The Effect of Vagus Nerve Stimulation on the Rehabilitation of Stroke: A Systematic Review and Meta-analysis.
Min Yu, Shuna Wang
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In 30 seconds
This systematic review and meta-analysis pooled 16 randomized controlled trials involving 819 patients with stroke to assess vagus nerve stimulation (VNS) alongside rehabilitation. Compared with control interventions, VNS was associated with better upper-limb motor outcomes: the mean difference on the Fugl-Meyer Assessment Upper Extremity was 5.00 (95% CI, 2.10-7.89; P<.01), and the standardized mean difference on the Wolf Motor Function Test was 1.02 (95% CI, 0.39-1.66; P<.01). The analysis also found benefits for activities of daily living and poststroke depression.
Key findings
- VNS improved Fugl-Meyer Assessment Upper Extremity scores (mean difference=5.00; 95% CI, 2.10-7.89; P<.01).
- Wolf Motor Function Test scores favored VNS (SMD=1.02; 95% CI, 0.39-1.66; P<.01).
- Activities of daily living improved with VNS (SMD=0.91; 95% CI, 0.47-1.34; P<.01).
- Poststroke depression scores favored VNS (SMD=-1.18; 95% CI: -1.91 to -0.44; P<.01).
Why it matters
Motor impairment, limitations in daily activities, and depressive symptoms can all affect recovery after stroke. This synthesis of randomized trials suggests that adding VNS to rehabilitation may benefit several of these outcomes, broadening the outcomes considered in rehabilitation research. The findings are promising but do not establish an optimal stimulation protocol.
What to keep in mind
The authors call for further large-scale randomized controlled trials to explore key treatment parameters and optimize protocols.