Cardiovascular effects of auricular stimulation -a systematic review and meta-analysis of randomized controlled clinical trials

Frontiers in Neuroscience

Neuroscience

Mike Cummings¹  Taras Usichenko²  Kevin Hua³  Benno Brinkhaus³  Joanna Dietzel³  Miriam Bernatik⁴ 

[1] British Medical Acupuncture Society, London, United Kingdom;Department for Anesthesiology, University Hospital Greifswald, Greifswald, Germany;Department of Anesthesia, McMaster University, Hamilton, ON, Canada;Institute 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, Germany;International Society for Chinese Medicine, Munich, Germany;

关键词: auricular acupuncture;    auricular stimulation;    cardiovascular;    randomized controlled trials;    systematic review;    transauricular vagus nerve stimulation;   

DOI  :  10.3389/fnins.2023.1227858

 received in 2023-05-23, accepted in 2023-08-17,  发布年份 2023

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

Unknown   
Copyright © 2023 Hua, Cummings, Bernatik, Brinkhaus, Usichenko and Dietzel.