Vagus Nerve Stimulation in Movement Disorders, from Principles to a Systematic Review of Evidence.

IF 7.6 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2025-09-30 DOI:10.1002/mds.70044

Francesca Proietti,Matteo Maria Ottaviani,Elisabetta Burchi,Giorgio Vivacqua,Gaia Anzini,Riccardo Antonio Ricciuti,Fioravante Capone,Vaughan G Macefield,Vincenzo Di Lazzaro,Massimo Marano

{"title":"Vagus Nerve Stimulation in Movement Disorders, from Principles to a Systematic Review of Evidence.","authors":"Francesca Proietti,Matteo Maria Ottaviani,Elisabetta Burchi,Giorgio Vivacqua,Gaia Anzini,Riccardo Antonio Ricciuti,Fioravante Capone,Vaughan G Macefield,Vincenzo Di Lazzaro,Massimo Marano","doi":"10.1002/mds.70044","DOIUrl":null,"url":null,"abstract":"BACKGROUND\r\nThe vagus nerve (VN), the principal component of the parasympathetic branch of the autonomic nervous system (ANS), mediates bidirec communication between the central nervous system (CNS) and peripheral organs. Vagus nerve stimulation (VNS), delivered through invasive (iVNS) or non-invasive (transcutaneous cervical [tcVNS] and transcutaneous auricular [taVNS]), exerts multimodal effects on multiple circuits and neurotransmitters, and is currently under investigation in movement disorders.\r\n\r\nOBJECTIVES\r\nThis systematic review evaluates the therapeutic potential of VNS in movement disorders (MDs), with a focus on Parkinson's disease (PD), parkinsonism, tremor and essential tremor (ET), cervical dystonia (CD), and Tourette's syndrome (TS).\r\n\r\nMETHODS\r\nA systematic search of PubMed, Web of Science, and Scopus was conducted for studies published between 2020 and 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.\r\n\r\nRESULTS\r\nThirty-two studies met the inclusion criteria: 22 on PD or parkinsonism (14 clinical and 8 preclinical on PD, 1 clinical on multisystem atrophy), 6 on tremor and ET (4 clinical, 2 preclinical), 2 clinical studies on CD, and 1 clinical study on TS. Across conditions, VNS was reported to improve motor and non-motor, enhance synaptic plasticity, modulate neurotransmitter activity relevant to MDs (GABA, norepinephrine, dopamine, and acetylcholine), and reduce neuroinflammation.\r\n\r\nCONCLUSIONS\r\nCurrent evidence supports the multimodal effect of VNS in MDs, particularly in PD, where the most consistent benefits were observed. Non-invasive taVNS represents a promising, safer alternative to iVNS. Larger randomized controlled trials with standardized protocols are needed to validate efficacy, optimize stimulation parameters, and determine long-term clinical and biological impact. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"65 1","pages":""},"PeriodicalIF":7.6000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Movement Disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/mds.70044","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

BACKGROUND The vagus nerve (VN), the principal component of the parasympathetic branch of the autonomic nervous system (ANS), mediates bidirec communication between the central nervous system (CNS) and peripheral organs. Vagus nerve stimulation (VNS), delivered through invasive (iVNS) or non-invasive (transcutaneous cervical [tcVNS] and transcutaneous auricular [taVNS]), exerts multimodal effects on multiple circuits and neurotransmitters, and is currently under investigation in movement disorders. OBJECTIVES This systematic review evaluates the therapeutic potential of VNS in movement disorders (MDs), with a focus on Parkinson's disease (PD), parkinsonism, tremor and essential tremor (ET), cervical dystonia (CD), and Tourette's syndrome (TS). METHODS A systematic search of PubMed, Web of Science, and Scopus was conducted for studies published between 2020 and 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. RESULTS Thirty-two studies met the inclusion criteria: 22 on PD or parkinsonism (14 clinical and 8 preclinical on PD, 1 clinical on multisystem atrophy), 6 on tremor and ET (4 clinical, 2 preclinical), 2 clinical studies on CD, and 1 clinical study on TS. Across conditions, VNS was reported to improve motor and non-motor, enhance synaptic plasticity, modulate neurotransmitter activity relevant to MDs (GABA, norepinephrine, dopamine, and acetylcholine), and reduce neuroinflammation. CONCLUSIONS Current evidence supports the multimodal effect of VNS in MDs, particularly in PD, where the most consistent benefits were observed. Non-invasive taVNS represents a promising, safer alternative to iVNS. Larger randomized controlled trials with standardized protocols are needed to validate efficacy, optimize stimulation parameters, and determine long-term clinical and biological impact. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

查看原文本刊更多论文

迷走神经刺激在运动障碍中的作用，从原理到证据的系统回顾。

迷走神经（VN）是自主神经系统（ANS）副交感神经分支的主要组成部分，介导中枢神经系统（CNS）和外周器官之间的双向交流。迷走神经刺激（VNS），通过侵入性（iVNS）或非侵入性（经皮颈[tcVNS]和经皮耳[taVNS]）传递，对多个回路和神经递质产生多模态效应，目前正在运动障碍的研究中。目的：本系统综述评估VNS在运动障碍（MDs）中的治疗潜力，重点关注帕金森病（PD）、帕金森病、震颤和特发性震颤（ET）、宫颈肌张力障碍（CD）和妥瑞特综合征（TS）。方法系统检索PubMed、Web of Science和Scopus，检索2020年至2025年间发表的研究，遵循系统评价和元分析2020指南的首选报告项目。结果32项研究符合纳入标准，其中PD或帕金森22项（PD临床14项，临床前8项，多系统萎缩1项），震颤和ET 6项（临床4项，临床前2项），CD 2项，TS 1项。在不同条件下，VNS均能改善运动和非运动，增强突触可塑性，调节与MDs相关的神经递质（GABA、去甲肾上腺素、多巴胺、乙酰胆碱）活性，减轻神经炎症。目前的证据支持VNS在MDs中的多模态效应，特别是在PD中，其中观察到最一致的益处。无创taVNS是iVNS的一种有前途的、更安全的替代方法。需要采用标准化方案的更大规模随机对照试验来验证疗效，优化刺激参数，并确定长期临床和生物学影响。©2025作者。Wiley期刊有限责任公司代表国际帕金森和运动障碍学会出版的《运动障碍》。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.