The effect of auricular vagus nerve stimulation on pain and pulse rate variability in women with migraine

There is a need to develop new treatments for migraine, which is a chronic and neurological disease. It was aimed to determine which application would be preferable and to evaluate the variables of pain and pulse rate on female patients with migraine, who were divided into three groups as "unilateral-right", "unilateral-left" and "bilateral" transcutaneous auricular vagus nerve stimulation (taVNS). Sixty women between the ages of 18-55 who were diagnosed with migraine by a neurologist were included in the study. Before and after stimulation, pain with Numerical Pain Rating Scale, migraine-induced loss on work, school, housework and social activities with Headache Impact Test (HIT-6), pulse rate variability (RMSSD, LF/HF) with autonomic nervous system and blood pressure was evaluated with digital sphygmomanometer. Auricular vagus nerve stimulation was applied to all participants in all three groups with the VAGUSTIM device. In the evaluations made for the study, the degree of significance was calculated as p<0.05. According to the results of the analysis, it was determined that the groups were homogeneously distributed and there were no significant differences between the groups in terms of parameters such as BMI, age, education level, smoking status (p>0.05). In group comparisons; Pain, Headache Impact Test (HIT-6), pulse, systolic and diastolic blood pressure decreased in all three groups (p<0.05). There was an increase in RMSSD measured from the left point finger in the unilateral-right ear stimulation group (p<0.05). In the comparisons made between the groups, an increase in LF/HF values was observed in the measurements taken from the right and left point fingers after the stimulation applied from the unilateral-left ear. This can be interpreted as unilateral-left ear stimulation may increase sympathetic activation in migraine patients. Therefore, it was concluded that unilateral-right and bilateral ear transcutaneous auricular vagus nerve stimulation, which provides an increase in RMSSD value and a decrease in LF/HF value, can be preferred among the parameters showing increased parasympathetic activation in migraine patients.