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Comparing Electrical and Ultrasound Transcutaneous Auricular Vagus Nerve Stimulation on Associative Memory

Benjamin J. Griffiths, Ziqi He, Irem Ciftepinar, Hyuk Choi, Jae-Jun Song, Marcus Kaiser, JeYoung Jung

Neuromodulation: Technology at the Neural Interface 2026 · 10.1016/j.neurom.2026.07.001

human healthyhealthybehaviour

Abstract

Objectives Associative memory, the ability to bind and retrieve relationships between unrelated elements, is a cornerstone of human cognition and a primary target for neurorehabilitation. Vagus nerve stimulation (VNS) has emerged as a promising method to modulate the locus coeruleus-norepinephrine system and hippocampal-prefrontal circuits essential for memory. However, the comparative efficacy of noninvasive modalities such as electrical transcutaneous VNS (E-taVNS) and the emerging field of ultrasound (U-taVNS) remains poorly understood in the context of active recall. Materials and methods In this study, participants performed a cross-modal video-word associative memory task before and after receiving either E-taVNS or U-taVNS in active and sham conditions. We investigated whether these modalities enhance cued recall accuracy and retrieval reaction time. Results Our results revealed that neither E-taVNS nor U-taVNS significantly improved recall accuracy. However, E-taVNS significantly accelerated response times specifically for correctly recalled items. These findings suggest that although taVNS may not increase the likelihood of recalling associative memories after a brief retention interval, electrical stimulation may enhance the efficiency with which we do so. Conclusions These findings suggest that E-taVNS is a viable tool for facilitating memory processes, although further research is required to optimize ultrasound parameters and validate mechanistic pathways through physiologic monitoring.

Abstract via europepmc.

Specieshuman
Subjects29 participants
Sessions per subject1
Randomisedyes
Blindingsingle
Sham / controlinactive transducer, sound only
Auditory controlsound only sham
Readout timingoffline
Anaesthesianot applicable
ReadoutsbehaviourCross-modal video-word associative memory task (cued recall accuracy and retrieval reaction time); side-effects questionnaire
Direction of effectno effectU-taVNS did not significantly improve associative memory accuracy versus sham or pre-stimulation, and unlike E-taVNS, did not produce a hastening of reaction times for correctly recalled items (active vs sham hastening for E-taVNS: t(29)=-2.999, p=0.003; no equivalent effect for U-taVNS: t(27)=-0.391, p=0.349).
Adverse eventsobservedNo significant aversive effects were observed relative to sham in either modality, though skin irritation was more frequently reported with E-taVNS than U-taVNS (chi2=3.86, p=0.049), indicating U-taVNS was associated with a lower incidence of skin irritation than E-taVNS. Minor events (e.g. dizziness, ear pain, other) were reported by a small number of U-taVNS participants (Table 2).

Exposures

Exposure 1: Ultrasound taVNS (U-taVNS) to right cymba conchae

Target: vagus nerve — “right cymba conchae
Device: other named manufacturer · NeurGear Inc, Rochester, NY · ZenBud

Pulse timing
Waveformpulsed
Fundamental frequency (kHz)5,300✓✓
Pulse duration (ms)not reportedimplied by duty cycle ÷ PRF: 12.1951 ms (not stated by the paper)
Pulse repetition frequency (Hz)41✓✓
Duty cycle (%)50✓✓
Sonication duration (s)1,800✓✓
Pressure and intensity, by domain
Free-field pressure (kPa)not reported
Free-field Isppa (W/cm²)not reported
Free-field Ispta (W/cm²)not reported
In-situ estimatenot reported
In-situ pressure (kPa)not reported
In-situ Isppa (W/cm²)not reported
In-situ Ispta (W/cm²)not reported
Pressure, domain unspecified (kPa)1,030✓✓
Isppa, domain unspecified (W/cm²)0.081✓✓
Protocol, in the paper’s words

Participants received 30 minutes of taVNS per session; each participant completed two sessions (active and sham), scheduled >=5 days apart, with stimulation order counterbalanced. For the sham condition, a dedicated sham device reproduced the same auditory buzzing sound as the active device but delivered no ultrasound output, matching auditory cues between active and sham sessions.

Consistency checks: intensity pressure inconsistent unspecified domain.

Flags from extraction

  • exposures[0].unspecified_domain.pressure_kpaThe paper reports this as 'an average pressure amplitude of 1.03 MPa', which is unambiguously a pressure value; converted to 1030 kPa.
  • exposures[0].unspecified_domain.isppa_w_cm2'A peak mechanical output of 0.081 W/cm2' is not explicitly labelled ISPPA or ISPTA; assigned to ISPPA given the word 'peak', but this is an inference.
  • exposures[0].timing.pulse_duration_msDuty cycle (50%) and PRF (41 Hz) are stated but pulse duration is not; not computed per the no-arithmetic rule.
  • exposures[0].free_fieldThe paper does not state whether the reported pressure/intensity values are free-field or in-situ; recorded under unspecified_domain.
  • sham_typeThe U-taVNS sham used a separate 'dedicated sham device' rather than the active transducer powered off; classified as inactive_transducer (no acoustic output) as the closest vocabulary match.