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Peer-reviewedCC BYClinics (Sao Paulo, Brazil)

Effects of transcutaneous vagus nerve stimulation on motor function in older adults: a randomized crossover study.

  • Silvia Ataides Alves Santana1
  • Fernando Zanela da Silva Arêas2
  • Sandy Daniely Alves Santana1
  • Taize Iolanda de Souza Ferreira1
  • Maycon Pelosato Duarte1
  • Francisdeise Suave Santos1
  • Leila Dutra de Oliveira1
  • Cassia da Luz Goulart3
  • Fernando Fonseca de Almeida Val4
  • Guilherme Peixoto Tinoco Areas1
4 affiliations
  1. 1Physiology Science Laboratory, Universidade Federal do Amazonas, Manaus, AM, Brazil.
  2. 2Baylor Scott and White Research Institute, Dallas, TX, USA; Laboratory of Neuromodulation and Neurorehabilitation, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
  3. 3Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
  4. 4Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, AM, Brazil. Electronic address: [email protected].
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Abstract

Background

Aging is associated with declines in gait performance and autonomic regulation, increasing the risk of functional limitations. Auricular transcutaneous Vagus Nerve Stimulation (tVNS) is a promising non-pharmacological intervention, but its acute effects on gait in older adults remain unclear. This study investigates whether acute tVNS can improve gait performance and autonomic function in healthy community-dwelling older women.Methods

A prospective, randomized, blinded, crossover trial was conducted with 17 healthy older women (≥60-years). Participants received active tVNS (left ear, 25 Hz, 500 μs, 30-min) and sham stimulation (right earlobe), separated by a 24-hour washout period. The primary outcome was the distance covered on the 6-Minute Walk Test (6MWT). Heart Rate Variability (HRV) was assessed as a key secondary outcome.Findings

Active tVNS significantly increased the resting Inter-Beat Interval (IBI, p = 0.008) and reduced heart rate (p = 0.03), indicating enhanced parasympathetic modulation. Sympathetic activity (LF and LF/HF ratio) decreased following active stimulation. Although absolute 6MWT distance did not significantly change (p = 0.07), the predicted walking distance improved significantly with active tVNS compared to sham (p < 0.01; Cohen's d = 0.65; mean difference -7.2%). Other clinical parameters remained unchanged.Interpretation

This first randomized crossover trial investigating the acute effects of transcutaneous vagus nerve stimulation in healthy older women demonstrated enhanced parasympathetic modulation and improved performance relative to predicted walking capacity. However, the primary outcome, absolute 6-minute walk distance, did not reach statistical significance. These findings should therefore be considered preliminary and hypothesis-generating, supporting the need for larger trials to determine the long-term clinical relevance of tVNS in older populations.

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Cite

BibTeXRIS
BibTeX
@article{santana2026effects,
  title = {{Effects of transcutaneous vagus nerve stimulation on motor function in older adults: a randomized crossover study.}},
  author = {Silvia Ataides Alves Santana and Fernando Zanela da Silva Arêas and Sandy Daniely Alves Santana and Taize Iolanda de Souza Ferreira and Maycon Pelosato Duarte and Francisdeise Suave Santos and Leila Dutra de Oliveira and Cassia da Luz Goulart and Fernando Fonseca de Almeida Val and Guilherme Peixoto Tinoco Areas},
  journal = {Clinics (Sao Paulo, Brazil)},
  year = {2026},
  month = oct,
  doi = {10.1016/j.clinsp.2026.101141},
  url = {https://europepmc.org/article/MED/42837835},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Effects of transcutaneous vagus nerve stimulation on motor function in older adults: a randomized crossover study.
AU  - Silvia Ataides Alves Santana
AU  - Fernando Zanela da Silva Arêas
AU  - Sandy Daniely Alves Santana
AU  - Taize Iolanda de Souza Ferreira
AU  - Maycon Pelosato Duarte
AU  - Francisdeise Suave Santos
AU  - Leila Dutra de Oliveira
AU  - Cassia da Luz Goulart
AU  - Fernando Fonseca de Almeida Val
AU  - Guilherme Peixoto Tinoco Areas
PY  - 2026
DA  - 2026/10/06
JO  - Clinics (Sao Paulo, Brazil)
DO  - 10.1016/j.clinsp.2026.101141
UR  - https://europepmc.org/article/MED/42837835
AB  - Background  Aging is associated with declines in gait performance and autonomic regulation, increasing the risk of functional limitations. Auricular transcutaneous Vagus Nerve Stimulation (tVNS) is a promising non-pharmacological intervention, but its acute effects on gait in older adults remain unclear. This study investigates whether acute tVNS can improve gait performance and autonomic function in healthy community-dwelling older women.Methods  A prospective, randomized, blinded, crossover trial was conducted with 17 healthy older women (≥60-years). Participants received active tVNS (left ear, 25 Hz, 500 μs, 30-min) and sham stimulation (right earlobe), separated by a 24-hour washout period. The primary outcome was the distance covered on the 6-Minute Walk Test (6MWT). Heart Rate Variability (HRV) was assessed as a key secondary outcome.Findings  Active tVNS significantly increased the resting Inter-Beat Interval (IBI, p = 0.008) and reduced heart rate (p = 0.03), indicating enhanced parasympathetic modulation. Sympathetic activity (LF and LF/HF ratio) decreased following active stimulation. Although absolute 6MWT distance did not significantly change (p = 0.07), the predicted walking distance improved significantly with active tVNS compared to sham (p < 0.01; Cohen's d = 0.65; mean difference -7.2%). Other clinical parameters remained unchanged.Interpretation  This first randomized crossover trial investigating the acute effects of transcutaneous vagus nerve stimulation in healthy older women demonstrated enhanced parasympathetic modulation and improved performance relative to predicted walking capacity. However, the primary outcome, absolute 6-minute walk distance, did not reach statistical significance. These findings should therefore be considered preliminary and hypothesis-generating, supporting the need for larger trials to determine the long-term clinical relevance of tVNS in older populations.
SN  - 1807-5932
SN  - 1980-5322
ER  -