{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T23:46:14Z","timestamp":1770507974429,"version":"3.49.0"},"reference-count":106,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2014,11,7]],"date-time":"2014-11-07T00:00:00Z","timestamp":1415318400000},"content-version":"unspecified","delay-in-days":2655,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS spectr."],"published-print":{"date-parts":[[2007,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Research advances have led to three methods for selectively activating one half of the autonomic nervous system in humans.The first method is an ancient yogic technique called unilateral forced nostril breathing (UFNB) that employs forced breathing through only one nostril while closing off the other. The second method works by stimulation of an autonomic reflex point on the fifth intercostal space near the axilla. The most recent method employs unilateral vagus nerve stimulation (VNS) via the mid-inferior cervical branch and requires surgical implantation of a wire and pacemaker. UFNB is non-invasive and seems to selectively activate the ipsilateral branch of the sympathetic nervous system with a possible compensation effect leading to contralateral VNS. UFNB and VNS have been employed to treat psychiatric disorders. While UFNB has been studied for its potential effects on the endogenous ultradian rhythms of the autonomic and central nervous system, and their tightly coupled correlates, VNS has yet to be studied in this regard. This article reviews these three methods and discusses their similarities, putative mechanisms, their studied effects on the endogenous autonomic nervous system and central nervous system rhythms, and their implications for the treatment of psychiatric disorders.<\/jats:p>","DOI":"10.1017\/s1092852900021428","type":"journal-article","created":{"date-parts":[[2016,8,2]],"date-time":"2016-08-02T00:55:45Z","timestamp":1470099345000},"page":"625-634","source":"Crossref","is-referenced-by-count":25,"title":["Selective Unilateral Autonomic Activation: <i>Implications for Psychiatry<\/i>"],"prefix":"10.1017","volume":"12","author":[{"given":"David S.","family":"Shannahoff-Khalsa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2014,11,7]]},"reference":[{"key":"S1092852900021428_ref103","doi-asserted-by":"publisher","DOI":"10.1016\/S0193-953X(05)70196-9"},{"key":"S1092852900021428_ref102","first-page":"224","article-title":"A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures","volume":"45","year":"1999","journal-title":"Neurology"},{"key":"S1092852900021428_ref101","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301082"},{"key":"S1092852900021428_ref100","first-page":"6","article-title":"A qualitative analysis of nonresponse: management of treatment-refractory obsessive-compulsive disorder","volume":"65","author":"Pallanti","year":"2004","journal-title":"J Clin Psychiatry"},{"key":"S1092852900021428_ref099","doi-asserted-by":"publisher","DOI":"10.1017\/S109285290000225X"},{"key":"S1092852900021428_ref098","doi-asserted-by":"publisher","DOI":"10.1017\/S1461145703003250"},{"key":"S1092852900021428_ref097","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(01)01343-9"},{"key":"S1092852900021428_ref096","unstructured":"Sackeim HA , Rush AJ , Marangell LB , et al. Long-term antidepressant effects of vagus nerve stimulation (VNS) in treatment-resistant depression. Paper presented at: Annual Meeting of the American College of Neuropsychopharmacology. December 12\u201316, 2004; San Juan, PR."},{"key":"S1092852900021428_ref092","doi-asserted-by":"publisher","DOI":"10.1016\/S0893-133X(01)00271-8"},{"key":"S1092852900021428_ref088","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1996.00550110128021"},{"key":"S1092852900021428_ref087","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000244532.71743.c6"},{"key":"S1092852900021428_ref086","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.51.1.48"},{"key":"S1092852900021428_ref084","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.8.1731"},{"key":"S1092852900021428_ref083","first-page":"351","article-title":"Posture and nasal patency","volume":"129","author":"Cole","year":"1984","journal-title":"Am Rev Respir Dis"},{"key":"S1092852900021428_ref090","volume-title":"VNS Therapy\u2122 Pulse Model 102 Generator and VNS Therapy\u2122 Pulse Duo Model 102R Generator","year":"2004"},{"key":"S1092852900021428_ref081","first-page":"1","article-title":"Unilateral nasal resistance and asymmetrical body pressure","volume":"16","author":"Haight","year":"1986","journal-title":"J