Vagus nerve stimulation combined with rehabilitation training in improving upper limb motor dysfunction in patients with ischemic stroke: a Meta-analysis
10.3760/cma.j.cn115354-20250619-00358
- VernacularTitle:迷走神经电刺激联合康复训练改善缺血性脑卒中患者上肢运动障碍的Meta分析
- Author:
Xiaonan LIU
1
;
Ya GAO
;
Liyuan ZHANG
;
Huan WANG
;
Minjia XIE
;
Tao XUE
;
Anchao YANG
Author Information
1. 首都医科大学附属北京天坛医院手术室，北京 100070
- Publication Type:Journal Article
- Keywords:
Vagus nerve stimulation;
Ischemic stroke;
Upper limb motor dysfunction;
Hemiplegia;
Rehabilitation training;
Meta-analysis;
Neural-modulation
- From:
Chinese Journal of Neuromedicine
2025;24(8):817-825
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of vagus nerve stimulation (VNS) combined with rehabilitation training in recovery of upper limb function in patients with ischemic stroke (IS) through Meta-analysis.Methods:Randomized controlled trials on upper limb motor dysfunction in IS patients accepted VNS published in PubMed, Web of Science, Embase, CNKI, Wanfang and VIP databases, and Chinese Biomedical Literature Database were retrieved. The retrieval period was from establishment of the databases to April 2025. Quality of the trials was assessed according to Cochrane handbook for systematic reviews of interventions (version 5.1). Two researchers independently screened the literature, extracted the data and evaluated the risk of bias of the included articles; and then, Meta-analysis was conducted by RevMan 5.4 software.Results:Eleven articles of randomized controlled trails were chosen, including 495 patients. Three articles were rated as A-level in terms of quality, and 8 were rated as B-level. Overall bias risk of the included studies was low. Results of Meta-analysis showed that compared with the control group (rehabilitation training alone), the intervention group (VNS combined with rehabilitation training) had significantly improved upper limb motor function (Fugl-Meyer assessment of upper limb motor function: standardized mean difference [ SMD]=0.77, 95% CI: 0.24-1.30, P<0.001) and activities of daily living (modified Barthel index: SMD=0.86, 95% CI: 0.56-1.16, P<0.001). Meanwhile, compared with those in the control group, incidence of adverse events ( RR=1.12, 95% CI: 0.95-1.33, P=0.170) and incidence of severe adverse events ( RR=1.67, 95% CI: 0.51-5.50, P=0.400) in the intervention group did not significantly increase. Results of subgroup analysis showed that compared with that in the control group, more significantly improved upper limb motor function was noted in patients from the non-invasive VNS intervention sub-group ( SMD=1.09, 95% CI: 0.46-1.72, P<0.001), intervention sub-group with a frequency of 5 times per week ( SMD=1.73, 95% CI: 0.58-2.87, P<0.001), and intervention sub-group with a duration of 4 weeks ( SMD=1.09, 95%CI: 0.72-1.47, P<0.001). Conclusion:VNS combined with rehabilitation training has good safety and efficacy in upper limb motor dysfunction after IS.
