经皮耳迷走神经刺激在脑卒中后运动康复中的应用OA

Transcutaneous auricular vagus nerve stimulation(taVNS)activates neural pathways akin to invasive vagus nerve stimulation(iVNS).With the advantages of low cost,safety,and high tolerability,taVNS serves as an alternative neuromodulatory technique to iVNS and presents promising prospects for motor function rehabilitation after stroke.However,there is a lack of con-sensus on specific application parameters and therapeutic effects of taVNS,with the underlying mechanisms remaining to be eluci-dated.This review comprehensively examines the application of taVNS in post-stroke motor rehabilitation,encompassing both asyn-chronous and synchronous combination with upper limb training,as well as monotherapy with taVNS.Its mechanisms of action include anti-inflammatory and neuroprotective effects,enhancement of blood-brain barrier integrity,and modulation of cortical excit-ability and neuroplasticity.The review further analyzed the stimulation parameters,safety,and efficacy of taVNS.However,high-quality clinical studies are still insufficient.The majority of taVNS research has focused on limb function scores without exploring the underlying neurophysiological mechanisms.There is no consensus on taVNS stimulation parameters,including stimulation inten-sity,frequency,duration,and timing.The safety profile of taVNS applied to the right ear warrants further validation.Limited studies have reported lateralized effects when taVNS is applied to the left ear.Future large-sample and high-quality studies are required to establish optimal stimulation parameters and elucidate the mechanisms of action,thereby informing the development of the most effective taVNS treatment protocols for clinical practice.