Key result
Non-invasive vagus nerve stimulation significantly improved step length variability in patients with Parkinson's disease (SMD -1.09, p<0.0001) compared to control groups, though it did not significantly affect other motor symptoms.
Why the study?
Current Parkinson's disease treatments have limitations and side effects, prompting exploration of non-pharmacological interventions like non-invasive vagus nerve stimulation for motor and non-motor symptoms.
Does non-invasive vagus nerve stimulation improve motor and non-motor symptoms in patients with Parkinson's disease?
Meta-Analysis (n=321)
Does non-invasive vagus nerve stimulation improve motor and non-motor symptoms in patients with Parkinson's disease?
Standardized Mean Difference: -1.09 (95% CI -1.6166–-0.5573)
p-value: p=<0.0001
Non-invasive vagus nerve stimulation may improve specific gait parameters like step length variability in Parkinson's disease, but does not significantly improve overall motor scores (MDS-UPDRS).
Purpose: Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms. Current treatments, primarily dopaminergic drugs, improve motor symptoms but have limitations and side effects. Non-pharmacological interventions like deep brain stimulation (DBS) and vagus nerve stimulation (VNS) are being explored for their potential to address both motor and non-motor symptoms, with VNS showing promise in preclinical models.Methods: A systematic review was conducted in September 2024 by searching PubMed, Scopus, and Web of Science, following the PRISMA guideline. The selection process involved a two-phase screening by independent researchers, with a third reviewer resolving discrepancies. Data extraction was performed using a standardized Excel sheet. Statistical analysis was performed using a random-effects model, while bias was evaluated with the ROBINS-I tool for non-randomized studies.Results: A total of 14 studies involving 321 patients undergoing non-invasive VNS were included in the analysis. Compared to control groups, no statistically significant effects were observed for MDS-UPDRS I (p=0.37) and III (p=0.48), postural sway (p=0.34), stride velocity variability (p=0.61), stride length (p=1.39), step length (p=1.71), stand time (p=0.35), rotation time (p=0.50), or freezing of gait (FOG; p=0.91). However, VNS did show a significant positive effect on step length variability (SMD=-1.09, p<0.0001).Conclusion: VNS shows potential as a non-pharmacological treatment for PD, particularly for step length variability. While broader effects on motor and non-motor symptoms require further investigation, the therapy appears safe and may modulate brain function and neuroinflammation.
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Golzarian et al. (2025) conducted a meta-analysis in Parkinson's disease (n=321). Non-invasive Vagus nerve stimulation (nVNS) vs. Sham or control group was evaluated on Step length variability (SMD -1.09, 95% CI -1.6166 to -0.5573, p=<0.0001). Non-invasive vagus nerve stimulation significantly improved step length variability in patients with Parkinson's disease (SMD -1.09, p<0.0001) compared to control groups, though it did not significantly affect other motor symptoms.
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