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Erschienen in: Clinical Autonomic Research 2/2023

29.04.2023 | Review Article

A systematic review of the effects of transcutaneous auricular vagus nerve stimulation on baroreflex sensitivity and heart rate variability in healthy subjects

verfasst von: Danesh Soltani, Bayan Azizi, Sepehr Sima, Kiarash Tavakoli, Negin Sadat Hosseini Mohammadi, Abdol-Hossein Vahabie, Kaveh Akbarzadeh-Sherbaf, Ali Vasheghani-Farahani

Erschienen in: Clinical Autonomic Research | Ausgabe 2/2023

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Abstract

Purpose

This systematic review aimed to evaluate the effect of transcutaneous auricular vagus nerve stimulation on heart rate variability and baroreflex sensitivity in healthy populations.

Method

PubMed, Scopus, the Cochrane Library, Embase, and Web of Science were systematically searched for controlled trials that examined the effects of transcutaneous auricular vagus nerve stimulation on heart rate variability parameters and baroreflex sensitivity in apparently healthy individuals. Two independent researchers screened the search results, extracted the data, and evaluated the quality of the included studies.

Results

From 2458 screened studies, 21 were included. Compared with baseline measures or the comparison group, significant changes in the standard deviation of NN intervals, the root mean square of successive RR intervals, the proportion of consecutive RR intervals that differ by more than 50 ms, high-frequency power, low-frequency to high-frequency ratio, and low-frequency power were found in 86%, 75%, 69%, 47%, 36%, and 25% of the studies evaluating the effects of transcutaneous auricular vagus nerve stimulation on these indices, respectively. Baroreflex sensitivity was evaluated in six studies, of which a significant change was detected in only one. Some studies have shown that the worse the basic autonomic function, the better the response to transcutaneous auricular vagus nerve stimulation.

Conclusion

The results were mixed, which may be mainly attributable to the heterogeneity of the study designs and stimulation delivery dosages. Thus, future studies with comparable designs are required to determine the optimal stimulation parameters and clarify the significance of autonomic indices as a reliable marker of neuromodulation responsiveness.

