ArticlePain2017
Modulation of brainstem activity and connectivity by respiratory-gated auricular vagal afferent nerve stimulation in migraine patients.
Article in Pain, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 81 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pilot, Effect of Respiratory-Gated Auricular Vagal Afferent Nerve Stimulation (RAVANS) on Post-Treatment Lyme Disease Syndrome
Effect Of Percutaneous Electrical Nerve Field Stimulation (PENFS) On Symptom Control And Autonomic Nervous System Activity In Patients With Diabetes Mellitus
Who cites it
81 citing papers in PubMed, 1 synthesis or guideline pooled it, 143 citations in OpenAlex.
- The solitary nucleus connectivity to key autonomic regions in humans.The European journal of neuroscience · 2022Pooled it
- Home-based respiratory-gated transcutaneous auricular vagus nerve stimulation for rheumatoid arthritis-a feasibility study.Clinical rheumatology · 2026Trial
- Auricular point acupressure for older adults with chronic low back pain: a randomized controlled trial.Pain medicine (Malden, Mass.) · 2025Trial
- Safety and preliminary efficacy of transcutaneous auricular vagus nerve stimulation on chronic knee pain: A pilot trial.Osteoarthritis and cartilage open · 2025Trial
- Daily heart rate variability biofeedback training decreases locus coeruleus MRI contrast in younger adults in a randomized clinical trial.International journal of psychophysiology : official journal of the International Organization of Psychophysiology · 2023Trial
- The Effects of Combined Respiratory-Gated Auricular Vagal Afferent Nerve Stimulation and Mindfulness Meditation for Chronic Low Back Pain: A Pilot Study.Pain medicine (Malden, Mass.) · 2022Trial
- Respiratory-gated auricular vagal afferent nerve stimulation (RAVANS) modulates brain response to stress in major depression.Journal of psychiatric research · 2021Trial
- Trial
- Transcutaneous auricular vagus nerve stimulation at 1 Hz modulates locus coeruleus activity and resting state functional connectivity in patients with migraine: An fMRI study.NeuroImage. Clinical · 2019Trial
- Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress.Brain stimulationTrial
- Vagus Nerve Stimulation for Neuromodulation: Evolution from Bench to Bedside.Neurology international · 2026Article
- Prediction of cardiac cycle duration for cardiac-gated closed-loop auricular vagus nerve stimulation.Frontiers in neuroscience · 2026Article
- A sham-controlled randomised trial evaluating the safety, acceptability, and efficacy of autonomic neuromodulation using transcutaneous vagal sensory stimulation in uncontrolled hypertensive patients: rationale and study design of the SCRATCH-HTN study.Frontiers in cardiovascular medicine · 2026Article
- Article
- Non-invasive neuromodulation for alleviating dyspnoea: protocol for a feasibility sham-controlled randomised trial.BMJ open · 2025Article
- Evaluating brain mechanisms of combined vagus nerve stimulation and mindfulness training for migraine: A randomized 2 × 2 factorial clinical trial protocol.Contemporary clinical trials · 2025Article
- Transcutaneous Vagal Nerve Stimulation for Gastrointestinal Disorders.Journal of translational gastroenterology · 2025Article
- Control of spatiotemporal activation of organ-specific fibers in the swine vagus nerve by intermittent interferential current stimulation.Nature communications · 2025Article
- Article
- Future Applications of Central Neuromodulation and Neurophysiological Testing in Cyclic Vomiting Syndrome.Neurogastroenterology and motility · 2025Review
21 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on byReply.2017
Authors and funding
11 authors at 7 institutions in 5 countries.
Funding
Abstract
Migraine pathophysiology includes altered brainstem excitability, and recent neuromodulatory approaches aimed at controlling migraine episodes have targeted key brainstem relay and modulatory nuclei. In this study, we evaluated the impact of respiratory-gated auricular vagal afferent nerve stimulation (RAVANS), a novel neuromodulatory intervention based on an existing transcutaneous vagus nerve stimulation approach, in the modulation of brainstem activity and connectivity in migraine patients. We applied 3T-functional magnetic resonance imaging with improved in-plane spatial resolution (2.62 × 2.62 mm) in episodic migraine (interictal) and age- and sex-matched healthy controls to evaluate brain response to RAVANS (gated to either inhalation or exhalation) and sham stimulation. We further investigated RAVANS modulation of tactile trigeminal sensory afference response in the brainstem using air-puff stimulation directed to the forehead during functional magnetic resonance imaging. Compared with sham and inhalatory-gated RAVANS (iRAVANS), exhalatory-gated RAVANS (eRAVANS) activated an ipsilateral pontomedullary region consistent with nucleus tractus solitarii (NTS). During eRAVANS, NTS connectivity was increased to anterior insula and anterior midcingulate cortex, compared with both sham and iRAVANS, in migraine patients. Increased connectivity was inversely correlated with relative time to the next migraine attack, suggesting clinical relevance to this change in connectivity. Poststimulation effects were also noted immediately after eRAVANS, as we found increased activation in putative pontine serotonergic (ie, nucleus raphe centralis) and noradrenergic (ie, locus coeruleus) nuclei in response to trigeminal sensory afference. Regulation of activity and connectivity of brainstem and cortical regions involved in serotonergic and noradrenergic regulation and pain modulation may constitute an underlying mechanism supporting beneficial clinical outcomes for eRAVANS applied for episodic migraine.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.