Transcutaneous auricular vagus nerve stimulation improves gait and cortical activity in Parkinson's disease: A pilot randomized study

Author: Heng Zhang1, Xing-Yue Cao1, Li-Na Wang1, Qing Tong1, Hui-Min Sun1, Cai-Ting Gan1, Ai-di Shan1, Yong-Sheng Yuan1, Ke-Zhong Zhang1
1 Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Conference/Journal: CNS Neurosci Ther
Date published: 2023 Jun 13
Other: Special Notes: doi: 10.1111/cns.14309. , Word Count: 228

In this randomized, double-blind, sham-controlled trial, we explored the effect of 20 Hz transcutaneous auricular vagus nerve stimulation (taVNS) on gait impairments in Parkinson's disease (PD) patients and investigated the underlying neural mechanism.

In total, 22 PD patients and 14 healthy controls were enrolled. PD patients were randomized (1:1) to receive active or sham taVNS (same position as active taVNS group but without releasing current) twice a day for 1 week. Meanwhile, all subjects were measured activation in the bilateral frontal and sensorimotor cortex during usual walking by functional near-infrared spectroscopy.

PD patients showed instable gait with insufficient range of motion during usual walking. Active taVNS improved gait characteristics including step length, stride velocity, stride length, and step length variability compared with sham taVNS after completion of the 7-day therapy. No difference was found in the Unified Parkinson's Disease Rating Scale III, Timed Up and Go, Tinetti Balance, and Gait scores. Moreover, PD patients had higher relative change of oxyhemoglobin in the left dorsolateral prefrontal cortex, pre-motor area, supplementary motor area, primary motor cortex, and primary somatosensory cortex than HCs group during usual walking. Hemodynamic responses in the left primary somatosensory cortex were significantly decreased after taVNS therapy.

taVNS can relieve gait impairments and remodel sensorimotor integration in PD patients.

Keywords: Parkinson's disease; functional near-infrared spectroscopy; gait impairments; primary somatosensory cortex; transcutaneous auricular vagus nerve stimulation.

PMID: 37311693 DOI: 10.1111/cns.14309