Graphical abstract

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Literatur
2.
Zurück zum Zitat Xu J, Murphy SL, Kochanek KD, Arias E (2015) Mortality in the United States. NCHS Data Brief 2016(267):1–8 Xu J, Murphy SL, Kochanek KD, Arias E (2015) Mortality in the United States. NCHS Data Brief 2016(267):1–8
7.
Zurück zum Zitat Curtis BM, Oeefe JH Jr (2002) Autonomic tone as a cardiovascular risk factor: the dangers of chronic fight or flight. Mayo Clin Proc 77:45–54CrossRefPubMed Curtis BM, Oeefe JH Jr (2002) Autonomic tone as a cardiovascular risk factor: the dangers of chronic fight or flight. Mayo Clin Proc 77:45–54CrossRefPubMed
12.
23.
Zurück zum Zitat Higgins JP, Savović J, Page MJ, Sterne JA (2021) Revised Cochrane risk of bias tool for randomized trials (RoB 2) additional considerations for crossover trials. RoB2 Development Group [Internet] Higgins JP, Savović J, Page MJ, Sterne JA (2021) Revised Cochrane risk of bias tool for randomized trials (RoB 2) additional considerations for crossover trials. RoB2 Development Group [Internet]
24.
Zurück zum Zitat Sterne J A, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. bmj 366 Sterne J A, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. bmj 366
25.
Zurück zum Zitat Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ et al (2019) Cochrane handbook for systematic reviews of interventions. John Wiley & SonsCrossRef Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ et al (2019) Cochrane handbook for systematic reviews of interventions. John Wiley & SonsCrossRef
36.
37.
Zurück zum Zitat Villani V, Tsakiris M, Azevedo R (2019) Transcutaneous vagus nerve stimulation improves interoceptive accuracy. Neuropsychologia 134:107201CrossRefPubMed Villani V, Tsakiris M, Azevedo R (2019) Transcutaneous vagus nerve stimulation improves interoceptive accuracy. Neuropsychologia 134:107201CrossRefPubMed
42.
Zurück zum Zitat Bretherton B, Atkinson L, Murray A, Clancy J, Deuchars S, Deuchars J (2019) Effects of transcutaneous vagus nerve stimulation in individuals aged 55 years or above: potential benefits of daily stimulation. Aging (Albany NY) 11(14):4836–4857CrossRefPubMed Bretherton B, Atkinson L, Murray A, Clancy J, Deuchars S, Deuchars J (2019) Effects of transcutaneous vagus nerve stimulation in individuals aged 55 years or above: potential benefits of daily stimulation. Aging (Albany NY) 11(14):4836–4857CrossRefPubMed
43.
Zurück zum Zitat Kleiger RE, Miller JP, Bigger JT Jr, Moss AJ (1987) Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 59(4):256–262CrossRefPubMed Kleiger RE, Miller JP, Bigger JT Jr, Moss AJ (1987) Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 59(4):256–262CrossRefPubMed
44.
Zurück zum Zitat Nolan J, Batin PD, Andrews R, Lindsay SJ, Brooksby P, Mullen M et al (1998) Prospective study of heart rate variability and mortality in chronic heart failure: results of the United Kingdom heart failure evaluation and assessment of risk trial (UK-heart). Circulation 98(15):1510–1516CrossRefPubMed Nolan J, Batin PD, Andrews R, Lindsay SJ, Brooksby P, Mullen M et al (1998) Prospective study of heart rate variability and mortality in chronic heart failure: results of the United Kingdom heart failure evaluation and assessment of risk trial (UK-heart). Circulation 98(15):1510–1516CrossRefPubMed
45.
Zurück zum Zitat Johansson M, Gao SA, Friberg P, Annerstedt M, Carlström J, Ivarsson T et al (2007) Baroreflex effectiveness index and baroreflex sensitivity predict all-cause mortality and sudden death in hypertensive patients with chronic renal failure. J Hypertens 25(1):163–168CrossRefPubMed Johansson M, Gao SA, Friberg P, Annerstedt M, Carlström J, Ivarsson T et al (2007) Baroreflex effectiveness index and baroreflex sensitivity predict all-cause mortality and sudden death in hypertensive patients with chronic renal failure. J Hypertens 25(1):163–168CrossRefPubMed
46.
Zurück zum Zitat La Rovere MT, Bigger JT, Marcus FI, Mortara A, Schwartz PJ (1998) Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. The Lancet 351(9101):478–484CrossRef La Rovere MT, Bigger JT, Marcus FI, Mortara A, Schwartz PJ (1998) Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. The Lancet 351(9101):478–484CrossRef
47.
Zurück zum Zitat Jouven X, Empana J-P, Schwartz PJ, Desnos M, Courbon D, Ducimetière P (2005) Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 352(19):1951–1958CrossRefPubMed Jouven X, Empana J-P, Schwartz PJ, Desnos M, Courbon D, Ducimetière P (2005) Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 352(19):1951–1958CrossRefPubMed
48.
