Transcutaneous Auricular Vagus Nerve Stimulation Combined With Slow Breathing: Speculations on Potential Applications and Technical Considerations

Szulczewski, Mikołaj Tytus

doi:10.1111/ner.13458

Cited by 14 publications

(12 citation statements)

References 288 publications

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“…An important factor that might modulate the effectiveness of taVNS in regulating cardiovascular function is the body's metabolic state (Kozorosky et al, 2022;Sclocco et al, 2019;Szulczewski, 2022). After the caloric load, we found that taVNS decreased HF-HRV and RMSSD further amplifying the reduction in RMSSD and HF-HRV induced by the milkshake.…”

Section: Discussionmentioning

confidence: 78%

“…In addition, small sample sizes (Wolf et al, 2021, meta-analysis: median(N) = 30, range(N) = 7-60 of taVNS studies with within-subject design), lack of a common stimulation protocol, appropriate baseline measurements, and adequate control conditions may contribute to discrepancies across studies. Likewise, other physiological factors, such as the respiratory rate or hormonal balance (Kozorosky et al, 2022;Sclocco et al, 2019;Szulczewski, 2022), interact with the effect of taVNS, indicating a complex interplay between physiological states and taVNS-induced changes. To summarize, pressing questions about the differential effects of taVNS at the left vs. the right ear and the emerging evidence of interactions with metabolic state (Altınkaya et al, 2023;Vosseler et al, 2020) call for additional studies on cardiovascular effects.…”

Section: Introductionmentioning

confidence: 99%

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Non-invasive vagus nerve stimulation decreases vagally mediated heart rate variability

Kaduk,

Petrella,

Müller

et al. 2023

Preprint

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The vagus nerve plays a critical role in balancing the body's physiological functions, including the cardiovascular system. Measures of heart rate (HR) and its variability (HRV) may provide non-invasive proxies of vagal activity in humans, but transcutaneous auricular vagus nerve stimulation (taVNS) has produced mixed effects so far — limited by a lack of studies stimulating the right branch. Here, we used a randomized cross-over design to study the effects of taVNS on HR and HRV. To estimate how the side of the stimulation (left vs. right ear) affects cardiovascular function, we recorded an electrocardiogram in four sessions per person (factors: Stimulation x Side). To evaluate potential interactions with physiological states, we investigated three phases per session: baseline, during stimulation (taVNS vs. sham), and after consuming a milkshake (~400 kcal) with concurrent stimulation. First, we found moderate evidence against an effect of taVNS on HR (BF10=0.21). Second, taVNS decreased HRV (multivariate p =.004) independent of physiological state with strong evidence for RMSSD (BF10=15.11) and HF-HRV (BF10=11.80). Third, taVNS-induced changes were comparable across sides and more strongly correlated (vs. sham), indicating similar cardiovascular effects independent of the stimulation side. We conclude that taVNS reduces HRV without altering HR, contradicting the common assumption that increased HRV indexes a heightened vagal tone. Instead, our results support a putative role of vagal afferent activation in arousal. Crucially, modulatory effects on the cardiovascular system can be safely elicited by taVNS on both sides, opening new options for treatment.

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Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Non-invasive vagus nerve stimulation decreases vagally mediated heart rate variability

Kaduk,

Petrella,

Müller

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…For example, Schlatter et al (2021) found that combined tDCS with HRV biofeedback (breath at 0.1 frequency) significantly reduced participants’ subjective stress. An insightful review pointed out that, considering the similarity of the mechanism and effects of taVNS and SPB, and their possible interactions at the level of the central autonomic network, this kind of hybrid intervention might have potential applications in both clinical and non-clinical areas ( Szulczewski, 2022 ). However, as the various neuromodulation techniques involve complex mechanisms, their combination might induce antagonistic effects ( Schabrun et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

“…Considering the unique effects of taVNS and SPB on cognition and their potential interaction, employing them simultaneously may lead to greater improvement in WM performance, i.e., a synergistic effect. Of note, a recent review commented that combining taVNS with SPB might produce positive effects via both interventions, which is certainly worth exploring ( Szulczewski, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Combined effect of transcutaneous auricular vagus nerve stimulation and 0.1 Hz slow-paced breathing on working memory

Tian

Cheng²,

Liu³

et al. 2023

Front. Neurosci.

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BackgroundPrevious research has found that transcutaneous auricular vagus nerve stimulation (taVNS) can improve working memory (WM) performance. It has also been shown that 0.1 Hz slow-paced breathing (SPB, i.e., breathing at a rate of approximately 6 breaths/min) can significantly influence physical state and cognitive function via changes in autonomic afferent activity. In the present study, we investigated the synergistic effects of taVNS and SPB on WM performance.MethodsA total of 96 healthy people participated in this within-subjects experiment involving four conditions, namely taVNS, SPB, combined taVNS with SPB (taVNS + SPB), and sham. Each participant underwent each intervention for 30 min and WM was compared pre- and post-intervention using the spatial and digit n-back tasks in a random order four times. Permutation-based analysis of variance was used to assess the interaction between time and intervention.ResultsFor the spatial 3-back task, a significant interaction between time and intervention was found for the accuracy rate of matching trials (mACC, p = 0.03). Post hoc analysis suggested that both taVNS and taVNS + SPB improved WM performance, however, no significant difference was found in the SPB or sham groups.ConclusionThis study has replicated the effects of taVNS on WM performance reported in previous studies. However, the synergistic effects of combined taVNS and SPB warrant further research.

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“…While this study focused on the effects of harmonic frequency breathing on blood pressure and autonomic balance, several studies have investigated how respiration affects other functions from a physiological or psychological perspective [ 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. One study showed that controlling breathing cycles to the harmonic breathing frequency of eight cycles per minute caused a decrease in anxiety levels compared with free respiration.…”

Section: Discussionmentioning

confidence: 99%

Effects of Temporary Respiration Exercise with Individual Harmonic Frequency on Blood Pressure and Autonomic Balance

Mun

Park

Whang

et al. 2022

IJERPH

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This study investigated the effects of modulated respiration on blood pressure and autonomic balance to develop a healthcare application system for stabilizing autonomic balance. Thirty-two participants were asked to perform self-regulated tasks with 18 different respiration sequences, and their electrocardiograms (ECG) and blood pressure were measured. Changes in cardiovascular system functions and blood pressure were compared between free-breathing and various respiration conditions. Systolic and diastolic blood pressures stabilized after individual harmonic breathing. Autonomic balance, characterized by heart rate variability, was also stabilized with brief respiration training according to harmonic frequency. Five machine-learning algorithms were used to classify the two opposing factors between the free and modulated breathing conditions. The random forest models outperformed the other classifiers in the training data of systolic blood pressure and heart rate variability. The mean areas under the curves (AUCs) were 0.82 for systolic blood pressure and 0.98 for heart rate variability. Our findings lend support that blood pressure and autonomic balance were improved by temporary harmonic frequency respiration. This study provides a self-regulated respiration system that can control and help stabilize blood pressure and autonomic balance, which would help reduce mental stress and enhance human task performance in various fields.

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Transcutaneous Auricular Vagus Nerve Stimulation Combined With Slow Breathing: Speculations on Potential Applications and Technical Considerations

Cited by 14 publications

References 288 publications

Non-invasive vagus nerve stimulation decreases vagally mediated heart rate variability

Non-invasive vagus nerve stimulation decreases vagally mediated heart rate variability

Combined effect of transcutaneous auricular vagus nerve stimulation and 0.1 Hz slow-paced breathing on working memory

Effects of Temporary Respiration Exercise with Individual Harmonic Frequency on Blood Pressure and Autonomic Balance

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