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SYSTEMATIC REVIEW article

Front. Neurosci.
Sec. Autonomic Neuroscience
Volume 18 - 2024 | doi: 10.3389/fnins.2024.1393826
This article is part of the Research Topic Enteric Nervous System and Its Implications for Human Health and Diseases View all 4 articles

Effects of auricular stimulation on weight and obesity related parameters -results of a systematic review and meta-analysis of randomized controlled clinical trials

Provisionally accepted
Joanna Dietzel Joanna Dietzel 1*Kevin Hua Kevin Hua 1Taras Usichenko Taras Usichenko 2Mike Cummings Mike Cummings 3Miriam Bernatick Miriam Bernatick 4Stefan N. Willich Stefan N. Willich 1Benno Brinkhaus Benno Brinkhaus 1
  • 1 Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin, Baden-Württemberg, Germany
  • 2 Department of Anesthesiology, University Medicine Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
  • 3 British Medical Acupuncture Society (BMAS), London, United Kingdom
  • 4 International Society for Chinese Medicine, Munich, Bavaria, Germany

The final, formatted version of the article will be published soon.

    The number of randomized controlled trials using stimulation of auricular vagal sensory nerves by the means of electrical stimulation, auricular acupuncture or acupressure to support weight loss has increased markedly over the last three decades. This systematic review focuses on effects of auricular stimulation on the anthropometric parameters and obesity related blood chemistry.The following databases were searched until November 2021: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. Data collection and analysis was conducted by two reviewers independently. Quality and risk assessment of included studies was performed using the risk of bias tool of the Cochrane Handbook and the meta-analysis of the effect of the most frequently assessed biomarkers was conducted using the statistical software RevMan.Results: Full texts of 1274 studies were screened, 22 contained data on obesity related outcomes, 15 trials with 1333 patients were included in the meta-analysis. The overall quality of the included trials was moderate. Auricular stimulationS(AS) significantly reduced BMI (mean difference (MD) = -0.38 BMI-points, 95% CI (-0.55 to -0.22), p<0.0001), weight (MD = -0.66 kg, 95% CI (-1.12 to -0.20), p=0.005), waist-circumference (MD = -1.44cm, 95% CI (-2.69 to -0.20), p=0.02) and the hormones leptin, insulin as well as the HOMA insulin resistance compared to controls. No significant reduction of body fat was found in body fat, hip circumference, ratio of waist/hip circumference, cholesterol, LDL, triglycerides, adiponectin, ghrelin, and glucose levels. The AS was safe throughout the trials, with only minor adverse reactions.The study results suggest that a reduction of weight and BMI can be achieved by AS in obese patients, however the size of the effect does not appear to be of clinical relevance.Effects might be underestimated due to active sham trials.

    Keywords: CES: cranial electrotherapy stimulation, CI: confidence intervals, SMD: standardized mean differences, RE: random effects, RoB: Risk of bias, taVNS: transauricular vagus nerve stimulation, Auricular vagus nerve stimulation, Obesity, Blood lipids, systematic review, metaanalysis

    Received: 29 Feb 2024; Accepted: 19 Jul 2024.

    Copyright: © 2024 Dietzel, Hua, Usichenko, Cummings, Bernatick, Willich and Brinkhaus. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Joanna Dietzel, Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin, 10117, Baden-Württemberg, Germany

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