A team at the University of Leeds used a standard TENS machine like those designed to relieve labour pains to apply electrical pulses to the tragus, the small raised flap at the front of the ear immediately in front of the ear canal.
The stimulation changed the influence of the nervous system on the heart by reducing the nervous signals that can drive failing hearts too hard.
Professor Jim Deuchars, Professor of Systems Neuroscience in the University of Leeds’ Faculty of Biological Sciences, said: “You feel a bit of a tickling sensation in your ear when the TENS machine is on, but it is painless. It is early days—so far we have been testing this on healthy subjects—but we think it does have potential to improve the health of the heart and might even become part of the treatment for heart failure.”
The researchers applied electrodes to the ears of 34 healthy people and switched on the TENS (Transcutaneous electrical nerve stimulation) machines for 15-minute sessions. They monitored the variability of subjects’ heartbeats and the activity of the part of the nervous system that drives the heart. Monitoring continued for 15 minutes after the TENS machine was switched off.
Lead researcher Dr Jennifer Clancy, of the University of Leeds’ School of Biomedical Sciences, said: “The first positive effect we observed was increased variability in subjects’ heartbeats. A healthy heart does not beat like a metronome. It is continually interacting with its environment—getting a little bit faster or a bit slower depending on the demands on it. An unhealthy heart is more like a machine constantly banging out the same beat. We found that when you stimulate this nerve you get about a 20% increase in heart rate variability.”
The second positive effect was in suppressing the sympathetic nervous system, which drives heart activity using adrenaline.
Dr Clancy said: “We measured the nerve activity directly and found that it reduced by about 50% when we stimulated the ear. This is important because if you have heart disease or heart failure, you tend to have increased sympathetic activity. This drives your heart to work hard, constricts your arteries and causes damage. A lot of treatments for heart failure try to stop that sympathetic activity—beta-blockers, for instance, block the action of the hormones that implement these signals. Using the TENS, we saw a reduction of the nervous activity itself.”
The researchers found significant residual effects, with neither heart rate variability or sympathetic nerve activity returning to the baseline 15 minutes after the TENS machine had been switched off.
The technique works by stimulating a major nerve called the vagus, which has an important role in regulating vital organs such as the heart. There is a sensory branch of the vagus in the outer ear and, by sending electrical current down the nerves and into the brain, researchers were able to influence outflows from the brain that regulate the heart. Vagal nerve stimulation has previously been used to treat conditions including epilepsy.
Professor Deuchars said: “We now need to understand how big and how lasting the residual effect on the heart is and whether this can help patients with heart problems, probably alongside their usual treatments. The next stage will be to conduct a pre-clinical study in heart failure patients.”
The research is published today in the journal Brain Stimulation and was funded by the University of Leeds.
Graham Askew, Simon Walker, BBSRC (Jan 2018), £699,781
Jennifer Tomlinson, Royal Society (Jan 2018), £512,801
Jennifer Tomlinson, Royal Society-Research Fellows Enhancement Award (Dec 2017), £94,681
Helen Miller, AB AGri Grant (Dec 2017), £73,600
Simon Walker, Royal Society Enhancement Award (Dec 2017), £10,000
Carrie Ferguson, Bryan Taylor, Harry Rossiter, The Physiological Society (Dec 2017), £7,392
Ralf Richter, Royal Society (Dec 2017), £6,000
Christine Foyer, British Council Newton Fund (Dec 2017), £49,840
Adrian Whitehouse and colleagues in School of Chemistry and University of Liverpool, MRC (Nov 2017), £622,319
Michelle Peckham, Neil Ransom, MRC (Nov 2017), £495,159
Dave Lewis, British Council India (Nov 2017), £22,540
Elton Zeqiraj, Royal Society (Nov 2017), £15,000
Hannah Dugdale, Royal Society (Nov 2017), £15,000
Shaunna Burke, Cancer Research UK Innovation Grant (Nov 2017), £20,000
Alex O'Neill and colleagues in Chemistry, BBSRC (Nov 2017), £431,865
Jessica Kwok, Wings for Life (Nov 2017), £87,365
Tom Bennett, BBSRC (Oct 2017), £523,679
Neil Ranson, Darren Tomlinson, BBSRC (Oct 2017), £494,318
Nikita Gamper, BBSRC (Oct 2017), £490,426
Amanda Bretman and colleagues from UEA, NERC (Oct 2017), £430,886
Juan Fontana, Rosetrees Trust consumables grant (Oct 2017), £22,500
Helen Miller, DSM Nutritional Products AG (Sep 2017), £69,988
Neil Ranson, Juan Fontana, Mark Harris, Michelle Peckham, Ralf Richter, Peter Stockley, Patricija Van Oosten-Hawle and colleagues in Engineering, FMH and MAPS, Wellcome Trust Equipment Call (Sep 2017), £418,000
Jamie Johnston, Physiological Society (Sep 2017), £10,000
Frank Sobott, Adrian Goldman, Mark Harris, Andrew Macdonald, Stephen Muench, Sheena Radford and colleagues in FMH and MAPS, Wellcome Trust Equipment Call (Aug 2017), £415,000
Ralf Richter, David Brockwell, Eric Hewitt, Jessica Kwok, Emanuele Paci and MAPS/FMH, BBSRC (Jun 2017), £600,000
Eric Blair, Adrian Whitehouse, Nicola Stonehouse, Alison Baker, Richard Bayliss, Joan Boyes, Ryan Seipke, Sally Boxall and MAPS/FMH, BBSRC (Jun 2017), £376,000
Stefan Kepinski, Yoselin Benitez-Alfonso, Tom Bennett, Michelle Peckham, BBSRC (Jun 2017), £331,000
Roman Tuma, Lars Jeuken, Paul Millner, Sheena Radford, Peter Stockley and MAPS/FMH, BBSRC (Jun 2017), £222,000
Vas Ponnambalam, Darren Tomlinson, Stephen Wheatcroft, BHF (May 2017), £107,878
Graham Askew in collaboration with Bangor University, BBSRC (Mar 2017), £477,383
Stephen Muench, BBSRC (Mar 2017), £132,945
Nic Stonehouse, MRC (Mar 2017), £906,341
Bill Kunin, Steve Sait, BBSRC (Mar 2017), £602,831
Adrian Goldman, EU (Mar 2017), £546,576
Sheena Radford, Wellcome Trust (Mar 2017), £1,836,482
Beatrice Filippi, Royal Society (Mar 2017), £15,000
Tom Bennett, Royal Society (Mar 2017), £15,000
Jamie Johnston, Royal Society (Mar 2017), £15,000
Ryan Seipke, BBSRC (Feb 2017), £52,116
Mary O'Connell, BBSRC (Feb 2017), £46,986
Hannah Dugdale, NERC (Feb 2017), £504,138
Anastasia Zhuravleva, EPSRC (Jan 2017), £100,792