Transcutaneous vagus nerve stimulation (tVNS) modulates flow experience

Exp Brain Res. 2018 Jan;236(1):253-257. doi: 10.1007/s00221-017-5123-0. Epub 2017 Nov 11.


Flow has been defined as a pleasant psychological state that people experience when completely absorbed in an activity. Previous correlative evidence showed that the vagal tone (as indexed by heart rate variability) is a reliable marker of flow. So far, it has not yet been demonstrated that the vagus nerve plays a causal role in flow. To explore this we used transcutaneous vagus nerve stimulation (tVNS), a novel non-invasive brain stimulation technique that increases activation of the locus coeruleus (LC) and norepinephrine release. A sham/placebo-controlled, randomized cross-over within-subject design was employed to infer a causal relation between the stimulated vagus nerve and flow as measured using the Flow Short-Scale in 32 healthy young volunteers. In both sessions, while being stimulated, participants had to rate their flow experience after having performed a task for 30 min. Active tVNS, compared to sham stimulation, decreased flow (as indexed by absorption scores). The results can be explained by the network reset theory, which assumes that high-phasic LC activity promotes a global reset of attention over exploitation of the current focus of attention, allowing rapid behavioral adaptation and resulting in decreased absorption scores. Furthermore, our findings corroborate the hypothesis that the vagus nerve and noradrenergic system are causally involved in flow.

Keywords: Flow experience; Locus coeruleus; Network reset theory; Norepinephrine; Parasympathetic activation; Transcutaneous vagus nerve stimulation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Attention / physiology*
  • Cross-Over Studies
  • Female
  • Heart Rate / physiology
  • Humans
  • Locus Coeruleus / physiology*
  • Male
  • Norepinephrine / metabolism
  • Psychomotor Performance / physiology*
  • Single-Blind Method
  • Transcutaneous Electric Nerve Stimulation* / methods
  • Vagus Nerve / physiology*
  • Vagus Nerve Stimulation* / methods
  • Young Adult


  • Norepinephrine