Wang Zhao-Di, Cheng Xiao-Ping, Liu Zhen-Yi, Wu Di, Ni Jun, Chen Chuan-Juan, Chen Xin-Yuan
Department of Rehabilitation Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China.
Front Neurosci. 2025 Jan 15;18:1499793. doi: 10.3389/fnins.2024.1499793. eCollection 2024.
Multiple system atrophy-cerebellar subtype (MSA-C) is a predominance of cerebellar ataxia and autonomic failure. MSA-C has a rapid progression, with average 9 years from symptom onset to death. Despite its prevalence, there is still a lack of effective treatments. In recent years, it has been established that taVNS has significant therapeutic effects on epilepsy, depression, migraine, insomnia, and other diseases. Hence, we performed taVNS treatment for one MSA-C patient to explore whether taVNS could alleviate patient's motor and non-motor symptoms.
A 65-year-old woman diagnosed with MSA-C received taVNS treatment for the following duration and course: once a day, 40 min a time, 20 times a month continually for 12 months. Meanwhile, she received assessments of motor and non-motor symptoms at baseline, 4-weeks and 12-months after taVNS treatment. Motor symptoms assessments was made by Scale for the Assessment and Rating of Ataxia (SARA) and Unified Multiple System Atrophy Rating Scale (UMSARS), non-motor symptoms assessment by Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD). After 4-weeks and 12-months of taVNS treatment, compared to baseline assessments, SARA scores decreased from 13 to 11 and then to 10.5, UMSARS scores from 28 to 24 and then to 23, PSQI scores from 19 to 13 and then to 6, HAMA scores from 13 to 3 and then remained unchanged, and HAMD scores from 7 to 4 and then remained unchanged.
In the case, we found that short-term taVNS treatment can alleviate ataxia, sleep problem, anxiety and depression of the MSA-C patient. The effects can be maintained and some symptoms may be further improved after receiving long-term treatment. Our case report supports the feasibility and effectiveness of taVNS treatment in MSA-C patients.
多系统萎缩小脑亚型（MSA-C）以小脑共济失调和自主神经功能衰竭为主。MSA-C进展迅速，从症状出现到死亡平均为9年。尽管其发病率较高，但仍缺乏有效的治疗方法。近年来，已证实经皮耳迷走神经刺激（taVNS）对癫痫、抑郁症、偏头痛、失眠等疾病具有显著的治疗效果。因此，我们对1例MSA-C患者进行了taVNS治疗，以探讨taVNS是否能缓解患者的运动和非运动症状。
一名65岁诊断为MSA-C的女性接受了如下疗程的taVNS治疗：每天1次，每次40分钟，每月连续20次，共12个月。同时，在taVNS治疗前基线、治疗后4周和12个月时对其运动和非运动症状进行评估。运动症状评估采用共济失调评估与评分量表（SARA）和统一多系统萎缩评定量表（UMSARS），非运动症状评估采用匹兹堡睡眠质量指数（PSQI）、汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）。taVNS治疗4周和12个月后，与基线评估相比，SARA评分从13降至11，然后降至10.5；UMSARS评分从28降至24，然后降至23；PSQI评分从19降至13，然后降至6；HAMA评分从13降至3，然后保持不变；HAMD评分从7降至4，然后保持不变。
在此病例中，我们发现短期taVNS治疗可缓解MSA-C患者的共济失调、睡眠问题、焦虑和抑郁。这些效果可以维持，长期治疗后一些症状可能会进一步改善。我们的病例报告支持taVNS治疗MSA-C患者的可行性和有效性。
