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. 2022 Oct 17;22(20):7884.
doi: 10.3390/s22207884.

Modulating Heart Rate Variability through Deep Breathing Exercises and Transcutaneous Auricular Vagus Nerve Stimulation: A Study in Healthy Participants and in Patients with Rheumatoid Arthritis or Systemic Lupus Erythematosus

Mette Kjeldsgaard Jensen  1 , Sally Søgaard Andersen  1 , Stine Søgaard Andersen  1 , Caroline Hundborg Liboriussen  1 , Salome Kristensen  2 , Mads Jochumsen  1
Affiliations

Modulating Heart Rate Variability through Deep Breathing Exercises and Transcutaneous Auricular Vagus Nerve Stimulation: A Study in Healthy Participants and in Patients with Rheumatoid Arthritis or Systemic Lupus Erythematosus

Mette Kjeldsgaard Jensen et al. Sensors (Basel). .

Abstract

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are associated with an impaired autonomic nervous system and vagus nerve function. Electrical or physiological (deep breathing-DB) vagus nerve stimulation (VNS) could be a potential treatment approach, but no direct comparison has been made. In this study, the effect of transcutaneous auricular VNS (taVNS) and DB on vagal tone was compared in healthy participants and RA or SLE patients. The vagal tone was estimated using time-domain heart-rate variability (HRV) parameters. Forty-two healthy participants and 52 patients performed 30 min of DB and 30 min of taVNS on separate days. HRV was recorded before and immediately after each intervention. For the healthy participants, all HRV parameters increased after DB (SDNN + RMSSD: 21-46%), while one HRV parameter increased after taVNS (SDNN: 16%). For the patients, all HRV parameters increased after both DB (17-31%) and taVNS (18-25%), with no differences between the two types of VNS. DB was associated with the largest elevation of the HRV parameters in healthy participants, while both types of VNS led to elevated HRV parameters in the patients. The findings support a potential use of VNS as a new treatment approach, but the clinical effects need to be investigated in future studies.

Keywords: autoimmune diseases; breathing; deep breathing; heart-rate variability; inflammation; neuromodulation; rheumatoid arthritis; systemic lupus erythematosus; transcutaneous auricular stimulation; vagus nerve stimulation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematization of the study design illustrating the time points of the ECG measurements, breaks, and interventions (deep breathing (DB) or transcutaneous auricular vagus nerve stimulation (taVNS)). Post1, Post2, and Post3 were measured 0–5, 12.5–17.5, and 25–30 min after the intervention, respectively.
Figure 2
Figure 2
HRV data for healthy participants (left column) and patients (right column). The baseline shows the mean values of Pre1 and Pre2, which were obtained prior to the interventions. Post1, Post2, and Post3 were obtained 0–5, 12.5–17.5, and 25–30 min after the interventions, respectively. Data are displayed as the mean ± standard error across participants. DB: Deep breathing. tVNS: Transcutaneous auricular vagus nerve stimulation.
Figure 3
Figure 3
Percentage change from baseline to post-measurements for healthy participants and patients performing deep breathing (DB) or transcutaneous auricular vagus nerve stimulation (taVNS). Data are displayed as the mean ± standard error across the participants.
See this image and copyright information in PMC

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