Dong Xiaoyang, Tang Yunliang, Zhou Yifan, Feng Zhen
Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Front Neurosci. 2023 Sep 15;17:1257378. doi: 10.3389/fnins.2023.1257378. eCollection 2023.
PURPOSE: The purpose of this study is to evaluate the efficacy and safety of stimulating the vagus nerve in patients with disorders of consciousness (DOCs). METHODS: A comprehensive systematic review was conducted, encompassing the search of databases such as PubMed, CENTRAL, EMBASE and PEDro from their inception until July 2023. Additionally, manual searches and exploration of grey literature were performed. The literature review was conducted independently by two reviewers for search strategy, selection of studies, data extraction, and judgment of evidence quality according to the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) Study Quality Scale. RESULTS: A total of 1,269 articles were retrieved, and 10 studies met the inclusion criteria. Among these, there were three case reports, five case series, and only two randomized controlled trials (RCTs). Preliminary studies have suggested that stimulation of vagus nerve can enhance the levels of DOCs in both vegetative state/unresponsive wakefulness state (VS/UWS) and minimally conscious state (MCS). However, due to a lack of high-quality RCTs research and evidence-based medical evidence, no definitive conclusion can be drawn regarding the intervention's effectiveness on consciousness level. Additionally, there were no significant adverse effects observed following stimulation of vagus nerve. CONCLUSION: A definitive conclusion cannot be drawn from this systematic review as there was a limited number of eligible studies and low-quality evidence. The findings of this systematic review can serve as a roadmap for future research on the use of stimulation of vagus nerve to facilitate recovery from DOCs.
目的:本研究旨在评估刺激迷走神经对意识障碍(DOCs)患者的疗效和安全性。 方法:进行了一项全面的系统评价,检索了PubMed、CENTRAL、EMBASE和PEDro等数据库,检索时间从各数据库建库至2023年7月。此外,还进行了手工检索和灰色文献探索。由两名评价者根据美国脑性瘫痪和发育医学学会(AACPDM)研究质量量表,独立进行文献检索策略、研究选择、数据提取和证据质量判断。 结果:共检索到1269篇文章,10项研究符合纳入标准。其中,有3篇病例报告、5篇病例系列,仅有2项随机对照试验(RCT)。初步研究表明,刺激迷走神经可提高植物状态/无反应觉醒状态(VS/UWS)和最低意识状态(MCS)患者的意识水平。然而,由于缺乏高质量的RCT研究和循证医学证据,无法就该干预措施对意识水平的有效性得出明确结论。此外,刺激迷走神经后未观察到明显不良反应。 结论:由于符合条件的研究数量有限且证据质量较低,本系统评价无法得出明确结论。本系统评价的结果可为未来利用刺激迷走神经促进DOCs患者康复的研究提供路线图。
Front Neurosci. 2023-9-15
Cochrane Database Syst Rev. 2022-2-1
Cochrane Database Syst Rev. 2015-4-3
Arch Phys Med Rehabil. 2013-9-11
Arch Phys Med Rehabil. 2010-12
Psychol Belg. 2025-6-11
Front Neurosci. 2023-2-17
Lancet. 2023-1-14
Neuropsychiatr Dis Treat. 2022-9-25
Front Hum Neurosci. 2021-8-9