Paulo S de Melo, João Parente, Ingrid Rebello-Sanchez, Anna Marduy, Anna Carolyna Gianlorenco, Chi Kyung Kim, Hyuk Choi, Jae-Jun Song, Felipe Fregni
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The risk of bias was evaluated by adapted Cochrane Collaboration's tool for animal studies (SYRCLES's RoB tool).</p><p><strong>Results: </strong>A total of 8 studies published between 2015 and 2022 were included in this review, including 391 animal models. In general, aVNS demonstrated a reduction in neurological deficits (SMD = -1.97, 95% CI -2.57 to -1.36, <i>I</i><sup>2</sup> = 44%), in time to perform the adhesive removal test (SMD = -2.26, 95% CI -4.45 to -0.08, <i>I</i><sup>2</sup> = 81%), and infarct size (SMD = -1.51, 95% CI -2.42 to -0.60, <i>I</i><sup>2</sup> = 58%). Regarding the neuroplasticity markers, aVNS showed to increase microcapillary density, CD31 proliferation, and BDNF protein levels and RNA expression.</p><p><strong>Conclusions: </strong>The studies analyzed show a trend of results that demonstrate a significant effect of the auricular vagal nerve stimulation in stroke animal models. Although the aggregated results show high heterogeneity and high risk of bias. 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引用次数: 1
摘要
背景:经耳迷走神经刺激(taVNS)作为一种可行的中风干预手段正在被研究，但这种非侵入性技术在大脑皮层中的作用机制仍然广泛未知。目的:本研究旨在系统回顾目前耳穴迷走神经刺激(aVNS)在脑卒中中的神经可塑性作用的临床前证据。方法:我们于2022年12月检索Medline、Cochrane、Embase和Lilacs数据库。作者在Excel中执行数据提取。偏倚风险采用Cochrane Collaboration的动物研究工具(SYRCLES的RoB工具)进行评估。结果:本综述共纳入2015 - 2022年间发表的8项研究，包括391个动物模型。总的来说，aVNS显示神经功能缺损(SMD = -1.97, 95% CI -2.57至-1.36,I2 = 44%)，及时进行黏合剂去除试验(SMD = -2.26, 95% CI -4.45至-0.08,I2 = 81%)和梗死面积(SMD = -1.51, 95% CI -2.42至-0.60,I2 = 58%)的减少。在神经可塑性标志物方面，aVNS显示微血管密度、CD31增殖、BDNF蛋白水平和RNA表达增加。结论:研究结果表明，刺激耳迷走神经对脑卒中动物模型有显著影响。虽然汇总结果显示高异质性和高偏倚风险。需要更多的研究来得出可靠的结论。
Understanding the Neuroplastic Effects of Auricular Vagus Nerve Stimulation in Animal Models of Stroke: A Systematic Review and Meta-Analysis.
Background: Transauricular vagus nerve stimulation (taVNS) is being studied as a feasible intervention for stroke, but the mechanisms by which this non-invasive technique acts in the cortex are still broadly unknown.
Objectives: This study aimed to systematically review the current pre-clinical evidence in the auricular vagus nerve stimulation (aVNS) neuroplastic effects in stroke.
Methods: We searched, in December of 2022, in Medline, Cochrane, Embase, and Lilacs databases. The authors executed the extraction of the data on Excel. The risk of bias was evaluated by adapted Cochrane Collaboration's tool for animal studies (SYRCLES's RoB tool).
Results: A total of 8 studies published between 2015 and 2022 were included in this review, including 391 animal models. In general, aVNS demonstrated a reduction in neurological deficits (SMD = -1.97, 95% CI -2.57 to -1.36, I2 = 44%), in time to perform the adhesive removal test (SMD = -2.26, 95% CI -4.45 to -0.08, I2 = 81%), and infarct size (SMD = -1.51, 95% CI -2.42 to -0.60, I2 = 58%). Regarding the neuroplasticity markers, aVNS showed to increase microcapillary density, CD31 proliferation, and BDNF protein levels and RNA expression.
Conclusions: The studies analyzed show a trend of results that demonstrate a significant effect of the auricular vagal nerve stimulation in stroke animal models. Although the aggregated results show high heterogeneity and high risk of bias. More studies are needed to create solid conclusions.
期刊介绍：
Neurorehabilitation & Neural Repair (NNR) offers innovative and reliable reports relevant to functional recovery from neural injury and long term neurologic care. The journal''s unique focus is evidence-based basic and clinical practice and research. NNR deals with the management and fundamental mechanisms of functional recovery from conditions such as stroke, multiple sclerosis, Alzheimer''s disease, brain and spinal cord injuries, and peripheral nerve injuries.
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