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Cited by 59Heart Rate Variability and Autonomic ControlTranscranial Magnetic Stimulation StudiesVagus Nerve Stimulation Research

The effects of noninvasive brain stimulation on heart rate and heart rate variability: a systematic review and meta-analysis

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Schmaußer, Maximilian, Hoffmann, Sven, Raab, Markus, Laborde, Sylvain·2022·Journal of Neuroscience Research
DOI 10.1002/jnr.25062
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Abstract

Noninvasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation and transcranial direct current stimulation are widely used to test the involvement of specific cortical regions in various domains such as cognition and emotion. Despite the capability of stimulation techniques to test causal directions, this approach has been only sparsely used to examine the cortical regulation of autonomic nervous system (ANS) functions such as heart rate (HR) and heart rate variability (HRV) and to test current models in this regard. In this preregistered (PROSPERO) systematic review and meta-analysis, we aimed to investigate, based on meta-regression, whether NIBS represents an effective method for modulating HR and HRV measures, and to evaluate whether the ANS is modulated by cortical mechanisms affected by NIBS. Here we have adhered to the PRISMA guidelines. In a series of four meta-analyses, a total of 131 effect sizes from 35 sham-controlled trials were analyzed using robust variance estimation random-effects meta-regression technique. NIBS was found to effectively modulate HR and HRV with small to medium effect sizes. Moderator analyses yielded significant differences in effects between stimulation of distinct cortical areas. Our results show that NIBS is a promising tool to investigate the cortical regulation of ANS, which may add to the existing brain imaging and animal study literature. Future research is needed to identify further factors modulating the size of effects. As many of the studies reviewed were found to be at high risk of bias, we recommend that methods to reduce potential risk of bias be used in the design and conduct of future studies.

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  • Stimulating the vagus nerve non-invasively represents a valid target for health-related issues.

    “By considering the importance of the parasympathetic nervous system for health-related issues, stimulating non-invasively the vagus nerve represents a valid target (Gerritsen & Band, 2018; Schmaußer, Hoffmann, Raab, & Laborde, 2022; Sevoz-Couche & Laborde, 2022; Vanderhasselt & Ottaviani, 2022)”

    From Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis (2022) · cites this paper as Schmaußer, Hoffmann, Raab, & Laborde, 2022

    Section 1.1 links vagal activity and heart-rate variability to cardiovascular health, and the Discussion and Conclusions report that noninvasive brain stimulation can modulate heart rate and heart-rate variability. But the interventions reviewed are TMS and tDCS targeting brain regions, not noninvasive stimulation of the vagus nerve itself. The paper therefore does not establish that vagus-nerve stimulation is a valid target for health-related issues. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Schmaußer, M., Hoffmann, S., Raab, M., & Laborde, S.
Affiliations
  • German Sport University Cologne (DE)
  • FernUniversität in Hagen (DE)
Corresponding author
Schmaußer, Maximilian
ORCID
Venue
Journal of Neuroscience Research
Publisher
Wiley
Published
2022-05-17
Volume
100
Issue
9
Pages
1664-1694
ISSN
  • 0360-4012 (ISSN-L)
  • 1097-4547
DOI
10.1002/jnr.25062
OpenAlex
W4280625488
Cited by
59
References
30
Citations by year
2026: 11 · 2025: 15 · 2024: 14 · 2023: 14 · 2022: 5
FWCI
2.44
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Neuroscience Research (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • Research Open (London South Bank University) (acceptedVersion, cc-by)
  • OSF Preprints (OSF Preprints) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
Keywords
non-invasive brain stimulation, transcranial magnetic stimulation, transcranial direct current stimulation, heart rate, heart rate variability, autonomic nervous system, risk of bias
MeSH terms
Animals, Brain, Cognition, Heart Rate, Transcranial Magnetic Stimulation, Transcranial Direct Current Stimulation

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