Otolaryngol Suppl"},{"key":"S1092852900021428_ref080","doi-asserted-by":"publisher","DOI":"10.3109\/00016488409130968"},{"key":"S1092852900021428_ref079","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1970.28.2.162"},{"key":"S1092852900021428_ref078","doi-asserted-by":"publisher","DOI":"10.2170\/jjphysiol.1.22"},{"key":"S1092852900021428_ref077","first-page":"31","article-title":"Skin pressure-vegetative reflex","volume":"4","author":"Takagi","year":"1955","journal-title":"Acta Med et Biol"},{"key":"S1092852900021428_ref071","first-page":"32","article-title":"Modulation of pulse rate by unilateral nostril breathing","volume":"20","author":"Mohan","year":"2002","journal-title":"J Indian Psychol"},{"key":"S1092852900021428_ref070","doi-asserted-by":"publisher","DOI":"10.3109\/00207459308987210"},{"key":"S1092852900021428_ref064","doi-asserted-by":"publisher","DOI":"10.3109\/00207458908991614"},{"key":"S1092852900021428_ref063","first-page":"1197","article-title":"Changes in blood glucose levels induced by differential forced unilateral nostril breathing, a technique which affects both brain hemisphericity and autonomic activity","volume":"16","author":"Backon","year":"1988","journal-title":"Med Science Res"},{"key":"S1092852900021428_ref060","doi-asserted-by":"publisher","DOI":"10.3109\/00016486009122404"},{"key":"S1092852900021428_ref058","first-page":"82","article-title":"Research on the homolateral reflex of the nasal cavity on the lung","volume":"14","author":"Sercer","year":"1930","journal-title":"Acta Otolaryng"},{"key":"S1092852900021428_ref057","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852900006805"},{"key":"S1092852900021428_ref056","doi-asserted-by":"publisher","DOI":"10.3109\/00207459608986347"},{"key":"S1092852900021428_ref055","doi-asserted-by":"publisher","DOI":"10.1006\/brcg.1995.1279"},{"key":"S1092852900021428_ref068","first-page":"R578","article-title":"Ultradian adrenocortical and circulatory oscillations in conscious dogs","volume":"258","author":"Benton","year":"1990","journal-title":"Am J Physiol"},{"key":"S1092852900021428_ref054","doi-asserted-by":"publisher","DOI":"10.2466\/pms.1994.79.3f.1499"},{"key":"S1092852900021428_ref053","doi-asserted-by":"publisher","DOI":"10.1016\/0278-2626(89)90028-6"},{"key":"S1092852900021428_ref052","unstructured":"Baglio S , Bucolo M , Fortuna L , et al. MEG signals spatial power distribution and gamma band activity in yoga breathing exercises. Paper presented at: Conference Proceedings of the IEEE Engineering in Medicine and Biology Society. October 23-26, 2002; Houston, Tex."},{"key":"S1092852900021428_ref049","doi-asserted-by":"publisher","DOI":"10.3109\/00207459109150697"},{"key":"S1092852900021428_ref046","first-page":"165","article-title":"Selective hemispheric stimulation by unilateral forced nostril breathing","volume":"6","author":"Werntz","year":"1987","journal-title":"Hum Neurobiol"},{"key":"S1092852900021428_ref045","unstructured":"Werntz DA , Bickford RG , Bloom FE , et al. Selective cortical activation by altering autonomic function. Abstract presented at: Annual Meeting of the Western EEG Society Meeting. February 21, 1981; Reno, Nev."},{"key":"S1092852900021428_ref062","first-page":"580","article-title":"Tierexperimentelle Untersuchungen uber den Weg des Inspirationsstromes jeder Nasenseite in die Lunge [German]","volume":"64","author":"Wotzilka","year":"1930","journal-title":"Mschr Ohrenheilk"},{"key":"S1092852900021428_ref043","volume-title":"Kundalini Yoga Meditation: Techniques Specific for Psychiatric Disorders, Couples Therapy, and Personal Growth","author":"Shannahoff-Khalsa","year":"2006"},{"key":"S1092852900021428_ref041","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1152\/ajplegacy.1968.215.3.560","article-title":"Effects of vagal stimulation on S-A and A-V nodes","volume":"215","author":"Hamlin","year":"1968","journal-title":"Am J Physiol"},{"key":"S1092852900021428_ref040","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1975.38.1.108"},{"key":"S1092852900021428_ref039","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1973.sp010179"},{"key":"S1092852900021428_ref038","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.19.3.650"},{"key":"S1092852900021428_ref037","volume-title":"Neural Control of the