Effect of transcutaneous auricular vagus nerve stimulation on post-stroke dysphagia

• Published in: Journal of neurology Vol. 270; no. 2; pp. 995 - 1003
• Main Authors: Wang, Ying, He, Yingxi, Jiang, Linlin, Chen, Xiaoxu, Zou, Fengjiao, Yin, Ying, Li, Jiani, Li, Changqing, Zhang, Guifang, Ma, Jingxi, Niu, Lingchuan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2023; Springer Nature B.V
• Subjects: Clinical trials; Deglutition Disorders - etiology; Deglutition Disorders - therapy; Dysphagia; Energy output; Humans; Medicine; Medicine & Public Health; Neurology; Neuroradiology; Neurosciences; Original Communication; Pilot Projects; Rehabilitation; Stroke; Stroke - complications; Stroke - therapy; Swallowing; Treatment Outcome; Vagus nerve; Vagus Nerve Stimulation - adverse effects; Swallowing function; Stroke; Dysphagia; Transcutaneous auricular electrical vagus nerve stimulation
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-022-11465-5

Background and purpose
It has been proved that electrical vagus nerve stimulation can promote the recovery of motor function after stroke. There were no trials on the use of transcutaneous auricular electrical vagus nerve stimulation (ta-VNS) in patients with dysphagia after acute stroke. Our aim was to confirm whether ta-VNS can promote the recovery of swallowing function in these acute stroke patients with dysphagia.
Methods
We conducted a sham-controlled, double-blinded, parallel pilot study in 40 acute stroke patients randomly assigned to receive ta-VNS or sham ta-VNS combined with conventional rehabilitation training. The intensity of ta-VNS treatment was adjusted according to the patient’s tolerance, 30 min each time, twice a day, five times a week, with a total course of 3 weeks. In the sham group, the parameters were the same except energy output. Swallowing function was assessed with Modified Mann assessment of swallowing ability (MASA), functional communication measure swallowing test (FCM), and the Rosenbek leakage/aspiration scale (RAS) according to swallowing video fluoroscopic (SVF) before the intervention (baseline, T0), immediately after the intervention (T1) and 4 weeks after the intervention (T2).
Results
After treatment, ta-VNS group statistically and clinically had larger change of MASA, FCM, and RAS scores compared with control group (
P
 < 0.05) and this improvement continued at least 4 weeks after the end of treatment. There were no serious adverse events occurred during the whole intervention.
Conclusion
The transcutaneous auricular electrical vagus nerve stimulation is effective as a novel and noninvasive treatment strategy for patients with dysphagia after acute stroke.
Trial registration
No: kelunshen No. 63 in 2020.