经皮迷走神经刺激在成年人执行功能中应用的Scoping综述

doi:10.3969/j.issn.1006-9771.2025.05.004

Abstract

Abstract:

Objective To review the efficacy and safety of transcutaneous vagus nerve stimulation (tVNS) in targeted interventions for executive function among adults.
Methods A systematic search of PubMed, Web of Science, CNKI and Wanfang data was conducted for original studies investigating tVNS intervention targeting executive function in adults, with publication during from inception to December, 2024. Data extraction and scoping review were performed, with literature quality assessed using the Physiotherapy Evidence Database (PEDro) scale.
Results A total of 14 researches were included, from China, Germany, United States, Netherlands and Finland, involving 598 participants. The subjects were mainly healthy adults and also covered patient groups with refractory epilepsy, post-traumatic stress disorder and sleep deprivation. The outcomes included three core components of executive function: inhibitory control (response inhibition and interference control), working memory and cognitive flexibility. The parameter settings of tVNS varied depending on the researches; the stimulation target was mainly the cymba conchae; the stimulation intensity was mostly 0.5 to 2.4 mA; the stimulation frequency was mainly 25 Hz; the on/off period was mostly 30 s on/30 s off; the pulse width was 200 μs to 500 ms; and the intervention period was mainly a single acute stimulation of 30 to 75 minutes. Behavioral results indicated that tVNS was effective on the response inhibition and working memory, but the effects on the interference control and cognitive flexibility were divergent. Mechanism-level evidence further supported that tVNS improved response inhibition and working memory by modulating frontal neural oscillations and enhancing frontal functional connectivity. In terms of safety, four researches reported transient adverse reactions, and no serious adverse events or participant withdrawals happened.
Conclusion tVNS demonstrates safe and effective improvement of some core subcomponents of executive function in adults, with overall benefits influenced by neural circuit specificity and stimulation parameters.

Key words: adult, transcutaneous vagus nerve stimulation, executive function, inhibitory control, working memory, scoping review

CLC Number:

R493

PAN Yi, HOU Shuanglong, WEN Xiaoni. Transcutaneous vagus nerve stimulation for executive function in adults: a scoping review[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 520-528.

Figures/Tables 5

Table 1

Figure 1

Table 2

Table 3

Basic characteristics of the included literatures"

纳入文献	国家	研究类型	样本量(C/T)/n	受试对象	干预(C/T)	结局指标	评价指标	主要结局
Pan等^[2](2024)	中国	随机对照试验	9/19	难治性颞叶癫痫患者	假刺激/tVNS	工作记忆	视觉延迟与样本匹配任务，脑电图	任务反应时间缩短；额叶中线θ振荡下降
Zhao等^[12](2023)	中国	交叉研究	25	睡眠剥夺人群	假刺激/tVNS	工作记忆	N-back任务	任务准确率提高
Konjusha等^[14](2022)	德国	交叉研究	37	健康成年人	假刺激/tVNS	抑制控制	Flanker任务，脑电图	任务准确率降低；前额叶区域α波段活性降低
Camargo等^[17](2024)	美国	随机对照试验	20/21	健康成年人	假刺激/tVNS	抑制控制	Go/No-go任务，脑电图	任务表现无显著变化；N2波幅提高
Zhu等^[18](2024)	中国	随机对照试验	41/41	健康成年人	假刺激/tVNS	抑制控制	Go/No-go 任务，功能性近红外光谱	任务准确性提高；双侧颞下回-眶额叶网络连接增强
Choudhary等^[19](2023)	美国	随机对照试验	7/8	创伤后应激障碍患者	假刺激/tVNS	工作记忆	N-back任务	任务表现无显著变化
Konjusha等^[20](2023)	德国	交叉研究	37	健康成年人	假刺激/tVNS	工作记忆	N-back任务，脑电图	任务反应时间缩短，准确率提高；额叶及下顶叶区域α波活性增强
Sun等^[21](2021)	中国	交叉研究	58	健康成年人	假刺激/任务前tVNS/任务中tVNS	工作记忆	N-back任务	任务准确率提高；反应时间缩短
Pihlaja等^[22](2020)	芬兰	交叉研究	25	健康成年人	假刺激/tVNS	抑制控制	Go/No-go任务，脑电图	任务表现无显著变化；N2波幅降低
Tona等^[23](2020)	荷兰	交叉研究	72	健康成年人	不同刺激强度的tVNS	认知灵活性	可预测的线索任务转换任务	任务表现无显著变化
Borges等^[24](2020)	德国	交叉研究	64	健康成年人	假刺激/tVNS	认知灵活性	数字-字母任务，尺寸变更卡排序任务	任务反应时间缩短
Keute等^[25](2020)	德国	交叉研究	22	健康成年人	假刺激/tVNS	抑制控制	Go/No-go任务，脑电图	任务准确性提高；额中线θ活动增强
Jongkees等^[26](2018)	荷兰	随机对照试验	20/20	健康成年人	假刺激/tVNS	抑制控制	序列反应时任务	任务反应时间缩短
Beste等^[27](2016)	德国	随机对照试验	26/26	健康成年人	假刺激/tVNS	抑制控制	后抑制任务，反应抑制任务	反应抑制任务准确率提高