Heart","author":"Levy","year":"1979"},{"key":"S1092852900021428_ref036","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.59.6_suppl_4.S3"},{"key":"S1092852900021428_ref035","doi-asserted-by":"publisher","DOI":"10.1002\/cne.900670104"},{"key":"S1092852900021428_ref034","doi-asserted-by":"publisher","DOI":"10.1016\/0024-3205(81)90698-6"},{"key":"S1092852900021428_ref033","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/5.4.311"},{"key":"S1092852900021428_ref031","doi-asserted-by":"publisher","DOI":"10.1002\/9780470719220.ch18"},{"key":"S1092852900021428_ref030","doi-asserted-by":"publisher","DOI":"10.1016\/0024-3205(86)90175-X"},{"key":"S1092852900021428_ref029","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(00)00066-6"},{"key":"S1092852900021428_ref028","doi-asserted-by":"publisher","DOI":"10.3109\/00207450008986490"},{"key":"S1092852900021428_ref027","first-page":"R962","article-title":"Low-frequency ultradian insulin rhythms are coupled to cardiovascular, autonomic, and neuroendocrine rhythms","volume":"272","author":"Shannahoff-Khalsa","year":"1997","journal-title":"Am J Physiol"},{"key":"S1092852900021428_ref025","doi-asserted-by":"publisher","DOI":"10.3109\/00016485309132516"},{"key":"S1092852900021428_ref024","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-192708000-00008"},{"key":"S1092852900021428_ref032","volume-title":"Phylogenetic, Ontogenetic and Environmental Determinants in the Evolution of Sleep-Wakefulness Cycles","author":"Kleitman","year":"1967"},{"key":"S1092852900021428_ref082","doi-asserted-by":"publisher","DOI":"10.1177\/000348948609500305"},{"key":"S1092852900021428_ref095","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v66n0902"},{"key":"S1092852900021428_ref050","doi-asserted-by":"publisher","DOI":"10.3109\/00207459308987211"},{"key":"S1092852900021428_ref073","first-page":"133","article-title":"Breathing through a particular nostril can alter metabolism and autonomic activities","volume":"38","author":"Telles","year":"1994","journal-title":"Indian J Physiol Pharmacol"},{"key":"S1092852900021428_ref047","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1981.tb04116.x"},{"key":"S1092852900021428_ref012","doi-asserted-by":"publisher","DOI":"10.1007\/BF02322411"},{"key":"S1092852900021428_ref091","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(99)00304-2"},{"key":"S1092852900021428_ref004","doi-asserted-by":"publisher","DOI":"10.1007\/BF01677525"},{"key":"S1092852900021428_ref044","unstructured":"Werntz DA , Bickford RG , Bloom FE , et al. Cerebral Hemispheric Activity and Autonomic Nervous Function. Paper presented at: 10th Annual Meeting of the Society for Neuroscience. November 9-14, 1980; Cincinnati, Oh."},{"key":"S1092852900021428_ref007","first-page":"155","volume-title":"Arch Anat Phsyiol (Physiol Abt)","author":"Karplus","year":"1914"},{"key":"S1092852900021428_ref059","first-page":"3","article-title":"Researches with the bilateral troncopneumograph on the movements of the respiratory mechanisms during breathing","volume":"35","author":"Samzelius-Lejdstrom","year":"1939","journal-title":"Acta Otolaryng"},{"key":"S1092852900021428_ref048","doi-asserted-by":"publisher","DOI":"10.1016\/0301-0511(86)90077-3"},{"key":"S1092852900021428_ref104","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2005.01.004"},{"key":"S1092852900021428_ref051","doi-asserted-by":"publisher","DOI":"10.2466\/pms.104.4.1289-1296"},{"key":"S1092852900021428_ref093","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.05.024"},{"key":"S1092852900021428_ref094","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.05.025"},{"key":"S1092852900021428_ref066","doi-asserted-by":"publisher","DOI":"10.1023\/B:INTE.0000006764.65209.06"},{"key":"S1092852900021428_ref003","doi-asserted-by":"publisher","DOI":"10.1016\/S0079-6123(00)26005-6"},{"key":"S1092852900021428_ref019","first-page":"39","article-title":"Alternating cerebral hemispheric activity and the lateralization of autonomic nervous function","volume":"2","author":"Werntz","year":"1983","journal-title":"Hum Neurobiol"},{"key":"S1092852900021428_ref042","first-page":"79","article-title":"Unilateral forced nostril breathing: basic science, clinical trials, and selected advanced techniques","volume":"12","author":"Shannahoff-Khalsa","year":"2001","journal-title":"Subtle Energies Energy Med J"},{"key":"S1092852900021428_ref069","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.1974.324299"},{"key":"S1092852900021428_ref076","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3950\/jibiinkoka.72.49","article-title":"Air flow and resistance in the nasal cavity. 