Vascular Autonomic Signal-Guided Photobiomodulation: Mechanisms and Clinical Applications in Autonomic Dysregulation

Background: Dysregulation of the autonomic nervous system contributes to chronic conditions including insomnia, anxiety, chronic pain, and vertigo. Auricular stimulation can modulate au-tonomic, limbic, and sensorimotor pathways via cranial and cervical nerve afferents, influencing neurotransmitter release and anti-inflammatory signalling. The Vascular Autonomic Signal (VAS) provides real-time, feedback-driven identification of physiologically active auricular points through transient changes in radial pulse amplitude.Methods: This review synthesises the origins, physiology, and clinical applications of the VAS, integrating evidence from historical observations, experimental models, and imaging studies. The synergistic application of photobiomodulation (PBM) to VAS-responsive points is exam-ined, highlighting mechanisms including mitochondrial activation, nitric oxide signalling, mi-crocirculatory modulation, and stem-cell mobilisation. Results: Clinical illustrations demonstrate that VAS-guided PBM can stabilise autonomic tone, enhance sleep, reduce neuropathic pain, and improve functional outcomes. Personalised dosing guided by VAS attenuates overstimulation while promoting parasympathetic dominance and regenerative processes.Conclusions: VAS-guided PBM represents a precise, non-invasive, and adaptive approach for modulating autonomic function and supporting regenerative mechanisms. Structured training and potential automated detection systems are essential to enhance reproducibility. Although preliminary evidence is promising, larger controlled trials are required to define optimal pa-rameters, effect sizes, and condition-specific protocols. This integrative modality offers a re-al-time, patient-specific tool for autonomic modulation within evidence-informed practice.