目的:本系统评价旨在评估经皮耳迷走神经刺激对健康人群心率变异性和压力反射敏感性的影响。
方法:PubMed,Scopus,Cochrane图书馆,Embase,和WebofScience进行了系统搜索,以研究经皮耳廓迷走神经刺激对明显健康个体的心率变异性参数和压力反射敏感性的影响。两名独立研究人员筛选了搜索结果,提取数据,并对纳入研究的质量进行评价。
结果:来自2458项筛选研究,包括21个。与基线测量或对照组相比,NN区间标准偏差的显著变化,连续RR间隔的均方根,差异超过50毫秒的连续RR间隔的比例,高频电源,低频与高频比,低频电力占86%,75%,69%,47%,36%,25%的研究评估经皮耳迷走神经刺激对这些指标的影响,分别。在六项研究中评估了压力反射敏感性,其中只有一个检测到显著的变化。一些研究表明,基本自主功能越差,经皮耳迷走神经刺激反应越好。
结论:结果喜忧参半,这可能主要归因于研究设计和刺激递送剂量的异质性。因此,未来需要具有可比设计的研究来确定最佳刺激参数,并阐明自主神经指数作为神经调节反应性的可靠标志物的重要性.
This systematic
review aimed to evaluate the effect of transcutaneous auricular vagus nerve stimulation on heart rate variability and
baroreflex sensitivity in healthy populations.
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.
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.
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.