2. Bilateral rhinometry using a pneumotachometer. Its principles and clinical application [Japanese]","volume":"72","author":"Konno","year":"1969","journal-title":"Nippon Jibiinkoka Gakkai Kaiho"},{"key":"S1092852900021428_ref009","first-page":"400","article-title":"Hypothalamic mechanisms","volume":"26","author":"Beattie","year":"1932","journal-title":"Can Med Assoc J"},{"key":"S1092852900021428_ref017","first-page":"101","article-title":"Die exacta messung der luftdurchgangigkeit der nase [German]","volume":"3","author":"Kayser","year":"1895","journal-title":"Archives of Laryngology and Rhinology"},{"key":"S1092852900021428_ref106","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijdevneu.2007.03.005"},{"key":"S1092852900021428_ref075","first-page":"875","article-title":"Automatic attentive breathing in angina pectoris","volume":"31","author":"Friedell","year":"1948","journal-title":"Minn Med"},{"key":"S1092852900021428_ref011","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/59.3.302"},{"key":"S1092852900021428_ref026","first-page":"R873","article-title":"Ultradian rhythms of autonomic, cardiovascular, and neuroendocrine systems are related in humans","volume":"270","author":"Shannahoff-Khalsa","year":"1996","journal-title":"Am J Physiol"},{"key":"S1092852900021428_ref067","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-004-0200-4"},{"key":"S1092852900021428_ref006","first-page":"107","article-title":"Gehirn und sympathicus. III. Sympathicusleitung im gehirn und halsmark [German]","volume":"143","author":"Karplus","year":"1912","journal-title":"Pfluger Arch Gesamte Physiol"},{"key":"S1092852900021428_ref065","doi-asserted-by":"publisher","DOI":"10.1007\/BF02169455"},{"key":"S1092852900021428_ref072","doi-asserted-by":"publisher","DOI":"10.1080\/00207450212019"},{"key":"S1092852900021428_ref105","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(99)00318-2"},{"key":"S1092852900021428_ref089","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.2000.tb00325.x"},{"key":"S1092852900021428_ref013","volume-title":"Diencephalon, Autonomic and Extrapyridimal Functions","author":"Hess","year":"1954"},{"key":"S1092852900021428_ref085","doi-asserted-by":"publisher","DOI":"10.1016\/0920-1211(94)00083-9"},{"key":"S1092852900021428_ref001","doi-asserted-by":"publisher","DOI":"10.1016\/0006-8993(76)90738-1"},{"key":"S1092852900021428_ref002","doi-asserted-by":"publisher","DOI":"10.1002\/cne.902370103"},{"key":"S1092852900021428_ref005","doi-asserted-by":"publisher","DOI":"10.1007\/BF01680226"},{"key":"S1092852900021428_ref008","first-page":"1","volume-title":"Handbook of Chemical Neuroanatomy, Vol. 5, Integrated Systems of the CNS","author":"Swanson","year":"1987"},{"key":"S1092852900021428_ref010","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1934.sp003128"},{"key":"S1092852900021428_ref014","doi-asserted-by":"publisher","DOI":"10.1016\/0167-8760(91)90017-R"},{"key":"S1092852900021428_ref015","volume-title":"Stress Technology Medicine, A New Paradigm for Stress and Considerations for Self-regulation","author":"Shannahoff-Khalsa","year":"1991"},{"key":"S1092852900021428_ref061","doi-asserted-by":"publisher","DOI":"10.1177\/000348947007900311"},{"key":"S1092852900021428_ref016","volume-title":"International Review of Neurobiology","volume":"80","author":"Shannahoff-Khalsa"},{"key":"S1092852900021428_ref018","doi-asserted-by":"publisher","DOI":"10.1007\/BF02102047"},{"key":"S1092852900021428_ref020","doi-asserted-by":"publisher","DOI":"10.3109\/00207459309000583"},{"key":"S1092852900021428_ref021","first-page":"96","article-title":"Uber den Weg der Athmungsluft durch die Nase [German]","volume":"20","author":"Kayser","year":"1889","journal-title":"Z Ohrerlheilh"},{"key":"S1092852900021428_ref022","doi-asserted-by":"publisher","DOI":"10.1080\/000164800750000388"},{"key":"S1092852900021428_ref074","doi-asserted-by":"publisher","DOI":"10.1089\/acm.1996.2.479"},{"key":"S1092852900021428_ref023","first-page":"20","article-title":"Variations resistance in man: a rhinomanometric study of cycle in 50 human subjects","volume":"16","author":"Hasegawa","year":"1978","journal-title":"Rhinology"}],"container-title":["CNS Spectrums"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1092852900021428","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T17:45:46Z","timestamp":1556732746000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1092852900021428\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,8]]},"references-count":106,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2007,8]]}},"alternative-id":["S1092852900021428"],"URL":"https:\/\/doi.org\/10.1017\/s1092852900021428","relation":{},"ISSN":["1092-8529","2165-6509"],"issn-type":[{"value":"1092-8529","type":"print"},{"value":"2165-6509","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,8]]}}}