Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy

IntroductionPeripheral neuropathy (PN) is the most common neurodegenerative disorder, and the primary causes are chemotherapy-induced peripheral neuropathy (CIPN) and diabetic neuropathy (DN). Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising non-pharmacological and non-invasiv...

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Main Authors: Marlon L. Wong, Eva Widerström-Noga, Jessica L. Bolanos, Gabriel Gonzalez, Frank J. Penedo, Peter J. Hosein, Melissa M. Tovin, Juan P. Gonzalez, Lisa M. McTeague
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Pain Research
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Online Access:https://www.frontiersin.org/articles/10.3389/fpain.2024.1516196/full
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author Marlon L. Wong
Eva Widerström-Noga
Jessica L. Bolanos
Gabriel Gonzalez
Frank J. Penedo
Peter J. Hosein
Melissa M. Tovin
Juan P. Gonzalez
Lisa M. McTeague
author_facet Marlon L. Wong
Eva Widerström-Noga
Jessica L. Bolanos
Gabriel Gonzalez
Frank J. Penedo
Peter J. Hosein
Melissa M. Tovin
Juan P. Gonzalez
Lisa M. McTeague
author_sort Marlon L. Wong
collection DOAJ
description IntroductionPeripheral neuropathy (PN) is the most common neurodegenerative disorder, and the primary causes are chemotherapy-induced peripheral neuropathy (CIPN) and diabetic neuropathy (DN). Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising non-pharmacological and non-invasive intervention that targets key pathways involved with PN. However, research is needed to determine the feasibility, acceptability, and effects of taVNS in people with PN. It is also critical that this research on taVNS include the perspectives of Black and Hispanic/Latino patients, who are often underrepresented in research.MethodsThis research was comprised of two consecutive studies: a survey and a pilot randomized sham-controlled trial (RCT). The survey assessed symptom burden, management strategies, and interest in taVNS among CIPN patients. The pilot RCT evaluated the feasibility, acceptability, and preliminary effects of taVNS in Black and Hispanic/Latino patients with CIPN or diabetic neuropathy. Participants were recruited from the University of Miami medical system, with culturally sensitive approaches to enhance minority participation.ResultsThe survey included 62 respondents, 78% Black or Hispanic/Latino, revealing high symptom burden and significant interest in taVNS (82% expressed moderate to high interest). The pilot RCT enrolled 28 participants, achieving a 42% recruitment rate and 86% retention. taVNS was well tolerated, with no significant adverse effects. Preliminary data indicated a decrease in neuropathic symptoms and an increased heart rate variability (HRV) during active taVNS, suggesting autonomic modulation. Tingling sensation and pain decreased by median values of 2.0 and 1.5, respectively. Additionally, the median values for standard deviation of the RR interval increased from 34.9 (CI = 21.6–44.8) at baseline to 44.8 (CI = 26.5–50.3) during intervention. Exit interviews highlighted positive participant experiences and identified potential barriers, such as protocol length and distrust in medical research.ConclusionThe findings underscore the need for novel CIPN treatments and demonstrate the feasibility of conducting taVNS research in historically underrepresented populations. High interest in taVNS and successful recruitment and retention rates suggest that culturally sensitive approaches can enhance minority participation in clinical trials. These findings will be used to develop a large clinical trial to determine the efficacy of repeated taVNS in a diverse cohort. Clinical Trial Registrationhttps://clinicaltrials.gov, identifier (NCT05896202).
