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SYSTEMATIC REVIEW article
Front. Aging Neurosci.
Sec. Parkinson’s Disease and Aging-related Movement Disorders
Volume 16 - 2024 |
doi: 10.3389/fnagi.2024.1498176
This article is part of the Research Topic Pathophysiology, Treatment and Rehabilitation of Neurodegenerative Diseases in Geriatric Population View all 14 articles
Transcutaneous Vagus Nerve Stimulation for Parkinson's Disease: A Systematic Review and Meta-Analysis
Provisionally accepted- 1 Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- 2 Centre for Healthy Ageing, National University Health System, Singapore, Singapore
- 3 New York University Shanghai, pudong, Shanghai, China
- 4 Queen Mary college, Nanchang University, Nanchang, Jiangxi Province, China
- 5 School of Medicine, Shanghai Jiao Tong University, Shanghai, Shanghai Municipality, China
- 6 Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai, Shanghai Municipality, China
- 7 Jiangxi Medical College, Nanchang University, Fuzhou, Fujian Province, China
Background: Transcutaneous vagus nerve stimulation (tVNS) has emerged as a novel noninvasive adjunct therapy for advanced Parkinson's disease (PD), yet no quantitative analysis had been conducted to assess its therapeutic effect.Objectives: This review aimed to investigate the efficacy of tVNS on motor function, other potential clinical targets and its safety in various treatment conditions.We searched six databases for randomized controlled trials (RCTs) that involved treating PD patients with tVNS. Primary outcome was motor functions, including severity of motor signs, functional mobility and balance, and gait parameters. Secondary outcomes were cognition, emotion, sleep related impairments, patient reported non-motor outcomes, and any adverse events. All outcomes were classified and analyzed according to the treatment duration and medication condition of an included study. Risk of bias was evaluated by referencing Cochrane risk of bias tool 1.0. Data was analyzed by Revman 5.4.Results: 6 RCTs with 176 PD patient were included. Several motor functions and non-motor functions measured during on-medication condition (severity of motor signs -0.48 [95% CI -0.93, -0.04], gait -0.48 [95% CI -0.85, -0.1], patients reported non-motor outcomes -0.4 [95% CI -0.78, -0.03]), improved significantly. However, verbal fluency, sleep-related impairment, and fatigue were negatively impacted by tVNS during on-medication condition. No distinct adverse events were reported.3 Conclusion: tVNS is a relatively safe adjunct treatment for PD. It has small to moderate therapeutic effects on motor functions and may negatively impact on a few other outcomes. Quality level of the evidence is low and further research is warranted.
Keywords: transcutaneous vagus nerve stimulation (tVNS), Parkinson's disease (PD), motor functions, Cognition, Meta-analysis
Received: 18 Sep 2024; Accepted: 27 Dec 2024.
Copyright: © 2024 Shan, Li, Ji, Zhang, Zhang, Zhu and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zehong Li, Queen Mary college, Nanchang University, Nanchang, Jiangxi Province, China
Miao Zhang, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, Shanghai Municipality, China
Yikang Zhu, Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai, 201108, Shanghai Municipality, China
Zhen Feng, Jiangxi Medical College, Nanchang University, Fuzhou, Fujian Province, China
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