{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:57:11Z","timestamp":1792789031478,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Air Force Medical University","award":["2024SJTK04-01"],"award-info":[{"award-number":["2024SJTK04-01"]}],"id":[{"id":"https:\/\/ror.org\/00ms48f15","id-type":"ROR","asserted-by":"crossref"}]},{"award":["2024SJTK04-01"],"award-info":[{"award-number":["2024SJTK04-01"]}],"id":[{"id":"https:\/\/ror.org\/00ms48f15","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sci.","Brain Sciences"],"abstract":"<jats:p>Objectives: Acute exposure to sustained high cognitive load rapidly depletes executive functions, yet rapid, field-compatible countermeasures remain scarce. This study examined whether transcutaneous auricular vagus nerve stimulation (taVNS) improves cognitive functions across multiple domains\u2014including the attention networks, cognitive flexibility, and working memory\u2014following sustained high cognitive load. Methods: Healthy young men completed a 1 h dual task combining spatial 1-back and color\u2013word Stroop judgments (the BS task) to induce a high-cognitive-load state; 65 participants were randomized to receive 30 min of active taVNS (left cymba conchae; 25 Hz; 500-\u03bcs pulse width; 30 s on\/30 s off) or sham stimulation under a single-blind design, and 62 provided complete data and were analyzed. Cognitive performance was assessed with the Attention Network Test, Cued Switching Task, and spatial 2-back task immediately after the intervention and after 1, 2, 4, and 8 h; baseline-corrected change scores were analyzed with linear mixed-effects models. Results: The induction task reliably increased subjective workload and degraded task accuracy. Immediately after the intervention, taVNS significantly reduced the conflict effect relative to sham (b = \u221216.43 ms, 95% CI [\u221232.03, \u22120.82], F(1, 127.5) = 4.34, p = 0.039, d = 0.64) and the switch cost (b = \u221259.79 ms, 95% CI [\u2212109.66, \u22129.92], F(1, 81.8) = 5.69, p = 0.019, d = 0.53); both immediate effects remained significant after Holm correction. Group \u00d7 time interactions were nonsignificant, and the temporal course of the between-group differences should therefore be interpreted cautiously. No significant effects were observed for alerting, orienting, or working memory. Conclusions: These findings indicate that taVNS selectively and immediately improves executive control and cognitive flexibility following sustained high cognitive load, supporting its potential as a portable, rapid-acting cognitive countermeasure for high-demand operational settings.<\/jats:p>","DOI":"10.3390\/brainsci16091001","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:06:51Z","timestamp":1790006811000},"page":"1001","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transcutaneous Auricular Vagus Nerve Stimulation Selectively Improves Executive Control and Cognitive Flexibility Following Sustained High Cognitive Load: A Randomized, Single-Blind, Sham-Controlled Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Haixu","family":"Lyu","sequence":"first","affiliation":[{"name":"Department of Military Medical Psychology, Air Force Medical University, Xi\u2019an 710032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6375-3946","authenticated-orcid":false,"given":"Haiyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Military Medical Psychology, Air Force Medical University, Xi\u2019an 710032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Military Medical Psychology, Air Force Medical University, Xi\u2019an 710032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanying","family":"Xing","sequence":"additional","affiliation":[{"name":"School of Teacher Education, Qiongtai Normal University, Haikou 571127, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingwei","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Military Medical Psychology, Air Force Medical University, Xi\u2019an 710032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xufeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Military Medical Psychology, Air Force Medical University, Xi\u2019an 710032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1152\/japplphysiol.91324.2008","article-title":"Mental Fatigue Impairs Physical Performance in Humans","volume":"106","author":"Marcora","year":"2009","journal-title":"J. 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