A growing body of evidence suggests that transcutaneous auricular vagus nerve stimulation (taVNS) may relieve symptoms of migraineurs. Frequency is one of the key stimulation parameters. The aim of this study is to investigate the modulation effect of taVNS frequency on the descending pain modulation system (DPMS) in patients with migraine. Twenty-four episodic migraineurs without aura (21 females) were recruited for the single-blind, crossover, functional magnetic resonance imaging (fMRI) study. Each participant attended two separate fMRI scan sessions, one for 1 Hz and another for 20 Hz taVNS, in a random order. Seed-based functional connectivity analysis was applied using the ventrolateral periaqueductal gray (PAG) as the region of interest. Compared with the pre-taVNS resting state, continuous 1 Hz taVNS (during) produced a significant increase in functional connectivity between the PAG and the bilateral middle cingulate cortex (MCC), right precuneus, left middle frontal gyrus (MFG), and left cuneus. Compared with 20 Hz taVNS, 1 Hz taVNS produced greater PAG connectivity increases with the MCC, right precuneus/posterior cingulate cortex, left insula, and anterior cingulate cortex (ACC). A significant negative correlation was observed between the number of migraine attacks in the previous 4 weeks and the PAG-MCC functional connectivity in the pre-taVNS resting-state before 1 Hz taVNS. Our findings suggest that taVNS with different frequencies may produce different modulation effects on the descending pain modulation system, demonstrating the important role of stimulation frequency in taVNS treatment.

中文翻译：

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1Hz和20Hz经皮耳迷走神经刺激对偏头痛患者导水管周围灰质功能连接的不同调制作用

越来越多的证据表明，经皮耳部迷走神经刺激 (taVNS) 可以缓解偏头痛的症状。频率是关键的刺激参数之一。本研究的目的是研究 tavns 频率对偏头痛患者下行疼痛调制系统 (DPMS) 的调制作用。招募了 24 名无先兆的偶发性偏头痛患者（21 名女性）进行单盲、交叉、功能性磁共振成像 (fMRI) 研究。每个参与者都参加了两个单独的 fMRI 扫描会议，一个用于 1 Hz，另一个用于 20 Hz tavNS，以随机顺序进行。使用腹外侧导水管周围灰质 (PAG) 作为感兴趣区域应用基于种子的功能连接分析。与 taVNS 前的静息状态相比，连续 1 Hz tavNS（期间）使 PAG 与双侧中扣带皮层 (MCC)、右侧楔前叶、左侧额中回 (MFG) 和左侧楔叶之间的功能连接显着增加。与 20 Hz tavns 相比，1 Hz tavns 产生更大的 PAG 连接增加与 MCC、右楔前叶/后扣带皮层、左岛叶和前扣带皮层 (acc)。在前 4 周的偏头痛发作次数与 1 Hz tavns 之前的 pre-taVNS 静息状态下的 PAG-MCC 功能连接之间观察到显着的负相关。我们的研究结果表明，不同频率的 tavns 可能对下行疼痛调制系统产生不同的调制作用，证明刺激频率在 tavns 治疗中的重要作用。