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经皮耳迷走神经刺激(taVNS)的安全性:系统评价和荟萃分析。

Safety of transcutaneous auricular vagus nerve stimulation (taVNS): a systematic review and meta-analysis.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medical Center, Seoul, Republic of Korea.

Uniao Metropolitana de Ensino e Cultura (UNIME) Salvador, Bahia, Brazil.

出版信息

Sci Rep. 2022 Dec 21;12(1):22055. doi: 10.1038/s41598-022-25864-1.


DOI:10.1038/s41598-022-25864-1
PMID:36543841
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9772204/
Abstract

Transcutaneous auricular vagus nerve stimulation (taVNS) has been investigated as a novel neuromodulation tool. Although taVNS is generally considered safe with only mild and transient adverse effects (AEs), those specifically caused by taVNS have not yet been investigated. This systematic review and meta-analysis on taVNS aimed to (1) systematically analyze study characteristics and AE assessment, (2) characterize and analyze possible AEs and their incidence, (3) search for predictable risk factors, (4) analyze the severity of AE, and (5) suggest an evidence-based taVNS adverse events questionnaire for safety monitoring. The articles searched were published through April 7, 2022, in Medline, Embase, Web of Science, Cochrane, and Lilacs databases. In general, we evaluated 177 studies that assessed 6322 subjects. From these, 55.37% of studies did not mention the presence or absence of any AEs; only 24.86% of the studies described that at least one adverse event occurred. In the 35 studies reporting the number of subjects with at least one adverse event, a meta-analytic approach to calculate the risk differences of developing an adverse event between active taVNS and controls was used. The meta-analytic overall adverse events incidence rate was calculated for the total number of adverse events reported on a 100,000 person-minutes-days scale. There were no differences in risk of developing an adverse event between active taVNS and controls. The incidence of AE, in general, was 12.84/100,000 person-minutes-days of stimulation, and the most frequently reported were ear pain, headache, and tingling. Almost half of the studies did not report the presence or absence of any AEs. We attribute this to the absence of AE in those studies. There was no causal relationship between taVNS and severe adverse events. This is the first systematic review and meta-analysis of transcutaneous auricular stimulation safety. Overall, taVNS is a safe and feasible option for clinical intervention.

摘要

经皮耳迷走神经刺激(taVNS)已被研究作为一种新型的神经调节工具。尽管 taVNS 通常被认为是安全的,只有轻微和短暂的不良反应(AE),但尚未研究那些专门由 taVNS 引起的 AE。本系统评价和 taVNS 的荟萃分析旨在:(1)系统分析研究特征和 AE 评估;(2)描述和分析可能的 AE 及其发生率;(3)寻找可预测的危险因素;(4)分析 AE 的严重程度;(5)提出一种基于证据的 taVNS 不良事件问卷进行安全监测。检索的文章发表于 2022 年 4 月 7 日之前,来自 Medline、Embase、Web of Science、Cochrane 和 Lilacs 数据库。总的来说,我们评估了评估 6322 名受试者的 177 项研究。其中,55.37%的研究没有提到是否存在任何 AE;只有 24.86%的研究描述了至少发生了一次不良事件。在报告至少有一个不良事件的受试者数量的 35 项研究中,使用荟萃分析方法计算了在主动 taVNS 和对照组之间发生不良事件的风险差异。使用报告的不良事件总数在 100000 人-分钟-天的比例上计算了荟萃分析的总体不良事件发生率。主动 taVNS 和对照组之间发生不良事件的风险没有差异。AE 的发生率一般为 12.84/100000 人-分钟-天的刺激,报告最多的是耳痛、头痛和刺痛。近一半的研究没有报告是否存在任何 AE。我们将这归因于那些研究中没有 AE。taVNS 与严重不良事件之间没有因果关系。这是关于经皮耳刺激安全性的首次系统评价和荟萃分析。总的来说,taVNS 是一种安全且可行的临床干预选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e5b/9772204/876f9ed85f70/41598_2022_25864_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e5b/9772204/876f9ed85f70/41598_2022_25864_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e5b/9772204/876f9ed85f70/41598_2022_25864_Fig1_HTML.jpg

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[2]
Transcutaneous Auricular Vagus Nerve Stimulation for Postpartum Contraction Pain During Elective Cesarean Delivery: A Randomized Clinical Trial.

JAMA Netw Open. 2025-8-1

[3]
Transcutaneous vagal nerve stimulation for the treatment of trauma- and stressor-related disorders: systematic review of randomised controlled studies.

BJPsych Open. 2025-8-1

[4]
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Front Psychol. 2025-7-11

[5]
Chronic Abdominal Discomfort Syndrome (CADS): A Narrative Review of Treatment Strategies.

J Pain Res. 2025-7-8

[6]
Improvement in facial seborrheic dermatitis following cervical transcutaneous vagal nerve stimulation.

JAAD Case Rep. 2025-4-26

[7]
Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) for Insomnia Disorder: A Narrative Review of Effectiveness, Mechanisms and Recommendations for Clinical Practice.

Nat Sci Sleep. 2025-6-13

[8]
Repeat round of auricular percutaneous electrical nerve field stimulation for pediatric disorders of gut brain interaction.

J Pediatr Gastroenterol Nutr. 2025-8

[9]
Neurotechnology for enhancing human operation of robotic and semi-autonomous systems.

Front Robot AI. 2025-5-23

[10]
Effects of Transcutaneous Auricular Vagus Nerve Stimulation on Hemodynamics and Autonomic Function During Exercise Stress Tests in Healthy Volunteers.

Circ Rep. 2025-4-11

本文引用的文献

[1]
Clinical perspectives on vagus nerve stimulation: present and future.

Clin Sci (Lond). 2022-5-13

[2]
Neuromodulation of Inflammation to Treat Heart Failure With Preserved Ejection Fraction: A Pilot Randomized Clinical Trial.

J Am Heart Assoc. 2022-2

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Transcutaneous auricular vagus nerve stimulators: a review of past, present, and future devices.

Expert Rev Med Devices. 2022-1

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Auricular Vagus Neuromodulation-A Systematic Review on Quality of Evidence and Clinical Effects.

Front Neurosci. 2021-4-30

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Front Hum Neurosci. 2021-3-23

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BMJ. 2021-3-29

[7]
Cervical transcutaneous vagal neuromodulation in chronic pancreatitis patients with chronic pain: A randomised sham controlled clinical trial.

PLoS One. 2021

[8]
Non-invasive peripheral nerve stimulation selectively enhances speech category learning in adults.

NPJ Sci Learn. 2020-8-6

[9]
Critical Review of Transcutaneous Vagus Nerve Stimulation: Challenges for Translation to Clinical Practice.

Front Neurosci. 2020-4-28

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Cochrane Database Syst Rev. 2019-10-3

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