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Transcutaneous auricular vagus nerve stimulation (taVNS) for migraine: an fMRI study
  1. Yue Zhang1,
  2. Yiting Huang2,
  3. Hui Li3,
  4. Zhaoxian Yan1,
  5. Ying Zhang1,
  6. Xian Liu1,
  7. Xiaoyan Hou1,
  8. Weicui Chen1,
  9. Yiheng Tu2,
  10. Sierra Hodges2,
  11. Helen Chen2,
  12. Bo Liu1 and
  13. Jian Kong2
  1. 1 Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
  2. 2 Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  3. 3 Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
  1. Correspondence to Jian Kong, Massachusetts General Hospital, Boston, USA; JKONG2{at}; Bo Liu, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China; liubogzcm{at}


Background Dysfunction of the thalamocortical connectivity network is thought to underlie the pathophysiology of the migraine. This current study aimed to explore the thalamocortical connectivity changes during 4 weeks of continuous transcutaneous vagus nerve stimulation (taVNS) treatment on migraine patients.

Methods 70 migraine patients were recruited and randomized in an equal ratio to receive real taVNS or sham taVNS treatments for 4 weeks. Resting-state functional MRI was collected before and after treatment. The thalamus was parceled into functional regions of interest (ROIs) on the basis of six priori-defined cortical ROIs covering the entire cortex. Seed-based functional connectivity analysis between each thalamic subregion and the whole brain was further compared across groups after treatment.

Results Of the 59 patients that finished the study, those in the taVNS group had significantly reduced number of migraine days, pain intensity and migraine attack times after 4 weeks of treatment compared with the sham taVNS. Functional connectivity analysis revealed that taVNS can increase the connectivity between the motor-related thalamus subregion and anterior cingulate cortex/medial prefrontal cortex, and decrease the connectivity between occipital cortex-related thalamus subregion and postcentral gyrus/precuneus.

Conclusion Our findings suggest that taVNS can relieve the symptoms of headache as well as modulate the thalamocortical circuits in migraine patients. The results provide insights into the neural mechanism of taVNS and reveal potential therapeutic targets for migraine patients.

  • complementary therapies
  • transcutaneous electric nerve stimulation
  • treatment outcome
  • chronic pain

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  • YZ and YH contributed equally.

  • Contributors Design and conceptualized study: YZ, BL and JK; Analyze and interpret the data: YH, JK and YT; Acquisition of data: YZ, HL, ZY, YZ, XL, XYH and WC; Manuscript preparation: YH, SH, HC and JK; Funding acquisition: YZ and BL.

  • Funding This study was supported by the Medical Scientific Research Foundation of Guangdong Province of China (A2017234) and the Administration of Traditional Chinese Medicine of Guangdong Province of China (20182047).

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval This study protocol was approved by the Institutional Review Board of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. Data are available on reasonable request, contact email: