The Effect of Vagus Nerve Stimulation on the Rehabilitation of Stroke: A Systematic Review and Meta-analysis

OBJECTIVE: This meta-analysis aimed to systematically evaluate the effects of vagus nerve stimulation (VNS) on limb motor function, activities of daily living (ADL), swallowing capacity, and emotional status in patients with stroke. DATA SOURCES: The search was performed in electronic databases EMBASE, Cochrane Library, and PubMed from inception to December 19, 2025. STUDY SELECTION: All randomized controlled trials (RCTs) that used VNS plus rehabilitation for stroke were included. DATA EXTRACTION: Two researchers independently extracted data after a predeveloped Excel data collection sheet, including basic information, research design, patient demographic characteristics, the intervention details for the experimental group and the control group, time of measurement, and evaluation of relevant results. The risk of bias was evaluated by the risk of bias 2 tool, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for reporting. A random-effects model was used to pool the data from individual studies. Data were analyzed using Stata 18.0 software. DATA SYNTHESIS: A total of 16 RCTs involving 819 patients were included. The results showed that patients receiving VNS had significant improvements in Fugl-Meyer Assessment Upper Extremity (FMA-UE) (mean difference=5.00; 95% confidence interval [CI], 2.10-7.89; P<.01) and Wolf Motor Function Test (WMFT) (standard mean difference [SMD]=1.02; 95% CI, 0.39-1.66; P<.01). VNS also exhibited beneficial effects on activity of daily living (SMD=0.91; 95% CI, 0.47-1.34; P<.01) and poststroke depression (SMD=-1.18; 95% CI: -1.91 to -0.44; P<.01). CONCLUSIONS: VNS can significantly improve FMA-UE, WMFT, and ADL in patients with stroke. In addition, VNS demonstrated significant benefits in enhancing the Box and Block Test, Fugl-Meyer Assessment for Lower Limb, and alleviating depressive symptoms. Further large-scale RCTs are warranted to optimize treatment protocols by exploring key parameters.