Transcutaneous Auricular Vagus Nerve Stimulation on Neurological and Mental
Disorders: From Germination to Future
Yu-tian Yu, Jing-jun Zhao, Xiao Guo, Pei-jing Rong*
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- *Corresponding Author:
- Pei-jing Rong
Institute of Acupuncture and Moxibustion
China Academy of Chinese Medical Sciences
Received date: July 19, 2016; Accepted date: August 26, 2016; Published date: September 02, 2016
Citation: Yu Y, Zhao J, Guo X, Rong P (2016) Transcutaneous Auricular Vagus Nerve Stimulation on Neurological and Mental Disorders: From Germination to Future. J Clin Trials 6:277. doi:10.4172/2167-0870.1000277
Copyright: © 2016 Yu Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,distribution, and reproduction in any medium, provided the original author and source are credited.
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Auricular therapies have been applied to diseases since ancient times. Inspired by auricular acupuncture of TCM, and to overcome the disadvantages classic vagus nerve stimulation (VNS), we developed transcutaneous auricular vagus nerve stimulation (taVNS). It was applied to neurological and mental disorders, and also shows a bright prospect to these diseases.
Transcutaneous auricular vagus nerve stimulation; taVNS; Pain;
Epilepsy; Major depressive disorder; MDD; Disorder of consciousness;
Ancient Applications of Auricular Treatments
Earrings have been favored by the ladies since ancient times (Figure
1). Meanwhile, ears have been used to treat diseases from time
immemorial (Figure 2A). The Egyptologist Alexandre Varille
(1909-1951) has demonstrated that women in ancient Egypt, who did
not want any more children, had their external ear pricked with a
needle or cauterized with heat . Mediterranean sailors’ wearing gold
earrings were not just used as decorations, but were said to improve
vision . Hippocrates, who was the father of Greek medicine,
reported doctors made small openings in the veins situated behind the
ear to facilitate ejaculation and reduce impotency problems .
Cutting of veins situated behind the ear was used to treat leg pain as
well . The Greek physician Galen introduced Hippocratic medicine
to the Roman Empire in the second century CE, commentating on the
healing value of scarification at the outer ear .
Figure 1: Dancing lady with charming earrings on a remnant of ceramics date to 3200 years ago, which is the Nineteenth Dynasty in the ancient Egypt.
Figure 2a: Brick of Chinese Han dynasty which engraved ancient miracle-working doctor Bian Que using auricular acupuncture for
After the fall of Roman Empire, the medical records of Egyptian,
Greek and Roman medicine were best preserved in ancient Persia and
Arabian world. Persian records were specific references to medical
treatments for sciatic pains and sexual related disease produced by
cauterization of the external ear (Figure 2B) .
Figure 2b: Persian Surgery Textbook (Imperial Surgery) in the 12th century illustrated that the doctor cauterizing the external ear for patient’s migraine.
From Auricular Acupuncture to Transcutaneous
Auricular Vagus Nerve Stimulation (taVNS)
Vagus nerve stimulation (VNS) has been approved by FDA (Figure
3) for epilepsy in 1997  and treatment-resistant depression in 2005
[6,7]. However, they have their limitations as well, including high cost,
the involvement of surgery, perioperative risks, and potentially
significant side effects .
Figure 3: Vagus Nerve Stimulation (VNS).
Transcutaneous auricular vagus nervestimulation (taVNS) is
developed from auricular acupuncture several years ago by our team.
Auricular acupuncture (Figure 4) is a very important part of
Traditional Chinese Medicine (TCM) . In the classic TCM text of
Huang Di Nei Jing was compiled in around 500 B.C whose correlation
between the auricle and the body had been described that all six Yang
meridians were directly connected to the auricle, whereas the six Yin
meridians were indirectly connected to the ear by their corresponding
yang meridian, respectively [4,10]. Since the ancient time, Chinese
doctors have been using auricular acupuncture to treat a wild range of
diseases, including insomnia, depression and anxiety etc . Nogier
presented his discovery in several congresses and published it in an
international circulation journal which eventually led to the
widespread acceptance of his approach. With some exceptions, the
Chinese charts were very similar to Nogier’s originals .
Figure 4: Auricular Acupuncture.
Also, according to anatomical studies which suggest that the ear is
the only place on the surface of human bodies where there is afferent
vagus nerve distribution [13,14], especially in the auricular concha
(Figure 5) , a direct stimulation of these afferent nerve fibres on ear
supposes to has similar effect to classic VNS without surgical
intervention, which is fertile for more disorders (Figure 6) .
Figure 5:The innervations of the auricular branch of the vagus nerve are marked by green color which is mainly distributed in
Figure 6: taVNS has similar effect to classic VNS.
Transcutaneous Auricular Vagus Nerve Stimulation
(taVNS) on Neurological and Mental Disorders
At the very beginning, transcutaneous auricular vagus nerve
stimulation (taVNS) was for pain relief [1,17,18]. As the classic VNS
was approved by US FDA for both epilepsy and treatment-resistant
depression, clinical trials of taVNS for these two diseases were
increased gradually [16,19-22]. And then, because auricular
acupuncture was very effective for insomnia disorder (ID), taVNS was
therefore applied to these patients . In addition to the above
mentioned, more and more results of taVNS on neurological and
mental disorders was achieved including tinnitus [24,25], chronic
migraine , schizophrenia [27,28], postoperative cognitive
In 2013, Compelling evidence exists to suggest that vagus nerve
stimulation (VNS) may improve outcomes after severe brain injury.
The clinical trial for which researchers have obtained FDA IDE clearance will be the first step in determining the efficacy of VNS for
improvement of consciousness after severe brain injury . Inspired
by this, our team is focusing on transcutaneous auricular vagus nerve
stimulation (taVNS) on patients with disorder of consciousness
(DOC). Stirring results are coming out.
Auricular treatments to diseases can be traced back to ancient
Egyptian and Chinese times. Inspired by auricular acupuncture of
TCM, and to overcome the disadvantages classic vagus nerve
stimulation (VNS), we developed transcutaneous auricular vagus
nerve stimulation (taVNS). It was applied to neurological and mental
disorders, including pain, epilepsy, depression, insomnia, tinnitus,
chronic migraine, schizophrenia, postoperative cognitive dysfunction
etc. It also shows a bright prospect in other neurological and mental
disorders. Further studies should be carried out.
1. Natural Science Foundation of China (No. 30973798, 81473780);
2. The Fundamental Research Funds for the Central Public Welfare
Research Institutes (ZZ16012); 3. Chinese Postdoctoral Science
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