Unlocking the Potential of tVNS in Cognitive Aging

Published on July 11, 2023

Just as a treasure map leads to hidden riches, research on transcutaneous Vagus Nerve Stimulation (tVNS) could lead to groundbreaking interventions for cognitive aging. With the population imbalance shifting toward older adults, there is an urgent need to identify ways to improve cognitive function and prevent the onset of dementia. This review explores the unique opportunities that tVNS offers in combating diseases of aging, such as depression and mild cognitive impairment. By examining recent literature and discussing the feasibility of remote data collection methods, it becomes apparent that tVNS has tremendous potential. However, limitations including small sample sizes and lack of standardized protocols hinder our understanding of its full impact. To unlock the true potential of tVNS, researchers must focus on improving representativeness, statistical power, and generalizability through the integration of remote data collection techniques. By delving deeper into this exciting field of study, we may discover new strategies to enhance cognition and improve the lives of older adults.

Differentiating healthy from pathological aging trajectories is extremely timely, as the global population faces an inversion where older adults will soon outnumber younger 5:1. Many cognitive functions (e.g., memory, executive functions, and processing speed) decline with age, a process that can begin as early as midlife, and which predicts subsequent diagnosis with dementia. Although dementia is a devastating and costly diagnosis, there remains limited evidence for medications, therapies, and devices that improve cognition or attenuate the transition into dementia. There is an urgent need to intervene early in neurodegenerative processes leading to dementia (e.g., depression and mild cognitive impairment). In this targeted review and commentary, we highlight transcutaneous Vagus Nerve Stimulation (tVNS) as a neurostimulation method with unique opportunities for applications in diseases of aging, reviewing recent literature, feasibility of use with remote data collection methods/telehealth, as well as limitations and conflicts in the literature. In particular, small sample sizes, uneven age distributions of participants, lack of standardized protocols, and oversampling of non-representative groups (e.g., older adults with no comorbid diagnoses) limit our understanding of the potential of this method. We offer recommendations for how to improve representativeness, statistical power, and generalizability of tVNS research by integrating remote data collection techniques.

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