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July 10, 2026Clinical Autonomic ResearchOpen Access

Transcutaneous vagus nerve stimulation enhances post-exercise autonomic recovery by improving vagal reactivation and baroreflex sensitivity.

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Why the study?

It was unclear whether transcutaneous vagus nerve stimulation modulates autonomic recovery following exercise-induced physiological stress in healthy individuals.

Does transcutaneous vagus nerve stimulation improve autonomic recovery following exercise-induced physiological stress in healthy individuals?

Comparison

Transcutaneous vagus nerve stimulation vs control

Design

Systematic review of randomised controlled trials

Key result

Transcutaneous vagus nerve stimulation modulated autonomic recovery following exercise-induced stress, enhancing vagal reactivation and spontaneous cardiovagal baroreflex sensitivity in selected protocols.

Authors

LSLaissa SaldanhaGQGarcía QuintanaJLJuan Francisco Loro-Ferrer

Discussion

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Overview

Low-certainty evidence precludes tVNS use for post-exercise recovery; leaves optimal parameters and clinical utility open for standardized trials.

Key Points

  • To synthesize evidence on the effects of transcutaneous vagus nerve stimulation on autonomic recovery after exercise-induced stress in healthy individuals.
  • Systematic review conducted per PRISMA 2020 guidelines involving six electronic databases.
  • Fifteen randomized controlled trials with a total of 566 participants were included.
  • Quality and bias were assessed using standardized tools.
  • Vagus nerve stimulation influenced autonomic recovery dynamics, enhancing vagal reactivation and baroreflex sensitivity in certain protocols.
  • Some studies exhibited null or divergent outcomes based on stimulation parameters and participant characteristics.
  • Overall evidence certainty varied from very low to low due to methodological heterogeneity and short follow-ups.

Study Design

Type

Systematic Review (n=566)

Structured PICO

Does transcutaneous vagus nerve stimulation improve autonomic recovery following exercise-induced physiological stress in healthy individuals?

P
Population
566 healthy adults aged 18-60 years across 15 randomized controlled trials evaluating transcutaneous vagus nerve stimulation during or after exercise-induced physiological stress.
I
Intervention
Transcutaneous vagus nerve stimulation
O
Outcome
Autonomic recovery following exercise-induced physiological stress (vagal reactivation, spontaneous cardiovagal baroreflex sensitivity, sympathetic modulation and inflammatory responses)surrogate

Transcutaneous vagus nerve stimulation may enhance vagal reactivation and autonomic recovery after exercise, but evidence is currently limited by methodological heterogeneity and small sample sizes.

Limitations

  • Substantial methodological heterogeneity in stimulation parameters and outcome assessments
  • Small sample sizes
  • Short follow-up durations
  • Inconsistency in measurement tools
  • Variability in blinding procedures and allocation concealment
  • methodological heterogeneity
  • small sample sizes
  • short follow-up durations

Cite This Study

Saldanha et al. (2026) conducted a systematic review in Exercise-induced physiological stress (n=566). Transcutaneous vagus nerve stimulation vs. Sham stimulation, placebo procedures, or standard recovery strategies was evaluated on Autonomic indices including heart rate variability, spontaneous cardiovagal baroreflex sensitivity, and circulating inflammatory cytokines. Transcutaneous vagus nerve stimulation modulated autonomic recovery following exercise-induced stress, enhancing vagal reactivation and spontaneous cardiovagal baroreflex sensitivity in selected protocols.

synapsesocial.com/papers/6a508c766eeac72a437a08bdhttps://doi.org/10.1007/s10286-026-01226-z
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Non-invasive vagus nerve stimulation and exercise capacity in healthy volunteers: a randomized trial2025 · 21 citations
  2. 2Post-exercise auricular vagus nerve stimulation modulates autonomic and recovery responses in physically inactive young adults: a randomized controlled trial2026
  3. 3Effects of Transcutaneous Vagus Nerve Stimulation on Gastrointestinal Symptoms and Cardiovascular Autonomic Outcomes: A Systematic Review and Meta-Analysis2026
  4. 4Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress2019 · 92 citations
  5. 5Balancing the autonomic scale: the promise of transcutaneous vagus nerve stimulation in combating cardiovascular diseases2026