Effects of Transcutaneous Auricular Vagus Nerve Stimulation With Rehabilitation on the Recovery of Upper Extremity Function After Stroke: A Systematic Review and Meta-Analysis.

IF 3.7 4区 医学 Q2 Medicine
Neural Plasticity Pub Date : 2025-10-30 eCollection Date: 2025-01-01 DOI:10.1155/np/9927826
Hui-Lin Li, Yan-Bing Jia, Xiao-Yan Liu, Yu-Sen Wang, Ze-Kun Zhang, Kui-Cheng Li, Xi-Zhen Wang, Jia-Xin Pan, Hao Liu
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引用次数: 0

Abstract

Background: Upper limb motor dysfunction after stroke can significantly impede activities of daily living and quality of life. Transcutaneous auricular vagus nerve stimulation (taVNS) is a novel noninvasive treatment for stroke. Its combination with rehabilitation is a growing trend.

Objective: To explore the effects of taVNS combined with rehabilitation on upper limb function poststroke.

Methods: PubMed, EMBASE, Web of Science, EBSCO, CINAHL, and the Cochrane Library databases were searched up to September 16th, 2024. Two reviewers screened studies from these databases for eligible randomized controlled trials (RCTs) and extracted the data independently. The Cochrane collaboration tool (RoB 2.0) was used to assess the risk of bias.

Results: Four studies with 129 participants were included. Compared to controls, augmented treatment with taVNS had preferable effect on improving upper limb motor function after stroke (all outcomes: standardized mean difference [SMD] = 1.28, 95% CI: 0.65-1.90, I 2 = 72%, and p  < 0.0001; Fugl-Meyer assessment [FMA]: MD = 3.66, 95% CI: 0.50-6.83, I 2 = 90%, and p=0.02; Wolf Motor Function Test [WMFT]: MD = 6.77, 95% CI: -0.07 to 13.61, I 2 = 88%, and p=0.05)], especially combined with conventional rehabilitation (FMA: MD = 5.91, 95% CI: 1.37-10.45, I 2 = 90%, p=0.01). However, data from 3-month follow-up showed the similar therapeutic effects of rehabilitation with or without taVNS (FMA: MD = 4.66, 95% CI: -1.22 to 10.54, I 2 = 93%, and p=0.12; WMFT: MD = 6.86, 95% CI: -5.91 to 19.62, I 2 = 96%, and p=0.29). No obvious side effects were reported.

Conclusion: This meta-analysis showed augmented effect of taVNS on rehabilitation therapy in paretic upper limb motor function poststroke, especially combined with conventional rehabilitation. However, the high heterogeneity of aggregated results indicates more rigorously designed studies are needed.

经皮耳迷走神经刺激配合康复治疗对脑卒中后上肢功能恢复的影响:系统回顾和meta分析。
背景:脑卒中后上肢运动功能障碍会严重影响日常生活活动和生活质量。经皮耳迷走神经刺激(taVNS)是一种新型的无创脑卒中治疗方法。它与康复相结合是一个日益增长的趋势。目的:探讨taVNS联合康复治疗对脑卒中后上肢功能的影响。方法:检索截至2024年9月16日的PubMed、EMBASE、Web of Science、EBSCO、CINAHL、Cochrane Library数据库。两名审稿人从这些数据库中筛选符合条件的随机对照试验(rct),并独立提取数据。采用Cochrane协作工具(RoB 2.0)评估偏倚风险。结果:纳入4项研究,共129名受试者。与对照组相比,taVNS增强治疗在改善卒中后上肢运动功能方面效果更好(所有结果:标准化平均差[SMD] = 1.28, 95% CI: 0.65-1.90, i2 = 72%, p < 0.0001; Fugl-Meyer评估[FMA]: MD = 3.66, 95% CI: 0.50-6.83, i2 = 90%, p=0.02;Wolf运动功能测试[WMFT]: MD = 6.77, 95% CI: -0.07 ~ 13.61, i2 = 88%, p=0.05)],特别是结合常规康复(FMA: MD = 5.91, 95% CI: 1.37 ~ 10.45, i2 = 90%, p=0.01)。然而,3个月的随访数据显示,有无taVNS的康复治疗效果相似(FMA: MD = 4.66, 95% CI: -1.22 ~ 10.54, i2 = 93%, p=0.12; WMFT: MD = 6.86, 95% CI: -5.91 ~ 19.62, i2 = 96%, p=0.29)。无明显副作用报道。结论:本荟萃分析显示taVNS对卒中后麻痹性上肢运动功能康复治疗的增强作用,特别是与常规康复治疗相结合。然而,汇总结果的高度异质性表明需要更严格设计的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neural Plasticity
Neural Plasticity Neuroscience-Neurology
CiteScore
5.70
自引率
0.00%
发文量
0
审稿时长
1 months
期刊介绍: Neural Plasticity is an international, interdisciplinary journal dedicated to the publication of articles related to all aspects of neural plasticity, with special emphasis on its functional significance as reflected in behavior and in psychopathology. Neural Plasticity publishes research and review articles from the entire range of relevant disciplines, including basic neuroscience, behavioral neuroscience, cognitive neuroscience, biological psychology, and biological psychiatry.
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