Mechanisms of anticephalgic action of the vagus nerve electrostimulation: experimental study results

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Abstract

Cervical or auricular vagus nerve stimulation (VNS) is an effective and safe non-pharmacological treatment for epilepsy, depression, obesity, post-stroke motor impairments, and certain types of primary headaches (HA), including migraine. This review briefly summarizes data on various VNS device models, the pathophysiology of HA, and approved neuromodulatory therapies for headache management. Experimental findings have been analyzed regarding the role of sensory nuclei of the trigeminal and vagus nerves, as well as supraspinal structures of the central nervous system, particularly the dorsal raphe nucleus and locus coeruleus, in mediating the inhibitory effects of VNS on nociceptive transmission within the trigeminothalamocortical pathway, whose hyperactivity is a key mechanism in HA pathogenesis. The review details studies using rodent migraine models, which demonstrated VNS-mediated suppression of spinal trigeminal nucleus neuronal activity and cortical spreading depression, effects achieved through neurotransmitters such as serotonin, norepinephrine, and gamma-aminobutyric acid (GABA). The mechanisms of VNS therapeutic action in HA should remain a focus of experimental and clinical research, as current evidence in this field requires further updating and validation.

About the authors

Alexey Yu. Sokolov

Pavlov Institute of Physiology of the Russian Academy of Sciences; Pavlov First Saint Petersburg State Medical University

Author for correspondence.
Email: alexey.y.sokolov@gmail.com
ORCID iD: 0000-0002-6141-486X

Dr. Sci (Med.), Assoc. Prof., senior researcher, Head, Neuropharmacology department, Valdman Institute of Pharmacology

Russian Federation, St. Petersburg; St. Petersburg

Alexander V. Amelin

Pavlov First Saint Petersburg State Medical University

Email: avamelin@mail.ru
ORCID iD: 0000-0001-6437-232X

Dr. Sci (Med.), Professor, Department of neurology with a clinic, Head, Center for diagnostics and treatment of headache

Russian Federation, St. Petersburg

Olga A. Lyubashina

Pavlov Institute of Physiology of the Russian Academy of Sciences

Email: laglo2009@yandex.ru
ORCID iD: 0000-0002-6296-4628

Dr. Sci (Biol.), Head, Laboratory of cortico-visceral physiology

Russian Federation, St. Petersburg

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