Table 2. Summary of Evaluation Criteria and Outcome

First author (year) Evaluation criteria Outcome
Jukka Ylikoski15) (2017) HRV- HRV tests at pre- and post- stimulation(15-60 min test-tVNS) 1) The pre-treatment HRV recording showed lowered resting HRV, indicating sympathetic preponderance in 73% of the patients.2) RR intervals : 802→858 / HRV age : 64→56 / RMSSD(=Dynamics, root of the mean square of successive differences) : 37→573) Active tVNS significantly increased variability of R-R intervals in 75% of patients and HRV age was decreased in 70% of patients.
Liyan Peng16) (2018) 1) Heart rate and blood pressure2) fMRI data from the cortices was collected 1) Heart rate and blood pressure - Heart rate : 72±6beats/min→70±5beats/min(p=0.836) - Systolic blood pressure : 105±7㎜Hg→102±5㎜Hg(p=0.696) - Diastolic blood pressure : 68±5㎜Hg→67±3㎜Hg(p=0.410)2) Cortical activation(by fMRI) (1) taVNS at auricular acupoints CO10-12, TF4 can instantly and effectively generate blood oxygenation level dependent(BOLD) signal changes in the auditory, limbic and prefrontal cortices. (2) Acupoints vs sham stimulation - Significant activations in anterior stimulation compared with sham stimulation group in the ascending auditory pathway regions such as the left middle medial temporal gyrus, the left and right thalamus (3) Acupoints vs anterior stimulation - The only different brain region between these two groups was the superior temporal cortex. In the anterior stimulation group, this area was not significantly activated compared to the acupoints group.
Jian-feng Tu17) (2019) Measures of HRV and THI were obtained at baseline and after the sixth acupuncture session in all patients.1) THI2) HRV- The six measurement phases with 5 min each were as follows : one before stimulation(a), four during acupuncture(b–e), and one after acupuncture(f) 1) THI : Deep acupuncture(54.00±1.58→37.33±1.68)vs Shallow acupuncture(55.87±1.29→52.73±1.74)(p=0.04)2) HRV - The low frequency/high frequency(LF/HF) ratio - Compared with the baseline, LF/HF showed significant increases during and after the first treatment session in both groups. - After 3-week deep acupuncture treatment, the LF/HF pattern did not show a significant increase at (b–f) phases compared with that at (a) phase. In the shallow acupuncture group, the LF/HF pattern continually increased during (a–f) phases. - mean HR : no significant change in the mean HR before, during, or after deep or shallow acupuncture either in the first or last treatment
Jukka Ylikoski18) (2020) HRV- HRV tests at pre- and post- stimulation(15-60 min test-taVNS) 1) Baseline HRV data : more than three quarters of the 171 patients had increased sympathetic activity before test-tVNS.2) Test-tVNS shifted mean values of different HRV parameters toward increased parasympathetic activity in about 80% of patients. - RR intervals(815→868), HRV age(65→56), RMSSD(=Dynamics, root of the mean square of successive differences)(32→49)3) Questionnaires about 1 year after the first visit(n=78) - Loudness and annoyance of tinnitus had decreased in 60%, 72% of patients.- Stress had decreased in 82% of patients.
tVNS: transcutaneous vagal nerve stimulation, taVNS: transauricular vagus nerve stimulation, THI: tinnitus handicap inventory, HRV: heart rate variability