Transcutaneous vagus nerve stimulation for Parkinson’s disease: a systematic review and meta-analysis

BackgroundTranscutaneous 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.ObjectivesThis review aimed to investigate the efficacy of tVNS on motor...

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Main Authors: Jiatong Shan, Zehong Li, Minxiu Ji, Miao Zhang, Caidi Zhang, Yikang Zhu, Zhen Feng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Aging Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnagi.2024.1498176/full
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author Jiatong Shan
Jiatong Shan
Jiatong Shan
Zehong Li
Minxiu Ji
Miao Zhang
Caidi Zhang
Yikang Zhu
Zhen Feng
author_facet Jiatong Shan
Jiatong Shan
Jiatong Shan
Zehong Li
Minxiu Ji
Miao Zhang
Caidi Zhang
Yikang Zhu
Zhen Feng
author_sort Jiatong Shan
collection DOAJ
description BackgroundTranscutaneous 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.ObjectivesThis review aimed to investigate the efficacy of tVNS on motor function, other potential clinical targets and its safety in various treatment conditions.MethodsWe 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.Results6 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.ConclusiontVNS 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.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#recordDetails, identifier CRD42024503322 (PROSPERO).
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issn 1663-4365
language English
publishDate 2025-01-01
publisher Frontiers Media S.A.
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spelling doaj-art-351c505038c040daa1338d0d6a6977f22025-01-14T06:10:37ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652025-01-011610.3389/fnagi.2024.14981761498176Transcutaneous vagus nerve stimulation for Parkinson’s disease: a systematic review and meta-analysisJiatong Shan0Jiatong Shan1Jiatong Shan2Zehong Li3Minxiu Ji4Miao Zhang5Caidi Zhang6Yikang Zhu7Zhen Feng8Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeCentre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore, SingaporeNew York University Shanghai, Shanghai, ChinaNanchang University Queen Mary School, Nanchang, Jiangxi, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaAffiliated Rehabilitation Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaBackgroundTranscutaneous 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.ObjectivesThis review aimed to investigate the efficacy of tVNS on motor function, other potential clinical targets and its safety in various treatment conditions.MethodsWe 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.Results6 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.ConclusiontVNS 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.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#recordDetails, identifier CRD42024503322 (PROSPERO).https://www.frontiersin.org/articles/10.3389/fnagi.2024.1498176/fulltranscutaneous vagus nerve stimulationParkinson’s diseasemotor functionscognitionmeta-analysis
spellingShingle Jiatong Shan
Jiatong Shan
Jiatong Shan
Zehong Li
Minxiu Ji
Miao Zhang
Caidi Zhang
Yikang Zhu
Zhen Feng
Transcutaneous vagus nerve stimulation for Parkinson’s disease: a systematic review and meta-analysis
Frontiers in Aging Neuroscience
transcutaneous vagus nerve stimulation
Parkinson’s disease
motor functions
cognition
meta-analysis
title Transcutaneous vagus nerve stimulation for Parkinson’s disease: a systematic review and meta-analysis
title_full Transcutaneous vagus nerve stimulation for Parkinson’s disease: a systematic review and meta-analysis
title_fullStr Transcutaneous vagus nerve stimulation for Parkinson’s disease: a systematic review and meta-analysis
title_full_unstemmed Transcutaneous vagus nerve stimulation for Parkinson’s disease: a systematic review and meta-analysis
title_short Transcutaneous vagus nerve stimulation for Parkinson’s disease: a systematic review and meta-analysis
title_sort transcutaneous vagus nerve stimulation for parkinson s disease a systematic review and meta analysis
topic transcutaneous vagus nerve stimulation
Parkinson’s disease
motor functions
cognition
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fnagi.2024.1498176/full
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