Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Department of General Internal Medicine, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.
Expert Rev Med Devices. 2021 Oct;18(10):971-984. doi: 10.1080/17434440.2021.1969913. Epub 2021 Sep 8.
Parkinson's disease (PD) is a common progressive neurodegenerative disorder with multifactorial etiology. While dopaminergic medication is the standard therapy in PD, it provides limited symptomatic treatment and non-pharmacological interventions are currently being trialed.
Recent pathophysiological theories of Parkinson's suggest that aggregated α-synuclein form in the gut and spread to nuclei in the brainstem via autonomic connections. In this paper, we review the novel hypothesis that noninvasive vagus nerve stimulation (nVNS), targeting efferent and afferent vagal projections, is a promising therapeutic tool to improve gait and cognitive control and ameliorate non-motor symptoms in people with Parkinson's. We conducted an unstructured search of the literature for any studies employing nVNS in PD as well as for studies examining the efficacy of nVNS on improving cognitive function and where nVNS has been applied to co-occurring conditions in PD.
Evidence of nVNS as a novel therapeutic to improve gait in PD is preliminary, but early signs indicate the possibility that nVNS may be useful to target dopa-resistant gait characteristics in early PD. The evidence for nVNS as a therapeutic tool is, however, limited and further studies are needed in both brain health and disease.
帕金森病（PD）是一种常见的进行性神经退行性疾病，其病因具有多因素性。虽然多巴胺能药物是 PD 的标准治疗方法，但它只能提供有限的对症治疗，目前正在尝试非药物干预。
帕金森病的最新病理生理学理论表明，聚集的α-突触核蛋白在肠道中形成，并通过自主神经连接传播到脑干中的核团。在本文中，我们回顾了一个新的假设，即非侵入性迷走神经刺激（nVNS），针对传出和传入迷走神经投射，是一种有前途的治疗工具，可以改善帕金森病患者的步态和认知控制，并改善非运动症状。我们对任何使用 nVNS 治疗 PD 的研究以及研究 nVNS 改善认知功能的有效性以及 nVNS 应用于 PD 共存疾病的研究进行了非结构化的文献检索。
nVNS 作为一种改善 PD 步态的新型治疗方法的证据尚初步，但早期迹象表明，nVNS 可能对靶向早期 PD 中多巴胺抵抗的步态特征有用。然而，nVNS 作为一种治疗工具的证据是有限的，需要在脑健康和疾病方面进行进一步的研究。