Zurück zum Zitat Kiviniemi AM, Tulppo MP, Hautala AJ, Perkiömäki JS, Ylitalo A, Kesäniemi YA et al (2014) Prognostic significance of impaired baroreflex sensitivity assessed from Phase IV of the Valsalva maneuver in a population-based sample of middle-aged subjects. Am J Cardiol 114(4):571–576CrossRefPubMed Kiviniemi AM, Tulppo MP, Hautala AJ, Perkiömäki JS, Ylitalo A, Kesäniemi YA et al (2014) Prognostic significance of impaired baroreflex sensitivity assessed from Phase IV of the Valsalva maneuver in a population-based sample of middle-aged subjects. Am J Cardiol 114(4):571–576CrossRefPubMed
49.
Zurück zum Zitat Mischel NA, Mueller PJ (2011) (In)activity-dependent alterations in resting and reflex control of splanchnic sympathetic nerve activity. J Appl Physiol 111(6):1854–1862CrossRefPubMedPubMedCentral Mischel NA, Mueller PJ (2011) (In)activity-dependent alterations in resting and reflex control of splanchnic sympathetic nerve activity. J Appl Physiol 111(6):1854–1862CrossRefPubMedPubMedCentral
50.
Zurück zum Zitat Triposkiadis F, Karayannis G, Giamouzis G, Skoularigis J, Louridas G, Butler J (2009) The sympathetic nervous system in heart failure: physiology, pathophysiology, and clinical implications. J Am Coll Cardiol 54(19):1747–1762CrossRefPubMed Triposkiadis F, Karayannis G, Giamouzis G, Skoularigis J, Louridas G, Butler J (2009) The sympathetic nervous system in heart failure: physiology, pathophysiology, and clinical implications. J Am Coll Cardiol 54(19):1747–1762CrossRefPubMed
52.
Zurück zum Zitat Task Force of the European Society of Cardiology the North A Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 93(5):1043–1065CrossRef Task Force of the European Society of Cardiology the North A Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 93(5):1043–1065CrossRef
53.
Zurück zum Zitat Shaffer F, McCraty R, Zerr CL (2014) A healthy heart is not a metronome: an integrative review of the heart’s anatomy and heart rate variability. Front Psychol 5:1040CrossRefPubMedPubMedCentral Shaffer F, McCraty R, Zerr CL (2014) A healthy heart is not a metronome: an integrative review of the heart’s anatomy and heart rate variability. Front Psychol 5:1040CrossRefPubMedPubMedCentral
54.
Zurück zum Zitat Mertens A, Carrette S, Klooster D, Lescrauwaet E, Delbeke J, Wadman WJ et al (2022) Investigating the effect of transcutaneous auricular vagus nerve stimulation on cortical excitability in healthy males. Neuromodulation Technol Neural Interface 5(3):395–406CrossRef Mertens A, Carrette S, Klooster D, Lescrauwaet E, Delbeke J, Wadman WJ et al (2022) Investigating the effect of transcutaneous auricular vagus nerve stimulation on cortical excitability in healthy males. Neuromodulation Technol Neural Interface 5(3):395–406CrossRef
55.
Zurück zum Zitat Machetanz K, Berelidze L, Guggenberger R, Gharabaghi A (2021) Transcutaneous auricular vagus nerve stimulation and heart rate variability: analysis of parameters and targets. Auton Neurosci 236:102894CrossRefPubMed Machetanz K, Berelidze L, Guggenberger R, Gharabaghi A (2021) Transcutaneous auricular vagus nerve stimulation and heart rate variability: analysis of parameters and targets. Auton Neurosci 236:102894CrossRefPubMed
56.
Zurück zum Zitat Umetani K, Singer DH, McCraty R, Atkinson M (1998) Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. J Am Coll Cardiol 31(3):593–601CrossRefPubMed Umetani K, Singer DH, McCraty R, Atkinson M (1998) Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. J Am Coll Cardiol 31(3):593–601CrossRefPubMed
57.
Zurück zum Zitat Messina G, Vicidomini C, Viggiano A, Tafuri D, Cozza V, Cibelli G et al (2012) Enhanced parasympathetic activity of sportive women is paradoxically associated to enhanced resting energy expenditure. Auton Neurosci 169(2):102–106CrossRefPubMed Messina G, Vicidomini C, Viggiano A, Tafuri D, Cozza V, Cibelli G et al (2012) Enhanced parasympathetic activity of sportive women is paradoxically associated to enhanced resting energy expenditure. Auton Neurosci 169(2):102–106CrossRefPubMed
58.
Zurück zum Zitat De Couck M, Mravec B, Gidron Y (2012) You may need the vagus nerve to understand pathophysiology and to treat diseases. Clin Sci 122(7):323–328CrossRef De Couck M, Mravec B, Gidron Y (2012) You may need the vagus nerve to understand pathophysiology and to treat diseases. Clin Sci 122(7):323–328CrossRef
59.
Zurück zum Zitat Entschladen F, Drell TL, Lang K, Joseph J, Zaenker KS (2004) Tumour-cell migration, invasion, and metastasis: navigation by neurotransmitters. Lancet Oncol 5(4):254–258CrossRefPubMed Entschladen F, Drell TL, Lang K, Joseph J, Zaenker KS (2004) Tumour-cell migration, invasion, and metastasis: navigation by neurotransmitters. Lancet Oncol 5(4):254–258CrossRefPubMed
60.