Table 3

Table 4

References 40

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纳入文献	1	2	3	4	5	6	7	8	9	10	11	总分
Pan等^[2](2024)	√	√		√	√		√	√		√	√	7
Zhao等^[12](2023)	√	√		√				√		√	√	5
Konjusha等^[14](2022)	√	√		√	√			√		√	√	6
Camargo等^[17](2024)	√	√	√	√	√	√	√	√	√	√	√	10
Zhu等^[18](2024)	√	√		√	√			√		√	√	6
Choudhary等^[19](2023)	√	√		√	√		√	√	√	√	√	8
Konjusha等^[20](2023)	√	√		√	√			√		√	√	6
Sun等^[21](2021)	√	√		√				√		√	√	5
Pihlaja等^[22](2020)	√			√	√			√	√	√	√	6
Tona等^[23](2020)	√	√		√	√		√	√	√			6
Borges等^[24](2020)	√	√		√	√			√		√	√	6
Keute等^[25](2020)	√	√		√	√			√	√	√	√	7
Jongkees等^[26](2018)	√	√		√				√	√	√	√	6
Beste等^[27](2016)	√	√		√	√			√		√	√	6

纳入文献	刺激靶点	刺激强度	脉冲宽度	频率	通断周期	持续时间
Pan等^[2](2024)	耳甲艇	30~50 V	250 μs	25 Hz	未报告	每次30 min，每天3~5次，共20周
Zhao等^[12](2023)	左侧耳甲艇	患者主观感受中等强度	500 ms	25 Hz	30 s开/30 s关	每次30 min，共1次
Konjusha等^[14](2022)	左侧耳甲艇	0.5 mA	200~300 ms	25 Hz	30 s开/30 s关	任务前20 min+任务全过程，共1次
Camargo等^[17](2024)	双侧耳甲	患者主观耐受阈值	200~250 μs	30 Hz	连续刺激	每次60 min，共1次
Zhu等^[18](2024)	左侧耳甲	平均0.8 mA	200~250 μs	30 Hz	30 s开/30 s关	每次30 min，共1次
Choudhary等^[19](2023)	左侧颈部靠近甲状软骨区域	30 V	200 μs	25 Hz	未报告	每次5 min，每天2次，共12周
Konjusha等^[20](2023)	耳甲艇	患者主观耐受阈值	200~300 ms	25 Hz	连续刺激	任务前20 min+任务全过程，共1次
Sun等^[21](2021)	左侧耳甲艇	患者主观感受中等强度	500 ms	25 Hz	30 s开/30 s关	每次40 min，共1次
Pihlaja等^[22](2020)	耳屏	患者主观耐受阈值	250 ms	25 Hz	未报告	每次52 min，共1次
Tona等^[23](2020)	左侧耳甲	0.5 mA	200~300 μs	25 Hz	30 s开/30 s关	每次75 min，共1次
Borges等^[24](2020)	左侧耳甲艇	平均2.2 mA	200~300 μs	25 Hz	连续刺激	任务前16 min+任务全过程，共1次
Keute等^[25](2020)	左侧耳甲艇	平均2.4 mA	200 μs	25 Hz	30 s开/30 s关	每次46 min，共1次
Jongkees等^[26](2018)	左侧耳屏	0.5 mA	200~300 μs	25 Hz	30 s开/30 s关	每次45 min，共1次
Beste等^[27](2016)	左侧耳甲	0.5 mA	200~300 μs	25 Hz	30 s开/30 s关	每次30 min，共1次

Transcutaneous vagus nerve stimulation for executive function in adults: a scoping review

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