Cardiovascular effects of auricular stimulation -a systematic review and meta-analysis of randomized controlled clinical trials
BackgroundThe number of randomized controlled trials using auricular stimulation (AS) such as transauricular vagus nerve stimulation, or other auricular electrostimulation or auricular acupuncture or acupressure, in experimental and clinical settings, has increased markedly over the last three decad...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1227858/full |
| _version_ | 1797729009890492416 |
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| author | Kevin Hua Mike Cummings Miriam Bernatik Benno Brinkhaus Taras Usichenko Taras Usichenko Joanna Dietzel |
| author_facet | Kevin Hua Mike Cummings Miriam Bernatik Benno Brinkhaus Taras Usichenko Taras Usichenko Joanna Dietzel |
| author_sort | Kevin Hua |
| collection | DOAJ |
| description | BackgroundThe number of randomized controlled trials using auricular stimulation (AS) such as transauricular vagus nerve stimulation, or other auricular electrostimulation or auricular acupuncture or acupressure, in experimental and clinical settings, has increased markedly over the last three decades. This systematic review focusses on cardiovascular effects of auricular stimulation.Methods and analysisThe following databases were searched: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. RCTs were reviewed that had been published in English and European languages. Data collection and analysis was conducted by two reviewers independently. Quality and risk assessment of included studies was performed and the meta-analysis of the effect of the most frequently assessed biomarkers.ResultsAltogether, 78 trials were included. 38 studies assessed heart rate (HR), 19 studies analyzed heart rate variability (HRV), 31 studies analyzed blood pressure (BP) and 7 studies were identified that measured oxygen saturation (O2), 2 studies on baroreflex sensitivity and 2 studies on skin conductance were evaluated in this review. 26 studies contained continuous data and were eligible for meta-analysis, 50 trials reported non continuous data and were evaluated descriptively. The overall quality of the studies was moderate to low. AS leads to a significant reduction of HR, the changes though were not considered an adverse reaction. Furthermore, when looking at HRV, AS was able to reduce the LF/HF ratio significantly compared to control procedures. No other cardiovascular parameters (blood pressure, oxygen saturation, baroreflex sensitivity) were changed significantly. AS produced only minor side effects in all trials.ConclusionAS can lead to clinically safe reduction of HR and changes in the LF/HF ratio of the HRV, which is presumably via an increase in vagal activity. More research is needed to clarify whether AS can be used to modulate tachycardia or indications with autonomic imbalance.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=231885 PROSPERO, ID CRD42021231885. |
| first_indexed | 2024-03-12T11:22:39Z |
| format | Article |
| id | doaj.art-097234fb478d430fb58cebe9ce3df669 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-12T11:22:39Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-097234fb478d430fb58cebe9ce3df6692023-09-01T14:10:29ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-09-011710.3389/fnins.2023.12278581227858Cardiovascular effects of auricular stimulation -a systematic review and meta-analysis of randomized controlled clinical trialsKevin Hua0Mike Cummings1Miriam Bernatik2Benno Brinkhaus3Taras Usichenko4Taras Usichenko5Joanna Dietzel6Institute for Social Medicine, Epidemiology and Health Economics, Berlin Institute of Health, Charité - University Medicine, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyBritish Medical Acupuncture Society, London, United KingdomInternational Society for Chinese Medicine, Munich, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Berlin Institute of Health, Charité - University Medicine, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment for Anesthesiology, University Hospital Greifswald, Greifswald, GermanyDepartment of Anesthesia, McMaster University, Hamilton, ON, CanadaInstitute for Social Medicine, Epidemiology and Health Economics, Berlin Institute of Health, Charité - University Medicine, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyBackgroundThe number of randomized controlled trials using auricular stimulation (AS) such as transauricular vagus nerve stimulation, or other auricular electrostimulation or auricular acupuncture or acupressure, in experimental and clinical settings, has increased markedly over the last three decades. This systematic review focusses on cardiovascular effects of auricular stimulation.Methods and analysisThe following databases were searched: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. RCTs were reviewed that had been published in English and European languages. Data collection and analysis was conducted by two reviewers independently. Quality and risk assessment of included studies was performed and the meta-analysis of the effect of the most frequently assessed biomarkers.ResultsAltogether, 78 trials were included. 38 studies assessed heart rate (HR), 19 studies analyzed heart rate variability (HRV), 31 studies analyzed blood pressure (BP) and 7 studies were identified that measured oxygen saturation (O2), 2 studies on baroreflex sensitivity and 2 studies on skin conductance were evaluated in this review. 26 studies contained continuous data and were eligible for meta-analysis, 50 trials reported non continuous data and were evaluated descriptively. The overall quality of the studies was moderate to low. AS leads to a significant reduction of HR, the changes though were not considered an adverse reaction. Furthermore, when looking at HRV, AS was able to reduce the LF/HF ratio significantly compared to control procedures. No other cardiovascular parameters (blood pressure, oxygen saturation, baroreflex sensitivity) were changed significantly. AS produced only minor side effects in all trials.ConclusionAS can lead to clinically safe reduction of HR and changes in the LF/HF ratio of the HRV, which is presumably via an increase in vagal activity. More research is needed to clarify whether AS can be used to modulate tachycardia or indications with autonomic imbalance.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=231885 PROSPERO, ID CRD42021231885.https://www.frontiersin.org/articles/10.3389/fnins.2023.1227858/fullauricular acupunctureauricular stimulationcardiovascularrandomized controlled trialssystematic reviewtransauricular vagus nerve stimulation |
| spellingShingle | Kevin Hua Mike Cummings Miriam Bernatik Benno Brinkhaus Taras Usichenko Taras Usichenko Joanna Dietzel Cardiovascular effects of auricular stimulation -a systematic review and meta-analysis of randomized controlled clinical trials Frontiers in Neuroscience auricular acupuncture auricular stimulation cardiovascular randomized controlled trials systematic review transauricular vagus nerve stimulation |
| title | Cardiovascular effects of auricular stimulation -a systematic review and meta-analysis of randomized controlled clinical trials |
| title_full | Cardiovascular effects of auricular stimulation -a systematic review and meta-analysis of randomized controlled clinical trials |
| title_fullStr | Cardiovascular effects of auricular stimulation -a systematic review and meta-analysis of randomized controlled clinical trials |
| title_full_unstemmed | Cardiovascular effects of auricular stimulation -a systematic review and meta-analysis of randomized controlled clinical trials |
| title_short | Cardiovascular effects of auricular stimulation -a systematic review and meta-analysis of randomized controlled clinical trials |
| title_sort | cardiovascular effects of auricular stimulation a systematic review and meta analysis of randomized controlled clinical trials |
| topic | auricular acupuncture auricular stimulation cardiovascular randomized controlled trials systematic review transauricular vagus nerve stimulation |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1227858/full |
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