Effects of Transcutaneous Vagus Nerve Stimulation on Pain and Brain Activity in Healthy Adults

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-70
SponsorDavid A. Purger

About this trial

The goal of this clinical trial is to learn whether stimulating a nerve in the neck changes how much pain people feel. It also looks at whether this stimulation changes brain activity. The study is being done in healthy adults ages 18 to 70.

The nerve being studied is called the vagus nerve. It runs through the neck and connects to parts of the brain that handle pain. In this study, the nerve is stimulated from outside the body using a small device placed on the skin. There is no surgery, and nothing is implanted.

The main questions it aims to answer are: (1) Does stimulating the vagus nerve lower the pain people feel during a cold water test? (2) Does stimulating the vagus nerve change the electrical activity in the brain?

Researchers will compare pain ratings and brain activity under three conditions in the same person: no stimulation, real stimulation over the vagus nerve, and sham stimulation placed nearby on the neck. Sham stimulation feels similar but is not aimed at the nerve.

Participants will: (1) Come to one visit that lasts about 90 minutes, with no follow-up visits, (2) Wear a cap that records the brain's natural electrical signals for the whole visit, (3) Place both hands in cold water, about 39 degrees Fahrenheit, up to three times for up to 2 minutes each time, (4) Rate their pain after each cold water test, (5) Wear a stimulation device on the neck during two of the three cold water tests, (6) Not be told which of those two is the real stimulation until the visit is over.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Adults aged 18 to 70 years

Healthy, defined as having no history of chronic medical, neurological, or psychiatric conditions

Not currently experiencing acute illness or chronic pain

Not currently taking medications that influence the nervous system or pain sensitivity

Disqualifiers

History of vagal or vasovagal symptoms

Respiratory distress

Cardiac arrhythmia

Sleep apnea

Trial design

Design model

Crossover

Treatments tested in this trial

  • Active transcutaneous vagus nerve stimulation

    Device

    Stimulation applied over the cervical branch of the vagus nerve, anterior to the sternocleidomastoid along the carotid sheath. Pulse width 200 microseconds, frequency 30 Hz, rectangular monophasic waveform, intensity titrated between 17.8 and 39.5 volts to a mild tingling sensation below the threshold of discomfort. Stimulation is maintained for 20 minutes before the cold pressor test and continues throughout it.

  • Sham transcutaneous vagus nerve stimulation

    Device

    Identical device, parameters, and duration as the active condition, differing only in placement. The device is positioned slightly posterior on the neck, away from the cervical branch of the vagus nerve.

  • Cold pressor test

    Other intervention

    Immersion of both hands up to the wrist in water maintained at 4 degrees Celsius with ice for up to two minutes or as long as tolerated. Performed three times per participant: once with no stimulation, once during active stimulation, and once during sham stimulation.

Treatment groups

20 Participants
are divided into 2 treatment groups
Group A: Active Stimulation First, Then ShamExperimental treatment 3 interventions
Group B: Sham Stimulation First, Then ActiveExperimental treatment 3 interventions

Trial outcomes

Primary outcomes

1

Pain intensity measured by the Numerical Pain Rating Scale

Participant-reported pain intensity on an 11-point scale from 0 to 10, where 0 is no pain and 10 is the worst pain imaginable. Higher scores indicate greater pain. Rated immediately after each cold pressor test.

Time frame
Immediately after each of the three cold pressor tests during a single visit, approximately 90 minutes.
2

Pain intensity measured by the Visual Analogue Scale

Participant-reported pain intensity is marked on a 100 mm line anchored at 0 mm for no pain and 100 mm for the worst imaginable pain. The distance in millimeters from the left anchor is recorded as the score. Higher scores indicate greater pain. Rated immediately after each cold pressor test.

Time frame
Immediately after each of the three cold pressor tests during a single visit, approximately 90 minutes.
3

Pain threshold during cold pressor test

Time in seconds from hand immersion to the participant's first verbalized sensation of pain, recorded separately for each hand.

Time frame
During each of the three cold pressor tests within a single visit, approximately 90 minutes.

Secondary outcomes

1

Change in EEG spectral power

Change in spectral power within canonical frequency bands (delta 1 to 4 Hz, theta 4 to 8 Hz, alpha 8 to 12 Hz, beta 13 to 30 Hz, gamma above 30 Hz), measured by continuous 16-channel electroencephalography, compared across resting baseline, stimulation without noxious stimulus, and stimulation during cold pressor test.

Time frame
Continuously throughout a single visit, approximately 90 minutes.
2

Change in EEG functional connectivity

Change in functional connectivity between brain regions, derived from continuous 16-channel electroencephalography. Phase locking values are computed for each pair of EEG channels within canonical frequency bands, and connectivity metrics are derived from those values. Coherence is assessed in the frequency domain. Analyses are restricted to predefined, theory-driven regions and frequency bands. Compared across resting baseline, stimulation without noxious stimulus, and stimulation during the cold pressor test.

Time frame
Continuously throughout a single visit, approximately 90 minutes.

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

David A. Purger

Lead sponsor

Indiana University

Sponsor institution

Indiana University Health

Collaborator

Indiana University Health Methodist Hospital

Collaborator

Purdue University

Collaborator

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