Volume 62, Issue 1 e14754
SPECIAL ISSUE ARTICLE

Transcutaneous Auricular Vagus Nerve Stimulation Does Not Accelerate Fear Extinction: A Randomized, Sham-Controlled Study

Martina D'Agostini

Corresponding Author

Martina D'Agostini

Research Group Health Psychology, KU Leuven, Leuven, Belgium

Emotion Cognition Lab, USC Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA

Correspondence:

Martina D'Agostini ([email protected])

Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Software, Visualization, Writing - original draft, Writing - review & editing

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Lucas Vanden Bossche

Lucas Vanden Bossche

Research Group Health Psychology, KU Leuven, Leuven, Belgium

Contribution: Data curation, ​Investigation, Project administration, Software, Writing - review & editing

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Andreas M. Burger

Andreas M. Burger

Research Group Health Psychology, KU Leuven, Leuven, Belgium

Contribution: Conceptualization, Funding acquisition, Methodology, Software, Writing - review & editing

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Ilse Van Diest

Ilse Van Diest

Research Group Health Psychology, KU Leuven, Leuven, Belgium

Contribution: Conceptualization, Funding acquisition, Methodology, Writing - review & editing

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First published: 08 January 2025
Citations: 4

Funding: This work was supported by postdoctoral mandates PDM/19/051 (A.M.B.) and PDMT2/22/020 (M.D.) of KU Leuven; the Asthenes long-term structural funding (METH/15/011)—Methusalem grant of the Flemish Government (I.V.D., AvL); FWO Strategic basic research PhD fellowship [1SC1719N] (M.D., I.V.D.); by an infrastructure grant from FWO [AKUL/19/06] (AvL, I.V.D.); and by the FWO-sponsored European Research network on tVNS (Wetenschappelijke Onderzoeksgemeenschap WOG W001520N) (I.V.D., A.M.B.).

ABSTRACT

Transcutaneous auricular vagus nerve stimulation (taVNS) has been tested as a strategy to facilitate fear extinction learning based on the hypothesis that taVNS increases central noradrenergic activity. Four studies out of six found taVNS to enhance extinction learning especially at the beginning of extinction. Facilitatory effects of taVNS were mainly observed in US expectancy, less in fear-potentiated startle (FPS), and not in the skin conductance response (SCR). Suboptimal stimulation parameters may explain the reported mixed results. Also, variability in selected fear conditioning paradigms and statistical power impedes the comparability between studies. This study sought to further test whether taVNS accelerates fear extinction learning as indexed by US expectancy, FPS, and SCR. Similar to most previous studies, we employed a differential fear conditioning paradigm. The left ear of 79 healthy participants was stimulated with either sham (earlobe) or taVNS (cymba concha) during extinction learning. To maximize the beneficial effects of taVNS, the stimulation of the left cymba concha was administered continuously at the maximum level below the pain threshold. Results of the pre-registered frequentist and exploratory Bayesian analyses indicate that taVNS did not accelerate extinction learning in any of the outcomes. The null results indicate that taVNS with commonly used stimulation parameters does not reliably optimize fear extinction learning. More research is needed to test if the stimulation protocol determines the efficacy of taVNS in optimizing fear extinction learning.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

Research data are not shared.

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