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

Soltani, Danesh; Azizi, Bayan; Sima, Sepehr; Tavakoli, Kiarash; Mohammadi, Negin; Vahabie, Abdol-Hossein; Akbarzadeh-Sherbaf, Kaveh; Vasheghani‐Farahani, Ali

doi:10.1007/s10286-023-00938-w

Cited by 8 publications

(4 citation statements)

References 67 publications

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“…Previous studies have shown that increased CPT1α contributes to VSMC proliferation, migration and survival, while excessive glucose metabolism damages VSMCs (Adhikari et al 2011 ; Hall et al 2001 ; Kaiser et al 1993 ; Peiró et al 2016 ; Vesely et al 2009 ; Wall et al 2018 ). In the present study, VNS obviously increased the expression of SDF-1α and CPT1α/β in VSMCs in infarcted hearts, leading to more α-SMA-positive vessels, which was consistent with the effects of SDF-1α and CPT1α/β on coronary sprouting and lymphangiogenesis (Das et al 2019 ; Marín-Juez et al 2019 ; Schoors et al 2015 ; Wong et al 2017 ). These results indicated that the optimized VSMC metabolism pattern induced by VNS could be involved in arteriogenesis and angiogenesis.…”

Section: Discussionsupporting

confidence: 89%

VNS improves VSMC metabolism and arteriogenesis in infarcted hearts through m/n-AChR-Akt-SDF-1α in adult male rats

Li,

Liu,

Wang

et al. 2024

J Mol Histol

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Vagal nerve stimulation (VNS) provides a novel therapeutic strategy for injured hearts by activating cholinergic anti-inflammatory pathways. However, little information is available on the metabolic pattern and arteriogenesis of VSMCs after MI. VNS has been shown to stimulate the expression of CPT1α, CPT1β, Glut1, Glut4 and SDF-1α in coronary VSMCs, decreasing the number of CD68-positive macrophages while increasing CD206-positive macrophages in the infarcted hearts, leading to a decrease in TNF-α and IL-1β accompanied by a reduced ratio of CD68- and CD206-positive cells, which were dramatically abolished by atropine and mecamylamine in vivo. Knockdown of SDF-1α substantially abrogated the effect of VNS on macrophagecell alteration and inflammatory factors in infarcted hearts. Mechanistically, ACh induced SDF-1α expression in VSMCs in a dose-dependent manner. Conversely, atropine, mecamylamine, and a PI3K/Akt inhibitor completely eliminated the effect of ACh on SDF-1α expression. Functionally, VNS promoted arteriogenesis and improved left ventricular performance, which could be abolished by Ad-shSDF-1α. Thus, VNS altered the VSMC metabolism pattern and arteriogenesis to repair the infarcted heart by inducing SDF-1α expression, which was associated with the m/nAChR-Akt signaling pathway.

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Section: Discussionsupporting

confidence: 89%

VNS improves VSMC metabolism and arteriogenesis in infarcted hearts through m/n-AChR-Akt-SDF-1α in adult male rats

Li,

Liu,

Wang

et al. 2024

J Mol Histol

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“…Findings also have implications for adopting a tailored approach when considering the therapeutic uses of tANS. A recent systematic review has highlighted some similar points (41) and in agreement with one major outcome of that review, we conclude that further research in optimising tANS stimulation parameters, the most effective set-up for specific target groups may be established.…”

Section: Discussionsupporting

confidence: 85%

The autonomic effects of transcutaneous auricular nerve stimulation at different sites on the external auricle of the ear

