{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:24:09Z","timestamp":1786119849039,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Autonomic nervous system (ANS) imbalance may contribute to functional pelvic disorders such as overactive bladder (OAB). Transcutaneous tibial nerve stimulation (TTNS) is a non\u2010invasive therapy for OAB; however, its autonomic modulation mechanisms remain unclear. This exploratory study evaluated the acute effects of TTNS on ANS activity in healthy volunteers using heart rate variability (HRV) to model neuroautonomic pathways relevant to OAB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this open\u2010label, prospective, exploratory, single\u2010arm study, 20 healthy volunteers (11 women; median age 31 years) underwent three 10\u2010min phases: baseline rest, continuous submotor TTNS via surface electrodes on the left tibial nerve, and post\u2010stimulation recovery. HRV was recorded using a Polar H10 sensor and analyzed with Kubios software. Time\u2010domain (SDNN, RMSSD, pNN50), frequency\u2010domain (LF, HF, LF\/HF), and additional indices (PNS, SNS, Stress indices) were assessed in standardized 5\u2010min windows. Friedman and Wilcoxon tests with Bonferroni correction were applied. A vagal\u2010oriented composite response score (\n                      <jats:italic>z<\/jats:italic>\n                      \u2010delta mean) was correlated with age and BMI (Spearman, permutation\u2010based\n                      <jats:italic>p<\/jats:italic>\n                      values).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant phase effects were observed for PNS index, SNS index, Stress index, SDNN, and RMSSD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Post\u2010hoc analyses confirmed increases in PNS index, SDNN, and RMSSD, and decreases in SNS and Stress indices during stimulation compared with baseline. Partial post\u2010stimulation persistence was noted for SDNN and Stress index, although these changes did not remain significant after Bonferroni correction. The composite response score correlated negatively with age (\u03c1\u2009=\u2009\u22120.52;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019; permutation\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016) and showed a non\u2010significant positive trend with BMI (\u03c1\u2009=\u20090.38;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.10).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Acute TTNS enhances parasympathetic and suppresses sympathetic activity, with partially sustained effects after stimulation. Younger age predicts stronger vagal responsiveness, suggesting age\u2010dependent neuromodulatory efficacy. Validation in OAB populations is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70245","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T09:20:02Z","timestamp":1770974402000},"page":"627-634","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Effects of Transcutaneous Tibial Nerve Stimulation on Autonomic Nervous System Activity in Healthy Volunteers: An Exploratory Study"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7381-8797","authenticated-orcid":false,"given":"Javier A.","family":"Mu\u00f1oz","sequence":"first","affiliation":[{"name":"Departamento de Urolog\u00eda Hospital Regional de Coyhaique, Coyhaique Regi\u00f3n de Ays\u00e9n Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0934-8201","authenticated-orcid":false,"given":"Carla","family":"Basualto\u2010Alarc\u00f3n","sequence":"additional","affiliation":[{"name":"Centro PUENTES de Investigaci\u00f3n en Salud, Departamento de Ciencias de la Salud Universidad de Ays\u00e9n, Coyhaique Regi\u00f3n de Ays\u00e9n Chile"},{"name":"Laboratorio de Fisiolog\u00eda Celular y Metabolismo, Departamento de Ciencias de la Salud Universidad de Ays\u00e9n, Coyhaique Regi\u00f3n de Ays\u00e9n Chile"},{"name":"Departamento de Anatom\u00eda y Medicina Legal, Facultad de Medicina Universidad de Chile Santiago, Regi\u00f3n Metropolitana Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9024-0531","authenticated-orcid":false,"given":"Mat\u00edas D.","family":"del Camino","sequence":"additional","affiliation":[{"name":"Departamento de Neurolog\u00eda Hospital Regional de Coyhaique, Coyhaique Regi\u00f3n de Ays\u00e9n Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1721-9020","authenticated-orcid":false,"given":"Diego","family":"Leiva","sequence":"additional","affiliation":[{"name":"Departamento de Urolog\u00eda Hospital Regional de Coyhaique, Coyhaique Regi\u00f3n de Ays\u00e9n Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7923-3115","authenticated-orcid":false,"given":"Pablo","family":"G\u00e1lvez","sequence":"additional","affiliation":[{"name":"Departamento de Urolog\u00eda Hospital Regional de Coyhaique, Coyhaique Regi\u00f3n de Ays\u00e9n Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8491-2830","authenticated-orcid":false,"given":"Joaqu\u00edn","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Departamento de Urolog\u00eda Hospital Regional de Coyhaique, Coyhaique Regi\u00f3n de Ays\u00e9n Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5875-933X","authenticated-orcid":false,"given":"Gabriela","family":"Asenjo","sequence":"additional","affiliation":[{"name":"Departamento de Salud P\u00fablica Hospital Regional de Coyhaique, Coyhaique Regi\u00f3n de Ays\u00e9n Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4700-3647","authenticated-orcid":false,"given":"Alfonso","family":"Le\u00f3n","sequence":"additional","affiliation":[{"name":"Departamento de Neurolog\u00eda Hospital Base de Valdivia Valdivia Regi\u00f3n de los Rios Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5979-3873","authenticated-orcid":false,"given":"Joaqu\u00edn","family":"Soto","sequence":"additional","affiliation":[{"name":"Departamento de Neurolog\u00eda Hospital Regional de Coyhaique, Coyhaique Regi\u00f3n de Ays\u00e9n Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0052-5977","authenticated-orcid":false,"given":"Juan P.","family":"Valdevenito","sequence":"additional","affiliation":[{"name":"Departamento de Urolog\u00eda. 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