a scale from 0 to 10) in an outpatient psychiatric clinic near San Diego, California. Subjects received 10 to 15 tVNS treatments within a three-month span.

Each tVNS treatment consisted of consistent stimulation of 20 Hz at a current just below the patient’s threshold of perception for 20 minutes. A statistically significant benefit was measured in reported anxiety (p = .002). Improvement was measures related to anxiety (p = .007 for Relaxed, .021 for Restless, .004 for Tense). While quality of life improved on average, the change was not statistically significant (p = .075).

These results suggest a need for a double-blind, placebo-controlled trial to confirm the viability of tVNS to be used as a treatment modality for anxiety. Further research is also needed to assess how this treatment may work for individuals with different anxiety disorders (obsessive compulsive disorder, post-traumatic stress disorder, etc.), as well as into identifying factors that would make tVNS a more or less suitable treatment modality (age, other medications, etc.).

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