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

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Abstract

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.

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Acknowledgements

The authors would like to thank all participants and the clinical study team for the conduct of the study.

Funding

The experiment was funded by Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) (No. 2019MSXM017), General project of Chongqing Natural Science Foundation (General project of Chongqing Natural Science Foundation (Chongqing Science and Technology Bureau) (cstc2021jcyj-msxmX0232).

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Author notes

  1. Ying Wang, Yingxi He and Linlin Jiang are first authors.

Authors and Affiliations

  1. Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China

    Ying Wang, Yingxi He, Linlin Jiang, Xiaoxu Chen, Fengjiao Zou, Ying Yin & Lingchuan Niu

  2. Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China

    Jiani Li, Changqing Li & Guifang Zhang

  3. Department of Neurology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, 401147, China

    Jingxi Ma

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Contributions

Study design: LN. Manuscript preparation and literature search: YW, LJ and YH. Data collection and statistical analysis: CL, GZ and JM. Swallowing and VNS therapy: XC and FZ. Swallowing function assessments: YY and JL. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lingchuan Niu.

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Conflicts of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Ethical approval

This study was approved by the ethics committee of the medical ethics committee of the Second Affiliated Hospital of Chongqing Medical University (No: kelunshen No. 63 in 2020).and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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All persons gave their informed consent prior to their inclusion in the study.

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Wang, Y., He, Y., Jiang, L. et al. Effect of transcutaneous auricular vagus nerve stimulation on post-stroke dysphagia. J Neurol 270, 995–1003 (2023). https://doi.org/10.1007/s00415-022-11465-5

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  • DOI: https://doi.org/10.1007/s00415-022-11465-5

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