Transcutaneous auricular vagus nerve stimulation combined with task-oriented training to improve upper extremity function in post stroke hemiplegia
10.3969/j.issn.1001-1242.2024.06.004
- VernacularTitle:经皮迷走神经刺激联合任务导向训练改善卒中后偏瘫患者上肢功能的研究
- Author:
Menghuan WANG
1
;
Yurou KONG
;
Min XIE
Author Information
1. 南京医科大学附属逸夫医院,江苏省南京市,211100
- Keywords:
stroke;
upper extremity motor function;
vagus nerve stimulation;
task-oriented training;
motor evoked potential
- From:
Chinese Journal of Rehabilitation Medicine
2024;39(6):782-790
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore effects of transcutaneous auricular vagus nerve stimulation(taVNS)with task-oriented training(TOT)on upper extremity function and brain plasticity in post stroke hemiplegia patients. Method:Forty patients with stroke hemiplegia were randomly assigned to the experiment group(n=20)and the control group(n=20).The experiment group received taVNS combined with TOT,while the control group received only TOT.At baseline and at the end of treatment,the patients were assessed with motor evoked po-tentials(MEP),the Fugl-Meyer assessment upper extremity(FMA-UE),the Hongkong version of functional test for the hemiplegic upper extremity(FTHUE),the action research arm test(ARAT),the modified Barthel index(MBI),and the fatigue severity scale(FSS).The side effects were monitored during the treatment. Result:There were no significant differences in FMA-UE,FTHUE,ARAT,MBI and FSS between the two groups at baseline(P＞0.05).After treatment,all the functional outcomes except FSS in both two groups in-creased significantly compared with baseline(P＜0.05),and the FMA-UE、FTHUE、ARAT、MBI(occupational abili-ty)scores in the experiment group were significantly higher than those in the control group(P＜0.05).There were no significant differences in the latency,amplitude and induced rate of motor evoked potential(MEP)at baseline between the two groups(P＞0.05).Compare with the control group after treatment,the latency of con-tralesional MEP in the experiment group was significantly shorter than that in the control group(P＜0.05),and the induced rates of ipsilesional MEP were significantly higher(P＜0.05),but there were no significant differenc-es in contralesional amplitudes between the two groups.There was a significant correlation between the chang-es of contralesional MEP latency and the changes of FMA-UE(r=-0.705),FTHUE(r=-0.458),MBI in occu-pation(r=-0.654)in the experiment group(P＜0.05). Conclusion:taVNS combined with TOT can improve upper extremity motor function in patients with stroke hemiplegia by modulating plasticity of motor cortex.
