Background

Transcutaneous auricular vagus nerve stimulation (taVNS) may modulate cardiac autonomic function. However, the response rate of the traditional tonic paradigm is low, and the results remain inconsistent. A recent pilot study presented a novel burst paradigm to activate the cardiac parasympathetic system, which might offer a new approach to treat cardiac autonomic function. The present study reassessed the effect of burst taVNS on modulating heart rate variability and explored the difference between burst and traditional tonic paradigms.

Materials and Methods

Forty-two young adults were recruited for this study. Each participant underwent three types of taVNS with sham (30 sec of stimulation), tonic (25 Hz, 500 μsec), and burst (five pulses at 500 Hz every 200 msec) paradigms, respectively, with simultaneous electrocardiogram recording. One-way analysis of variance, multivariate analysis of variance, and linear regression were used for analysis. Multiple testing was performed using Bonferroni correction.

Results

Both burst and tonic paradigms induced a significant decrease in heart rate, which continued until poststimulation, and increased cardiac parasympathetic activity. Moreover, two parasympathetic system indicators showed significant increase only in burst taVNS. The response rates during burst (35.7%) and tonic (38.1%) stimulations were both higher than that during sham stimulation (11.9%). The response to taVNS showed parameter specificity with few nonresponders to the tonic paradigm responding to the burst paradigm. The overall response rate increased from 38.1% in tonic taVNS to 54.8% in taVNS using both burst and tonic paradigms. For both burst and tonic responders, baseline cardiac parasympathetic activity was found to be significantly negatively correlated with changes during stimulation.

Conclusion

The burst parameter could be used as an alternative strategy for regulating cardiac parasympathetic function by taVNS, which has the potential to be used as a complementary paradigm to traditional tonic taVNS for promoting clinical treatment efficacy.

中文翻译：

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使用新的突发范式重新评估经皮耳廓迷走神经刺激对健康年轻人心脏自主神经功能的影响

背景

经皮耳迷走神经刺激 (taVNS) 可以调节心脏自主神经功能。然而，传统的补品范式的响应率较低，结果仍然不一致。最近的一项试点研究提出了一种新的爆发范式来激活心脏副交感神经系统，这可能为治疗心脏自主神经功能提供一种新方法。本研究重新评估了突发 taVNS 对调节心率变异性的影响，并探讨了突发和传统补品范式之间的差异。

材料和方法

这项研究招募了 42 名年轻人。每位参与者分别接受了三种类型的 taVNS，包括假（30 秒刺激）、强直（25 赫兹，500 微秒）和突发（每 200 毫秒 500 赫兹的五个脉冲）范式，同时记录心电图。分析采用单因素方差分析、多元方差分析和线性回归分析。使用 Bonferroni 校正进行了多次测试。

结果

爆发和强直范式都导致心率显着下降，这种下降一直持续到刺激后，并增加了心脏副交感神经活动。此外，两个副交感神经系统指标仅在突发 taVNS 中显示出显着增加。爆发（35.7%）和补品（38.1%）刺激期间的反应率均高于假刺激期间（11​​.9%）。对 taVNS 的反应显示出参数特异性，几乎没有对补品范式响应突发范式的无反应者。使用突发和补品范式的总体反应率从补品 taVNS 中的 38.1% 增加到 54.8%。对于爆发和强直反应者，发现基线心脏副交感神经活动与刺激期间的变化显着负相关。

结论

爆发参数可用作 taVNS 调节心脏副交感神经功能的替代策略，有可能用作传统补品 taVNS 的补充范例，以促进临床治疗效果。