Exploring the impact of transcutaneous vagus nerve stimulation in subjects with and without burnout: Potential benefits for executive function and neural processing.

Introduction: Many brain disorders and conditions, including occupational burnout, are linked with challenges in executive function (EF). Yet, there is a lack of treatments geared at restoring them. We have previously demonstrated that VNS enhances EF in patients with epilepsy and that transcutaneous VNS (tVNS) modulates the underlying neural processes in healthy subjects. In this study, we investigated the immediate impact of tVNS on EF in subjects with and without occupational burnout. Material and methods: We hypothesized that tVNS enhances EF, as reflected in both behavioral and neural levels. Subjects with (n = 27) and without burnout (n = 24) performed an integrated computer-based test of EF, the Executive Reaction Time (RT) test. At the same time, EEG was recorded and tVNS or sham stimulation was delivered to each subject in an alternating manner. Event-related potentials, N2 and P3, peak and interpeak amplitudes, and latencies were used to evaluate the speed and allocation of neural processes linked with EFs and errors and RTs to assess performance. Results: Frontal N2-P3 interpeak latency (IPL) in the NoGo condition was shorter with active tVNS (m = 157.6 ms (IQR = 59.2 ms)) than with sham (m = 169.6 ms (IQR = 88.4 ms), p = 0.01). Further, active tVNS reduced total errors in healthy subjects. Conclusion: Active tVNS resulted in partly accelerated neural processing in the context of response inhibition in both groups and enhanced EF performance in subjects without burnout. We suggest that tVNS enhances neural processes underlying EFs in specific situations. Even though caution is warranted, tVNS shows some promise as a potential cognitive enhancer.