Zurück zum Zitat Haensel A, Mills PJ, Nelesen RA, Ziegler MG, Dimsdale JE (2008) The relationship between heart rate variability and inflammatory markers in cardiovascular diseases. Psychoneuroendocrinology 33(10):1305–1312CrossRefPubMedPubMedCentral Haensel A, Mills PJ, Nelesen RA, Ziegler MG, Dimsdale JE (2008) The relationship between heart rate variability and inflammatory markers in cardiovascular diseases. Psychoneuroendocrinology 33(10):1305–1312CrossRefPubMedPubMedCentral
61.
Zurück zum Zitat Tsutsumi T, Ide T, Yamato M, Kudou W, Andou M, Hirooka Y et al (2008) Modulation of the myocardial redox state by vagal nerve stimulation after experimental myocardial infarction. Cardiovasc Res 77(4):713–721CrossRefPubMed Tsutsumi T, Ide T, Yamato M, Kudou W, Andou M, Hirooka Y et al (2008) Modulation of the myocardial redox state by vagal nerve stimulation after experimental myocardial infarction. Cardiovasc Res 77(4):713–721CrossRefPubMed
62.
Zurück zum Zitat Vlcek M, Radikova Z, Penesova A, Kvetnansky R, Imrich R (2008) Heart rate variability and catecholamines during hypoglycemia and orthostasis. Auton Neurosci 143(1–2):53–57CrossRefPubMed Vlcek M, Radikova Z, Penesova A, Kvetnansky R, Imrich R (2008) Heart rate variability and catecholamines during hypoglycemia and orthostasis. Auton Neurosci 143(1–2):53–57CrossRefPubMed
65.
66.
Zurück zum Zitat Barantke M, Krauss T, Ortak J, Lieb W, Reppel M, Burgdorf C et al (2008) Effects of gender and aging on differential autonomic responses to orthostatic maneuvers. J Cardiovasc Electrophysiol 19(12):1296–1303CrossRefPubMed Barantke M, Krauss T, Ortak J, Lieb W, Reppel M, Burgdorf C et al (2008) Effects of gender and aging on differential autonomic responses to orthostatic maneuvers. J Cardiovasc Electrophysiol 19(12):1296–1303CrossRefPubMed
67.
Zurück zum Zitat Abhishekh HA, Nisarga P, Kisan R, Meghana A, Chandran S, Raju T et al (2013) Influence of age and gender on autonomic regulation of heart. J Clin Monit Comput 27:259–264CrossRefPubMed Abhishekh HA, Nisarga P, Kisan R, Meghana A, Chandran S, Raju T et al (2013) Influence of age and gender on autonomic regulation of heart. J Clin Monit Comput 27:259–264CrossRefPubMed
68.
Zurück zum Zitat Almeida-Santos MA, Barreto-Filho JA, Oliveira JLM, Reis FP, da Cunha Oliveira CC, Sousa ACS (2016) Aging, heart rate variability and patterns of autonomic regulation of the heart. Arch Gerontol Geriatr 63:1–8CrossRefPubMed Almeida-Santos MA, Barreto-Filho JA, Oliveira JLM, Reis FP, da Cunha Oliveira CC, Sousa ACS (2016) Aging, heart rate variability and patterns of autonomic regulation of the heart. Arch Gerontol Geriatr 63:1–8CrossRefPubMed
69.
Zurück zum Zitat Koenig J, Thayer JF (2016) Sex differences in healthy human heart rate variability: a meta-analysis. Neurosci Biobehav Rev 64:288–310CrossRefPubMed Koenig J, Thayer JF (2016) Sex differences in healthy human heart rate variability: a meta-analysis. Neurosci Biobehav Rev 64:288–310CrossRefPubMed
70.
Zurück zum Zitat Krames E, Peckham PH, Rezai AR (2018) Neuromodulation: comprehensive textbook of principles, technologies, and therapies. Academic Press Krames E, Peckham PH, Rezai AR (2018) Neuromodulation: comprehensive textbook of principles, technologies, and therapies. Academic Press
71.
Zurück zum Zitat Polak T, Markulin F, Ehlis AC, Langer JB, Ringel TM, Fallgatter AJ (2009) Far field potentials from brain stem after transcutaneous vagus nerve stimulation: optimization of stimulation and recording parameters. J Neural Transm 116:1237–1242CrossRefPubMed Polak T, Markulin F, Ehlis AC, Langer JB, Ringel TM, Fallgatter AJ (2009) Far field potentials from brain stem after transcutaneous vagus nerve stimulation: optimization of stimulation and recording parameters. J Neural Transm 116:1237–1242CrossRefPubMed
72.
Zurück zum Zitat Kaniusas E, Kampusch S, Tittgemeyer M, Panetsos F, Gines RF, Papa M, et al. (2019) Current directions in the auricular vagus nerve stimulation I–a physiological perspective. Frontiers in neuroscience 854 Kaniusas E, Kampusch S, Tittgemeyer M, Panetsos F, Gines RF, Papa M, et al. (2019) Current directions in the auricular vagus nerve stimulation I–a physiological perspective. Frontiers in neuroscience 854
Metadaten
Titel
A systematic review of the effects of transcutaneous auricular vagus nerve stimulation on baroreflex sensitivity and heart rate variability in healthy subjects
verfasst von
Danesh Soltani
Bayan Azizi
Sepehr Sima
Kiarash Tavakoli
Negin Sadat Hosseini Mohammadi
Abdol-Hossein Vahabie
Kaveh Akbarzadeh-Sherbaf
Ali Vasheghani-Farahani
Publikationsdatum
29.04.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Autonomic Research / Ausgabe 2/2023
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-023-00938-w

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