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Effect of combined vagus nerve stimulation on recovery of upper extremity function in patients with stroke: a systematic review and meta-analysis
Liu Y, Zhang L, Zhang X, Ma J, Jia G
Journal of Stroke & Cerebrovascular Diseases 2022 Jun;31(6):106390
systematic review

OBJECTIVE: To evaluate the effectiveness of vagus nerve stimulation (VNS) combined with rehabilitation therapies in restoring upper extremity (UE) function following stroke. Data Sources A search was implemented in key databases along with hand searches of relevant papers and performed on 31 July 2021. MATERIALS AND METHODS: Only randomized controlled trials (RCTs) assessing the effect of VNS focusing on UE dysfunction in patients post-stroke were identified in this systematic review. Data were extracted independently by two authors. The study was conducted by the Preferred Reporting Items for Meta-Analyses (PRISMA) guidelines. Meta-analyses were performed when deemed feasible. RESULTS: Five RCTs involving 178 patients (VNS/C 87/91) were included. The primary outcome was the function assessment by upper UE Fugl-Meyer assessment (FMA-U). As secondary outcomes, strength was assessed with the Wolf motor function test (WMFT), the Stroke Impact Scale (SIS) and the Motor Activity Log (MAL). Meta-analysis showed a significant immediate favoring VNS-based rehabilitation (five studies) for improving upper extremity function after stroke (mean difference (MD) 3.31; 95% confidence interval (CI) 2.33 to 4.29; p < 0.0001, fixed-effects model), along the lines of the long-term effect (three studies) (MD 3.13; 95% CI 1.47 to -4.79; p < 0.0001, fixed-effects model). No effect was observed when compared with control groups in adverse outcomes (Risk Ratio (RR) 1.61; 95% CI 0.65 to 3.99; p = 0.30). CONCLUSIONS: VNS combined with rehabilitation training may be considered as a promising intervention in UE recovery in stroke patients.
Copyright by WB Saunders Company.

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