综合康复训练与经皮迷走神经电刺激对促进脑卒中患者中枢神经系统重塑的效果分析

Analysis of the effect of combined rehabilitation training and transcutaneous vagus nerve electrical stimulation on promoting central nervous system remodeling in stroke patients.

作者信息

Zhang Jun, Xing Yingru, Du Weixiang, Liu Liping, Di Xiaoxia

机构信息

Department of Neurological Rehabilitation Xi'an Gaoxin Hospital Xi'an China.

出版信息

Brain Res. 2025 Mar 15;1851:149460. doi: 10.1016/j.brainres.2025.149460. Epub 2025 Jan 17.

DOI:10.1016/j.brainres.2025.149460

PMID:39828183

Abstract

OBJECTIVE

To explore the effect of combined rehabilitation training and transcutaneous vagus nerve electrical stimulation (t-VNS) on promoting central nervous system remodeling and neurological function recovery in stroke patients.

METHODS

A total of 124 S patients admitted to our hospital from January to December 2023 were included in this study. The therapeutic effects were evaluated using the Modified Barthel Index (MBI) and the simplified Fugl-Meyer Assessment Scale (sFMA) to measure patients' activities of daily living and motor function recovery. Additionally, neurophysiological assessments, including electromyography (EMG) and motor evoked potentials (MEPs), were conducted to evaluate changes in neuromuscular and central nervous system function. Changes in neural activity in the frontal lobe and motor cortex were assessed through transcutaneous vagus nerve stimulation and electroencephalography. Moreover, all adverse events were recorded.

RESULTS

After treatment, patients in the t-VNS combined with rehabilitation training group showed significant improvements in sFMA and MBI scores compared to the pure rehabilitation training group (P < 0.05). In terms of neurophysiology, patients in the combined treatment group exhibited significant increases in electromyographic activity and MEPs (P < 0.05). EEG results indicated enhanced neuroplasticity of the frontal lobe and motor cortex with t-VNS treatment. The incidence of skin stimulation and ear pain in the combined treatment group was significantly higher than that in the pure rehabilitation training group.

CONCLUSION

Combined rehabilitation training and transcutaneous vagus nerve electrical stimulation have significant effects on neurological function recovery and central nervous system remodeling in stroke patients, effectively improving patients' motor function and activities of daily living.

摘要

目的

探讨综合康复训练与经皮迷走神经电刺激（t-VNS）对促进脑卒中患者中枢神经系统重塑和神经功能恢复的作用。

方法

本研究纳入了2023年1月至12月我院收治的124例脑卒中患者。采用改良Barthel指数（MBI）和简化Fugl-Meyer评估量表（sFMA）评估治疗效果，以测量患者的日常生活活动能力和运动功能恢复情况。此外，进行神经生理学评估，包括肌电图（EMG）和运动诱发电位（MEP），以评估神经肌肉和中枢神经系统功能的变化。通过经皮迷走神经刺激和脑电图评估额叶和运动皮层神经活动的变化。此外，记录所有不良事件。

结果

治疗后，t-VNS联合康复训练组患者的sFMA和MBI评分较单纯康复训练组有显著改善（P<0.05）。在神经生理学方面，联合治疗组患者的肌电图活动和MEP显著增加（P<0.05）。脑电图结果表明，t-VNS治疗可增强额叶和运动皮层的神经可塑性。联合治疗组皮肤刺激和耳部疼痛的发生率显著高于单纯康复训练组。