Journal Article

Vagus Nerve Stimulation Increases Energy Expenditure: Relation to Brown Adipose Tissue Activity

Rijkers, Kim, Vijgen, Guy H. E. J., van Marken Lichtenbelt, Wouter D., Cornips, Erwin, Bouvy, Nicole D., Leenen, Loes, Brans, Boudewijn, Majoie, Marian

2013

Overview

Human brown adipose tissue (BAT) activity is inversely related to obesity and positively related to energy expenditure. BAT is highly innervated and it is suggested the vagus nerve mediates peripheral signals to the central nervous system, there connecting to sympathetic nerves that innervate BAT. Vagus nerve stimulation (VNS) is used for refractory epilepsy, but is also reported to generate weight loss. We hypothesize VNS increases energy expenditure by activating BAT. Fifteen patients with stable vns therapy (age: 45 ± 10 yrs; body mass index; 25.2 ± 3.5 kg/m(2)) were included between January 2011 and June 2012. Ten subjects were measured twice, once with active and once with inactivated VNS. Five other subjects were measured twice, once with active VNS at room temperature and once with active VNS under cold exposure in order to determine maximal cold-induced BAT activity. BAT activity was assessed by 18-Fluoro-Deoxy-Glucose-Positron-Emission-Tomography-and-Computed-Tomography. Basal metabolic rate (BMR) was significantly higher when VNS was turned on (mean change; +2.2%). Mean BAT activity was not significantly different between active VNS and inactive VNS (BAT SUV(Mean); 0.55 ± 0.25 versus 0.67 ± 0.46, P = 0.619). However, the change in energy expenditure upon VNS intervention (On-Off) was significantly correlated to the change in BAT activity (r = 0.935, P<0.001). VNS significantly increases energy expenditure. The observed change in energy expenditure was significantly related to the change in BAT activity. This suggests a role for BAT in the VNS increase in energy expenditure. Chronic VNS may have a beneficial effect on the human energy balance that has potential application for weight management therapy. The study was registered in the Clinical Trial Register under the ClinicalTrials.gov Identifier NCT01491282.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adipose tissue / Adipose tissue (brown) / Adipose Tissue, Brown - metabolism / Adult / Analysis of Variance / Body fat / Body mass / Body mass index / Body size / Body weight loss / Calorimetry, Indirect / Care and treatment / Central nervous system / Cold / Cold Temperature / Computed tomography / Diabetes / Emission analysis / Energy / Energy balance / Energy expenditure / Energy management / Energy Metabolism - physiology / Epilepsy / Epilepsy - therapy / Female / Gastrointestinal surgery / Humans / Male / Metabolic rate / Metabolism / Middle Aged / Nerves / Nervous system / Neurosurgery / Nutrition / Obesity / Patients / Positron emission tomography / Rodents / Stimulation / Studies / Sympathetic nerves / Therapy / Thermogenesis / Tomography / Toxicology / Vagus nerve / Vagus Nerve Stimulation / Weight control / Weight loss