Stimulation du nerf vague comme traitement de la peur et de l'anxiété chez les personnes avec un diagnostic de troubles du spectre de l'autisme

Aperçu: G.M.

Les troubles anxieux touchent un grand pourcentage de personnes avec un diagnostic de trouble du spectre de l'autisme (dTSA). Chez les enfants avec un dTSA, une anxiété excessive est également liée à des problèmes gastro-intestinaux, à des comportements d'automutilation et à des symptômes dépressifs. Les thérapies cognitivo-comportementales basées sur l'exposition sont des traitements efficaces pour les troubles anxieux chez les enfants avec un dTSA, mais des taux de rechute élevés indiquent la nécessité de stratégies de traitement supplémentaires. 

Cette perspective discute des preuves issues de la recherche préclinique, qui indiquent que la stimulation du nerf vague (SNV) associée à l'exposition à des stimuli et à des situations provoquant la peur pourrait offrir des avantages en tant que traitement adjuvant des troubles anxieux qui coexistent avec les TSA. 

La stimulation du nerf vague est approuvée pour une utilisation dans le traitement de l'épilepsie, de la dépression et, plus récemment, comme adjuvant dans l'entraînement de réadaptation après un AVC. 

Dans les modèles précliniques, la SNV semble prometteuse pour améliorer simultanément la consolidation des souvenirs d'extinction et réduire l'anxiété. Dans cette revue, nous présenterons les mécanismes potentiels par lesquels la SNV pourrait traiter la peur et l'anxiété dans les TSA. 

Nous discutons également des utilisations potentielles de la SNV pour traiter la dépression et l'épilepsie dans le contexte des TSA, et des méthodes non invasives pour stimuler le nerf vague.

 

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. 2022;7(4):e220007.

doi: 10.20900/jpbs.20220007. Epub 2022 Sep 23.

Vagus Nerve Stimulation as a Treatment for Fear and Anxiety in Individuals with Autism Spectrum Disorder

Tanushree Shivaswamy  ¹ , Rimenez R Souza  ¹ , Crystal T Engineer  ¹ , Christa K McIntyre  ¹

Affiliations

• PMID: 36303861
• PMCID: PMC9600938
• DOI: 10.20900/jpbs.20220007

Abstract

Anxiety disorders affect a large percentage of individuals who have an autism spectrum disorder (ASD). In children with ASD, excessive anxiety is also linked to gastrointestinal problems, self-injurious behaviors, and depressive symptoms. Exposure-based cognitive behavioral therapies are effective treatments for anxiety disorders in children with ASD, but high relapse rates indicate the need for additional treatment strategies. This perspective discusses evidence from preclinical research, which indicates that vagus nerve stimulation (VNS) paired with exposure to fear-provoking stimuli and situations could offer benefits as an adjuvant treatment for anxiety disorders that coexist with ASD. Vagus nerve stimulation is approved for use in the treatment of epilepsy, depression, and more recently as an adjuvant in rehabilitative training following stroke. In preclinical models, VNS shows promise in simultaneously enhancing consolidation of extinction memories and reducing anxiety. In this review, we will present potential mechanisms by which VNS could treat fear and anxiety in ASD. We also discuss potential uses of VNS to treat depression and epilepsy in the context of ASD, and noninvasive methods to stimulate the vagus nerve.

Keywords: behavioral therapy; exposure therapy; neurodevelopmental disorders; neuromodulation; rehabilitation.

Conflict of interest statement

CONFLICTS OF INTEREST CT Engineer is married to an employee of MicroTransponder, Inc. CK McIntyre is an author of a patent entitled “Methods for Enhancing Exposure Therapy using Vagus Nerve Stimulation”.

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