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• Clinical Article •
Modulation of triple network connectivity in premenstrual syndrome by transcutaneous auricular vagus nerve stimulation: A fMRI study
LIN Shihuan  ZHANG Yan  LAI Yinqi  ZHANG Qingping  CHEN Ya  LAI Ziyan  OU Yuanyuan  LI Shanshan  ZHOU Hui  TUO Sijing  WU Yuejuan  LIU Zhen  DENG Demao 

Cite this article as: LIN S H, ZHANG Y, LAI Y Q, et al. Modulation of triple network connectivity in premenstrual syndrome by transcutaneous auricular vagus nerve stimulation: A fMRI study[J]. Chin J Magn Reson Imaging, 2025, 16(9): 8-14, 27. DOI:10.12015/issn.1674-8034.2025.09.002.


[Abstract] Objective To investigate the immediate effects of transcutaneous auricular vagus nerve stimulation (taVNS) at different stimulation frequencies on abnormal functional connectivity (FC) and functional network connectivity (FNC) within the triple network model (TNM) in patients with premenstrual syndrome (PMS).Materials and Methods This single-center, prospective study enrolled 56 patients with PMS and 67 healthy controls (HC). All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) and clinical assessments before and after taVNS. Independent component analysis (ICA) was used to extract FC and FNC of key brain networks within TNM, including the default mode network (DMN), executive control network (ECN), and salience network (SN). Based on the TNM network templates, two-sample t-tests were conducted to compare differences in FC and FNC between the PMS and HC groups, and correlation analyses were performed between the altered brain regions and clinical psychological scale scores. Furthermore, paired-sample t-tests were used to evaluate the modulatory effects of taVNS at different stimulation frequencies (2 Hz, 25 Hz, and sham stimulation) on abnormal FC and FNC within the TNM in PMS patients.Results Compared to HC, patients with PMS exhibited increased FC within the SN, specifically in the left inferior frontal gyrus (LIFG), insula, and superior temporal gyrus (STG), which positively correlated with emotional, physical, cognitive, and behavioral symptoms (r = 0.377-0.403, P < 0.05, FDR corrected). Altered FNC was also observed, with decreased SN-right ECN (rECN), increased SN-dorsal DMN(dDMN) and dDMN-rECN, the latter negatively associated with physical scores (r = -0.18, P < 0.05, FDR corrected). Following taVNS, both 2 Hz and 25 Hz significantly reduced FC within the SN in PMS patients (P < 0.05, FDR corrected). Specifically, 2 Hz mainly modulated the prefrontal cortex, LIFG, insula, and STG, while 25 Hz predominantly affected the STG. After sham stimulation (st-taVNS), no significant FC changes were observed within the SN in PMS patients. However, 25 Hz-taVNS led to a further decrease in FNC between the SN and rECN (P < 0.05, FDR corrected), whereas no significant changes were observed in the HC group.Conclusions TaVNS modulates abnormal FC and FNC within TNM-related brain networks in PMS patients. The immediate modulation effects vary by stimulation frequency, indicating the potential need for personalized frequency selection based on individual symptoms.
[Keywords] premenstrual syndrome；transcutaneous auricular vagus nerve stimulation；magnetic resonance imaging；functional connectivity；functional network connectivity

LIN Shihuan1   ZHANG Yan2   LAI Yinqi2   ZHANG Qingping2   CHEN Ya3   LAI Ziyan2   OU Yuanyuan2   LI Shanshan2   ZHOU Hui2   TUO Sijing2   WU Yuejuan4   LIU Zhen5   DENG Demao1, 2*  

1 Faculty of Medicine, Guangxi University, Nanning 530004, China

2 Department of Radiology, Guangxi Zhuang Autonomous Region People's Hospital, Nanning 530021, China

3 Department of Radiology, Wuhan No. 1 Hospital, Wuhan 430014, China

4 Department of Neurology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China

5 Department of Gynecology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China

Corresponding author: DENG D M, E-mail: demaodeng@163.com

Conflicts of interest   None.

Received  2025-05-08
Accepted  2025-09-03
DOI: 10.12015/issn.1674-8034.2025.09.002
Cite this article as: LIN S H, ZHANG Y, LAI Y Q, et al. Modulation of triple network connectivity in premenstrual syndrome by transcutaneous auricular vagus nerve stimulation: A fMRI study[J]. Chin J Magn Reson Imaging, 2025, 16(9): 8-14, 27. DOI:10.12015/issn.1674-8034.2025.09.002.

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