Transcutaneous auricular vagus nerve stimulation would be an alternative to implantable cervical vagus nerve stimulation in some situation.

Implantable cervical vagus nerve stimulation (iVNS) is a representative and promising neuromodulation. However, the invasive nature restricts its application. Traditional auricular acupuncture treatment has a long history. The auricular branch of the vagus nerve (ABVN) is a branch on the surface of the ear. Some studies demonstrates that transcutaneous auricular vagus nerve stimulation (taVNS) would achieve similar effects as iVNS. TaVNS and iVNS share a common anatomical basis and acting mechanism. In this article, we made a comparison between iVNS and taVNS in indications and efficacy. The recent studies have revealed similar clinical efficacy of taVNS, taVNS would expand the indication of iVNS. High-quality clinical evidences are needed before taVNS become be an alternative of iVNS.