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. 2025 Apr 28:19:1526236.
doi: 10.3389/fnins.2025.1526236. eCollection 2025.

Acute sonographic changes in common carotid artery after NESA neuromodulation intervention in healthy adults: a randomized controlled clinical trial

Isabel Mínguez-Esteban  1 , Mónica De la Cueva-Reguera  1 , Vanesa Abuín-Porras  1 , Carlos Romero-Morales  1 , Jaime Almazán-Polo  1 , María Bravo-Aguilar  1
Affiliations

Acute sonographic changes in common carotid artery after NESA neuromodulation intervention in healthy adults: a randomized controlled clinical trial

Isabel Mínguez-Esteban et al. Front Neurosci. .

Abstract

Introduction: The endothelium plays a key role in vascular health, and its dysfunction is a major risk factor for cardiovascular diseases (CVD). Non-invasive neuromodulation techniques, such as NESA, aim to improve vascular tone and function by targeting the autonomic nervous system. However, evidence regarding their acute vascular effects is still limited.

Methods: A randomized controlled trial was conducted with 40 participants divided into NESA (n = 20) and placebo (n = 20) groups. Both groups underwent 20-min interventions. Sonographic assessments of the left CCA, including lumen diameter (LD), intima-media thickness (IMT), and peak systolic velocity (PSV), along with blood pressure (BP) and heart rate (HR), were performed before and immediately after the intervention.

Results: Significant increases in LD and cross-sectional area (CSA) were observed in the NESA group compared to placebo (p < 0.001), alongside a decrease in IMT (p < 0.05). HR showed a significant reduction post-intervention in both groups, with a more pronounced effect in the NESA group (p = 0.001). No significant changes were found in BP or PSV.

Discussion: The findings demonstrate that NESA neuromodulation induces immediate changes in vascular parameters, including increased LD and CSA and decreased IMT. These results highlight measurable acute vascular effects in healthy individuals following NESA intervention.

Keywords: NESA neuromodulation; autonomic nervous system; common carotid artery (CCA); electrical nerve stimulation; lumen diameter (LD); peak systolic flow velocity; vascular ultrasonography; vascular ultrasound Doppler.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Ultrasonographic and ImageJ assessment of left CCA in long axis view (A) for PSV (B), LD and IMT (C); as well as in short axis (D) view for CSA (E, F). The probe was placed at the level of the left CCA using the SCM muscle as an acoustic window (A, B). Longitudinal sections on the left CCA (B, C) allowed to determine the peak systolic velocities (PSV) and the changes in the LD and IMT, while the transverse sections (E, F) allowed to determine the CSA. Abbreviations: CCA, common carotid artery; CSA, cross-sectional área; IMT, intima–media thickness; LD, lumen diameter; PSV, peak systolic velocities; SCM, sternocleidomastoid muscle.
Figure 2
Figure 2
Lumen diameter [(A) Relative, %; (B) Absolute, mm] differences between NESA and Placebo. *Significant differences were observed between groups.
See this image and copyright information in PMC

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