Key result
Vagus nerve stimulation plus rehabilitation improved motor function postintervention compared to rehabilitation alone in patients after stroke.
Why the study?
Vagus nerve stimulation plus rehabilitation has shown potential efficacy for stroke recovery, but systematic synthesis across motor function, mental health, and activities of daily living was needed.
Does vagus nerve stimulation plus rehabilitation improve motor function, mental health, and activities of daily living in patients with a stroke?
Meta-Analysis (n=263)
Does vagus nerve stimulation plus rehabilitation improve motor function, mental health, and activities of daily living in patients with a stroke?
Vagus nerve stimulation paired with rehabilitation improves motor function post-stroke compared to rehabilitation alone, but does not significantly improve mental health or activities of daily living.
Answers are grounded in this paper and cite their sources.
Supports adjunctive VNS for post-stroke motor recovery; extends RCT evidence with sustained large effects at follow-up.
OBJECTIVE: Vagus nerve stimulation (VNS) plus rehabilitation (Rehab) has shown a potential effect on recovery with a stroke. We systematically synthesised studies examining VNS+Rehab for improving motor function, mental health and activities of daily living (ADL) postintervention and at the end of follow-up in patients with a stroke. METHODS: The search was performed in electronic databases EMBASE, Medline, EBSCO, Cochrane Library, PubMed, PsycINFO, CINAHL, CNKI, and WANFANG and three clinical trial registries from inception to February 2022. Randomised controlled trials (RCTs) applied VNS+Rehab in stroke were included. RESULTS: Seven RCTs involving 263 (analysed) participants was included. The effect size of VNS+Rehab over Rehab for motor function was medium postintervention (g=0.432; 95% CI 0.186 to 0.678) and large at the end of follow-up (g=0.840; 95% CI 0.288 to 1.392). No difference was found in the effect of VNS+Rehab over traditional rehabilitation for ADL, mental health or safety outcomes. Subgroup analyses revealed larger effects for patients received taVNS (transcutaneous auricular VNS) devices (at acute/subacute phase of stroke, with lower VNS stimulation frequency or pluses per session, greater VNS on-off time or sessions, higher VNS intervention weekly frequency). CONCLUSION: The results suggest VNS+Rehab showed better motor function outcomes in patients after stroke, while no better than Rehab on mental health or ADL. Combinations of phase of stroke, specific parameters of VNS and VNS intervention frequency are key modulators of VNS effects. TRIAL REGISTRATION NUMBER: CRD42022310194.
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Gao et al. (2022) conducted a meta-analysis in stroke (n=263). Vagus nerve stimulation plus rehabilitation vs. Rehabilitation alone was evaluated on motor function postintervention (SMD 0.432, 95% CI 0.186-0.678). Vagus nerve stimulation plus rehabilitation improved motor function postintervention compared to rehabilitation alone in patients after stroke.
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