The effects of transcutaneous auricular vagal nerve stimulation on cognition in healthy individuals: A meta-analysis.

OBJECTIVE: Transcutaneous auricular vagal nerve stimulation (taVNS) may benefit cognition in healthy adults but may differentially affect specific domains of cognitive function. Currently, optimal stimulation parameters of taVNS have yet to be identified and the overall effectiveness of this approach remains unclear. METHOD: A literature review and random effects meta-analysis evaluated the effects of taVNS on cognitive performance outcomes across domains of function and outcome metrics (accuracy and response times). Subgroup meta-analyses and meta-regression models explored the moderating effects of stimulation parameters on performance outcomes. RESULTS: Meta-analyses on 19 eligible studies indicated a weighted effect size of 0.21 for the effect of taVNS on overall cognitive performance, with significant effects on measures of executive function and measures of accuracy. Parameter meta-analyses indicated that stimulation site was most associated with improvements in executive function (gtragus = 2.39, gcymba concha = 0.48; Q = 39.84, p < .0001; ß = -2.33, p = .03). CONCLUSIONS: taVNS may improve cognition, particularly executive function, and stimulation parameters may differentially influence outcomes. Continued research into the effects of taVNS as well as optimal stimulation parameters will be beneficial. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The role of vestibular cues in postural sway.

Controlling posture requires continuous sensory feedback about body motion and orientation, including from the vestibular organs. Little is known about the role of tilt vs. translation vs. rotation vestibular cues. We examined whether intersubject differences in vestibular function were correlated with intersubject differences in postural control. Vestibular function was assayed using vestibular direction-recognition perceptual thresholds, which determine the smallest motion that can be reliably perceived by a subject seated on a motorized platform in the dark. In study A, we measured thresholds for lateral translation, vertical translation, yaw rotation, and head-centered roll tilts. In study B, we measured thresholds for roll, pitch, and left anterior-right posterior and right anterior-left posterior tilts. Center-of-pressure (CoP) sway was measured in sensory organization tests (study A) and Romberg tests (study B). We found a strong positive relationship between CoP sway and lateral translation thresholds but not CoP sway and other thresholds. This finding suggests that the vestibular encoding of lateral translation may contribute substantially to balance control. Since thresholds assay sensory noise, our results support the hypothesis that vestibular noise contributes to spontaneous postural sway. Specifically, we found that lateral translation thresholds explained more of the variation in postural sway in postural test conditions with altered proprioceptive cues (vs. a solid surface), consistent with postural sway being more dependent on vestibular noise when the vestibular contribution to balance is higher. These results have potential implications for vestibular implants, balance prostheses, and physical therapy exercises.NEW & NOTEWORTHY Vestibular feedback is important for postural control, but little is known about the role of tilt cues vs. translation cues vs. rotation cues. We studied healthy human subjects with no known vestibular pathology or symptoms. Our findings showed that vestibular encoding of lateral translation correlated with medial-lateral postural sway, consistent with lateral translation cues contributing to balance control. This adds support to the hypothesis that vestibular noise contributes to spontaneous postural sway.

Vestibular Perceptual Thresholds Increase above the Age of 40.

We measured vestibular perceptual thresholds in 105 healthy humans (54F/51M) ranging from 18 to 80 years of age. Direction-recognition thresholds were measured using standard methods. The motion consisted of single cycles of sinusoidal acceleration at 0.2 Hz for roll tilt and 1.0 Hz for yaw rotation about an earth-vertical axis, inter-aural earth-horizontal translation (y-translation), inferior-superior earth-vertical translation (z-translation), and roll tilt. A large subset of this population (99 of 105) also performed a modified Romberg test of standing balance. Despite the relatively large population (54F/51M), we found no difference between thresholds of male and female subjects. After pooling across sex, we found that thresholds increased above the age of 40 for all five motion directions investigated. The data were best modeled by a two-segment age model that yielded a constant baseline below an age cutoff of about 40 and a threshold increase above the age cutoff. For all subjects who passed all conditions of the balance test, the baseline thresholds were 0.97°/s for yaw rotation, 0.66°/s for 1-Hz roll tilt, 0.35°/s for 0.2-Hz roll tilt, 0.58 cm/s for y-translation, and 1.24 cm/s for z-translation. As a percentage of the baseline, the fitted slopes (indicating the threshold increase each decade above the age cutoff) were 83% for z-translation, 56% for 1-Hz roll tilt, 46% for y-translation, 32% for 0.2-Hz roll tilt, and 15% for yaw rotation. Even taking age and other factors into consideration, we found a significant correlation of balance test failures with increasing roll-tilt thresholds.