{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:12:41Z","timestamp":1793293961032,"version":"4.5.0"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T00:00:00Z","timestamp":1667433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["52277230"],"award-info":[{"award-number":["52277230"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Transcutaneous auricular vagus nerve stimulation (taVNS) can improve autonomic nerve function and is currently undergoing extensive clinical research; however, its efficacy heterogeneity has caused great controversy. Heart rate variability (HRV), a biomarker reflecting autonomic function, exhibits a time-varying pattern with circadian rhythms, which may be the main reason for the inconsistent stimulation effects. To test this conjecture, we performed isochronous acute stimulation experiments at intervals of 12 h. The results showed that HRV indicators representing vagal nerve activity significantly increased when stimulation was performed in the morning, and the enhancement of high frequency continued into the recovery period. However, the evening stimulation did not yield similar results. In addition, we found that improvements in the measures of autonomic balance were more pronounced in the presence of lower vagal activity. By increasing the stimulation duration, we also found that the effect of taVNS on HRV was not regulated by duration; in other words, HRV changes only had the best effect at the beginning of stimulation. These studies allowed us to determine the optimal stimulation phase and duration and potentially screen the optimal candidates for taVNS.<\/jats:p>","DOI":"10.1371\/journal.pone.0277090","type":"journal-article","created":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T17:32:03Z","timestamp":1667496723000},"page":"e0277090","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Circadian stage-dependent and stimulation duration effects of transcutaneous auricular vagus nerve stimulation on heart rate variability"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9971-4633","authenticated-orcid":true,"given":"Duyan","family":"Geng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongxia","family":"An","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,11,3]]},"reference":[{"issue":"10","key":"pone.0277090.ref001","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1097\/HJH.0b013e32829baae7","article-title":"Sympathetic activity in major depressive disorder: identifying those at increased cardiac risk?","volume":"25","author":"DA Barton","year":"2007","journal-title":"J Hypertens"},{"issue":"10","key":"pone.0277090.ref002","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.2337\/diacare.24.10.1793","article-title":"Impaired autonomic function is associated with increased mortality, especially in subjects with diabetes, hypertension, or a history of cardiovascular disease: the Hoorn Study","volume":"24","author":"J Gerritsen","year":"2001","journal-title":"Diabetes Care"},{"issue":"8","key":"pone.0277090.ref003","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1161\/CIRCULATIONAHA.107.760405","article-title":"Parasympathetic nervous system and heart failure\u2014Pathophysiology and potential implications for therapy","volume":"118","author":"B Olshansky","year":"2008","journal-title":"Circulation"},{"issue":"11","key":"pone.0277090.ref004","doi-asserted-by":"crossref","first-page":"645","DOI":"10.12968\/hmed.2016.77.11.645","article-title":"Vagus nerve stimulation in clinical practice","volume":"77","author":"AD Farmer","year":"2016","journal-title":"Br J Hosp Med"},{"issue":"7","key":"pone.0277090.ref005","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1093\/eurheartj\/ehq391","article-title":"Chronic vagus nerve stimulation: a new and promising therapeutic approach for chronic heart failure","volume":"32","author":"GM De Ferrari","year":"2011","journal-title":"Eur Heart J"},{"issue":"10284","key":"pone.0277090.ref006","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(21)00475-X","article-title":"Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): a randomised, blinded, pivotal, device trial","volume":"397","author":"J Dawson","year":"2021","journal-title":"Lancet"},{"issue":"6","key":"pone.0277090.ref007","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1016\/j.brs.2018.08.010","article-title":"Safety and tolerability of Transcutaneous Vagus Nerve stimulation in humans; 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