Laterality matters: Auricular vagus nerve stimulation shows distinct immunomodulatory effects in fibromyalgia
A randomized, sham-controlled trial investigated the laterality-dependent effects of manual acupuncture stimulation targeting the auricular vagus nerve (aVNS) in women with fibromyalgia (FM). Participants were allocated to receive sham stimulation, right-sided aVNS (aVNS-R), or left-sided aVNS (aVNS-L) over four weeks. While the primary outcome of pain intensity did not show significant between-group differences, left-sided stimulation was associated with a modest reduction in global symptom severity. Crucially, aVNS-L produced a consistent anti-inflammatory biological response, decreasing pro-inflammatory cytokines IL-1β and TNF-α while increasing anti-inflammatory cytokines IL-4 and IL-10, alongside elevated levels of brain-derived neurotrophic factor (BDNF), a marker of neuroplasticity.
Why it might matter to you: This study highlights a novel neuromodulatory approach that directly targets central sensitization and inflammatory pathways, key mechanisms in chronic pain conditions like fibromyalgia. For rheumatology, it suggests that non-invasive stimulation strategies could be refined by considering laterality to optimize immunomodulatory effects, potentially informing adjunctive treatment protocols. The findings underscore the importance of evaluating biological markers alongside clinical pain scores to fully understand therapeutic mechanisms in complex, multi-system disorders.
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