Chen Xixi, Zhou Zhiqing, Chong Kayee, Zhao Jingjun, Wu Yuwei, Ren Meng, Huang Yu, Chen Songmei, Shan Chunlei
School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Hum Neurosci. 2024 Oct 8;18:1473535. doi: 10.3389/fnhum.2024.1473535. eCollection 2024.
Long-term post-stroke cognitive impairment (PSCI) exhibits an accelerated rate of long-term cognitive decline, which can impair communication, limit social engagement, and increase rate of institutional dependence. The aim of this case report is to provide evidence for the potential of home-based transcutaneous auricular vagus nerve stimulation (taVNS) for home-bound patients with severe, long-term PSCI.
A 71-year-old male suffered a stroke two and a half years ago, which imaging reported foci of cerebral infarction visible in the left temporal and parietal lobes. The patient was performed taVNS twice a day for 30 min, 5 times a week for 8 weeks. The patient was evaluated the changes of cognitive function and brain white matter at 4 time points: baseline (t0), 4 weeks without taVNS after baseline (t1), 4 weeks of intervention (t2), and 8 weeks of intervention (t3). The effect of taVNS on white matter changes was visualized by DTI.
After 8 weeks of taVNS treatment, the scores of Montreal cognitive assessment improved and the time to complete the shape trails test decreased. The DTI results showed that white matter in bilateral dorsal lateral prefrontal cortex remodeled after taVNS.
Eight-week home-based taVNS may be beneficial to long-term PSCI. Further studies of home-based taVNS treating patients with long-term PSCI are needed.
卒中后长期认知障碍(PSCI)呈现出加速的长期认知衰退速度,这会损害沟通能力、限制社交参与并增加机构依赖率。本病例报告的目的是为居家的重度长期PSCI患者采用居家经皮耳迷走神经刺激(taVNS)的潜力提供证据。
一名71岁男性在两年半前发生卒中,影像学报告显示左侧颞叶和顶叶可见脑梗死灶。患者每天进行2次taVNS,每次30分钟,每周5次,共8周。在4个时间点对患者的认知功能和脑白质变化进行评估:基线(t0)、基线后无taVNS的4周(t1)、干预4周(t2)和干预8周(t3)。通过弥散张量成像(DTI)观察taVNS对白质变化的影响。
经过8周的taVNS治疗后,蒙特利尔认知评估得分提高,完成图形追踪测试的时间缩短。DTI结果显示,taVNS后双侧背外侧前额叶皮质的白质发生重塑。
为期8周的居家taVNS可能对长期PSCI有益。需要进一步开展居家taVNS治疗长期PSCI患者的研究。