Clinical application of transcutaneous auricular vagus nerve stimulation: a scoping review

Transcutaneous auricular vagus nerve stimulation (taVNS) is an emerging non-invasive neuromodulation therapy. This study aimed to explore the therapeutic use of taVNS, optimal stimulation parameters, effective sham protocols, and safety. A scoping review was conducted. Five databases and grey literature were searched. The data extracted included stimulation parameters, adverse events (AEs), and therapeutic effects on clinical outcomes. 109 studies were included. taVNS was used across 21 different clinical populations, most commonly in psychiatric, cardiac, and neurological disorders. Overall, 2,214 adults received active taVNS and 1,017 received sham taVNS. Reporting of stimulation parameters was limited and inconsistent. taVNS appeared to have a favourable therapeutic effect across a wide range of clinical populations with varied parameters. Three sham protocols were reported but their effectiveness was documented in only two of the 54 sham-controlled studies. Most reported adverse events were localised to stimulation site. There is growing evidence for taVNS therapeutic effect. taVNS appears safe and tolerable. Sham protocols need evaluation. Standardised and comprehensive reporting of both stimulation parameters and adverse events is required. Two different questionnaires have been proposed to evaluate adverse events and the effectiveness of sham methods in blinding participants. Transcutaneous auricular vagus nerve stimulation (taVNS) showed therapeutic effect across a wide range of clinical populations including depression, epilepsy, and strokeThere is a preliminary indication that daily/weekly dose and overall duration of treatment are important to show therapeutic effectivenessWhen using taVNS as an intervention, the questionnaires proposed in this review should be used to evaluate blinding effectiveness and adverse events Transcutaneous auricular vagus nerve stimulation (taVNS) showed therapeutic effect across a wide range of clinical populations including depression, epilepsy, and stroke There is a preliminary indication that daily/weekly dose and overall duration of treatment are important to show therapeutic effectiveness When using taVNS as an intervention, the questionnaires proposed in this review should be used to evaluate blinding effectiveness and adverse events

经皮耳迷走神经刺激（Transcutaneous auricular vagus nerve stimulation, taVNS）是一种新兴的非侵入性神经调控疗法。本研究旨在探索taVNS的治疗用途、最优刺激参数、有效假刺激方案及其安全性。本次研究采用范围综述（scoping review）方法，检索了5个数据库及灰色文献，提取的数据包括刺激参数、不良事件（adverse events, AEs）以及对临床结局的治疗效果。本次综述共纳入109项研究，taVNS的应用覆盖21类不同临床人群，其中最常见的应用场景为精神疾病、心脏疾病及神经系统疾病。总计2214名成人接受了活性taVNS治疗，1017名接受了假刺激taVNS治疗。现有研究对刺激参数的报告存在局限性且不一致。taVNS在多种临床人群中使用不同参数时均展现出良好的治疗效果。研究报告了3种假刺激方案，但仅在54项假刺激对照研究中的2项中验证了其有效性。多数报告的不良事件均局限于刺激部位。目前关于taVNS治疗效果的证据正日益增多，taVNS看起来安全且耐受性良好。假刺激方案仍需开展进一步评估。当前亟需对刺激参数与不良事件进行标准化、全面的报告。本综述提出了两种不同的问卷，用于评估不良事件及假刺激方法对受试者的盲法效果。经皮耳迷走神经刺激（taVNS）对包括抑郁症、癫痫、中风在内的多种临床人群均展现出治疗效果；有初步迹象表明，每日/每周治疗剂量及总治疗时长对体现治疗有效性至关重要；在将taVNS作为干预手段时，应使用本综述提出的问卷评估盲法效果与不良事件。经皮耳迷走神经刺激（taVNS）对包括抑郁症、癫痫、中风在内的多种临床人群均展现出治疗效果；有初步迹象表明，每日/每周治疗剂量及总治疗时长对体现治疗有效性至关重要；在将taVNS作为干预手段时，应使用本综述提出的问卷评估盲法效果与不良事件。