Bretherton,

Murray,

Deuchars

et al. 2023

Preprint

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Transcutaneous auricular nerve stimulation (tANS) applied to specific parts of the external ear has positive health effects in both healthy volunteers and patient groups. However, due to differences between studies in ear stimulation sites and extent of effect on autonomic variables, it is challenging to determine what part of the external ear is the optimum site for electrode placement. This study investigated the autonomic effects of bilateral tANS at four different sites on the external auricle of the ear: tragus, cymba concha, helix and earlobe. tANS was performed using modified surface electrodes connected to a transcutaneous electrical nerve stimulation (TENS) machine. Participants (n = 24) each underwent four sessions where a 15 minute period of stimulation (pulse width: 200 micro seconds; pulse frequency: 30 Hz; current: adjusted to sensory threshold) was applied bilaterally to either the tragus, cymba concha, helix or earlobe. Heart rate and blood pressure were continuously recorded during 10-minute baseline, 15-minute stimulation and 10-minute recovery periods. Heart rate variability (HRV) was derived. Results showed that regardless of site, stimulation significantly influenced measures of HRV. Baseline LF/HF ratio predicted change in LF/HF ratio during stimulation for each site and for all sites combined. Response (i.e. change in LF/HF ratio between baseline and stimulation) was closely linked with measures reflecting starting autonomic function. This demonstrates the importance of evaluating how autonomic function is modulated by tANS in individual participants (as well as the whole group). These findings have key implications for adopting a tailored approach when considering the therapeutic/clinical applications of tANS.

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“…HRV is regarded as a noninvasive tool for assessing autonomic function ( Gitler et al, 2022 ), and is essential to systematically examine how iaES affects ANS. HRV could be used to assess the impact of this intervention on autonomic function, and could potentially be utilized as a predictive biomarker of iaES responsiveness since it could be used to select the right individuals, stimulation sites, and stimulation dosage to optimize neuromodulation therapies ( Soltani et al, 2023 ). Using this marker as a response evaluation tool in iaES could reflect response to treatment in real-time and allow optimization of patient selection and stimulation dosage.…”

Section: Discussionmentioning

confidence: 99%

State- and frequency-dependence in autonomic rebalance mediated by intradermal auricular electroacupuncture stimulation

Yang,

Wu,

Zhan

et al. 2024

Front. Neurosci.

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BackgroundVagus nerve stimulation (VNS) improves diseases such as refractory epilepsy and treatment-resistant depression, likely by rebalancing the autonomic nervous system (ANS). Intradermal auricular electro-acupuncture stimulation (iaES) produces similar effects. The aim of this study was to determine the effects of different iaES frequencies on the parasympathetic and sympathetic divisions in different states of ANS imbalance.MethodsWe measured heart rate variability (HRV) and heart rate (HR) of non-modeled (normal) rats with the treatment of various frequencies to determine the optimal iaES frequency. The optimized iaES frequency was then applied to ANS imbalance model rats to elucidate its effects.Results30 Hz and 100 Hz iaES clearly affected HRV and HR in normal rats. 30 Hz iaES increased HRV, and decreased HR. 100 Hz iaES decreased HRV, and increased HR. In sympathetic excited state rats, 30 Hz iaES increased HRV. 100 Hz iaES increased HRV, and decreased HR. In parasympathetic excited state rats, 30 Hz and 100 Hz iaES decreased HRV. In sympathetic inhibited state rats, 30 Hz iaES decreased HRV, while 100 Hz iaES decreased HR. In parasympathetic inhibited rats, 30 Hz iaES decreased HR and 100 Hz iaES increased HRV.Conclusion30 Hz and 100 Hz iaES contribute to ANS rebalance by increasing vagal and sympathetic activity with different amplifications. The 30 Hz iaES exhibited positive effects in all the imbalanced states. 100 Hz iaES suppressed the sympathetic arm in sympathetic excitation and sympathetic/parasympathetic inhibition and suppressed the vagal arm and promoted the sympathetic arm in parasympathetic excitation and normal states.

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

Cited by 8 publications

References 67 publications

VNS improves VSMC metabolism and arteriogenesis in infarcted hearts through m/n-AChR-Akt-SDF-1α in adult male rats

VNS improves VSMC metabolism and arteriogenesis in infarcted hearts through m/n-AChR-Akt-SDF-1α in adult male rats

The autonomic effects of transcutaneous auricular nerve stimulation at different sites on the external auricle of the ear

State- and frequency-dependence in autonomic rebalance mediated by intradermal auricular electroacupuncture stimulation

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