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spelling doaj-art-228b3ecb9bfd4f988be3e734908b04892025-01-17T06:50:32ZengFrontiers Media S.A.Frontiers in Pain Research2673-561X2025-01-01510.3389/fpain.2024.15161961516196Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathyMarlon L. Wong0Eva Widerström-Noga1Jessica L. Bolanos2Gabriel Gonzalez3Frank J. Penedo4Peter J. Hosein5Melissa M. Tovin6Juan P. Gonzalez7Lisa M. McTeague8Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL, United StatesThe Miami Project to Cure Paralysis, University of Miami, Miami, FL, United StatesDepartment of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL, United StatesDepartment of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL, United StatesSylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United StatesSylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United StatesDepartment of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL, United StatesDepartment of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL, United StatesDepartment of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United StatesIntroductionPeripheral neuropathy (PN) is the most common neurodegenerative disorder, and the primary causes are chemotherapy-induced peripheral neuropathy (CIPN) and diabetic neuropathy (DN). Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising non-pharmacological and non-invasive intervention that targets key pathways involved with PN. However, research is needed to determine the feasibility, acceptability, and effects of taVNS in people with PN. It is also critical that this research on taVNS include the perspectives of Black and Hispanic/Latino patients, who are often underrepresented in research.MethodsThis research was comprised of two consecutive studies: a survey and a pilot randomized sham-controlled trial (RCT). The survey assessed symptom burden, management strategies, and interest in taVNS among CIPN patients. The pilot RCT evaluated the feasibility, acceptability, and preliminary effects of taVNS in Black and Hispanic/Latino patients with CIPN or diabetic neuropathy. Participants were recruited from the University of Miami medical system, with culturally sensitive approaches to enhance minority participation.ResultsThe survey included 62 respondents, 78% Black or Hispanic/Latino, revealing high symptom burden and significant interest in taVNS (82% expressed moderate to high interest). The pilot RCT enrolled 28 participants, achieving a 42% recruitment rate and 86% retention. taVNS was well tolerated, with no significant adverse effects. Preliminary data indicated a decrease in neuropathic symptoms and an increased heart rate variability (HRV) during active taVNS, suggesting autonomic modulation. Tingling sensation and pain decreased by median values of 2.0 and 1.5, respectively. Additionally, the median values for standard deviation of the RR interval increased from 34.9 (CI = 21.6–44.8) at baseline to 44.8 (CI = 26.5–50.3) during intervention. Exit interviews highlighted positive participant experiences and identified potential barriers, such as protocol length and distrust in medical research.ConclusionThe findings underscore the need for novel CIPN treatments and demonstrate the feasibility of conducting taVNS research in historically underrepresented populations. High interest in taVNS and successful recruitment and retention rates suggest that culturally sensitive approaches can enhance minority participation in clinical trials. These findings will be used to develop a large clinical trial to determine the efficacy of repeated taVNS in a diverse cohort. Clinical Trial Registrationhttps://clinicaltrials.gov, identifier (NCT05896202).https://www.frontiersin.org/articles/10.3389/fpain.2024.1516196/fulltranscutaneous auricular vagus nerve stimulation (taVNS)transcutaneous auricular nerve stimulationnoninvasive vagus nerve stimulationperipheral neuropathychemotherapy-induced peripheral neuropathyhealth disparities
spellingShingle Marlon L. Wong
Eva Widerström-Noga
Jessica L. Bolanos
Gabriel Gonzalez
Frank J. Penedo
Peter J. Hosein
Melissa M. Tovin
Juan P. Gonzalez
Lisa M. McTeague
Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy
Frontiers in Pain Research
transcutaneous auricular vagus nerve stimulation (taVNS)
transcutaneous auricular nerve stimulation
noninvasive vagus nerve stimulation
peripheral neuropathy
chemotherapy-induced peripheral neuropathy
health disparities
title Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy
title_full Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy
title_fullStr Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy
title_full_unstemmed Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy
title_short Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy
title_sort feasibility of trancutaneous auricular vagus nerve stimulation in black and hispanic latino people with peripheral neuropathy
topic transcutaneous auricular vagus nerve stimulation (taVNS)
transcutaneous auricular nerve stimulation
noninvasive vagus nerve stimulation
peripheral neuropathy
chemotherapy-induced peripheral neuropathy
health disparities
url https://www.frontiersin.org/articles/10.3389/fpain.2024.1516196/full
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