Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea.
Medicine (Baltimore). 2022 Dec 16;101(50):e31808. doi: 10.1097/MD.0000000000031808.
In this mini review, 6 studies that investigated the effects of transcutaneous auricular vagus nerve stimulation (taVNS) in patients with disorders of consciousness (DOC) were reviewed. Generally, the application of taVNS in patients with DOC appears to be effective (positive results in 5 of 6 studies) and safe. Furthermore, 4 studies that evaluated changes in the brain following taVNS reported positive results (2 studies, functional magnetic resonance imaging and 2 studies, electroencephalography). Based on our review of the 6 studies, we believe that research and clinical application of taVNS in DOC are in the initial stages and have the following limitations. First, there is a shortage of studies on this topic, with only 6 studies, 2 of which were case reports. Second, 5 studies were performed without control or sham groups. Third, there was no standardization of treatment schedules and electrical stimulation parameters. Therefore, further studies to overcome the above limitations should be encouraged; further original studies involving a larger number of patients in the control or sham groups are needed. However, studies on the optimal conditions (treatment schedule and electrical stimulation parameters) for taVNS in patients with DOC are necessary. Furthermore, neuroimaging studies should be undertaken to elucidate the neurological mechanisms for the recovery of impaired consciousness in DOC and the lasting effects of taVNS on the brain.
在这篇小型综述中，回顾了 6 项研究经皮耳迷走神经刺激（taVNS）对意识障碍（DOC）患者的影响。一般来说，taVNS 在 DOC 患者中的应用似乎是有效的（6 项研究中有 5 项结果为阳性）且安全。此外，有 4 项评估 taVNS 后大脑变化的研究报告了阳性结果（2 项功能性磁共振成像研究和 2 项脑电图研究）。基于我们对这 6 项研究的回顾，我们认为 taVNS 在 DOC 中的研究和临床应用仍处于起步阶段，具有以下局限性。首先，关于这一主题的研究较少，仅有 6 项研究，其中 2 项为病例报告。其次，有 5 项研究没有对照组或假刺激组。第三，治疗方案和电刺激参数没有标准化。因此，应该鼓励开展克服上述局限性的进一步研究；需要在对照组或假刺激组中纳入更多患者的进一步原始研究。然而，研究 taVNS 治疗 DOC 患者的最佳条件（治疗方案和电刺激参数）是必要的。此外，应进行神经影像学研究，以阐明意识障碍患者意识恢复的神经机制以及 taVNS 对大脑的持久影响。
