中国卒中杂志2025，Vol.20Issue(9)：1097-1103,7.DOI:10.3969/j.issn.1673-5765.2025.09.004
侵入性迷走神经电刺激联合康复训练治疗缺血性卒中后上肢运动功能障碍的可行性、疗效与安全性研究
Study on the Feasibility,Efficacy,and Safety of Invasive Vagus Nerve Stimulation Combined with Rehabilitation Training for Upper Limb Motor Dysfunction after Ischemic Stroke
摘要
Abstract
Objective To explore the feasibility,efficacy,and safety of invasive vagus nerve stimulation(iVNS)combined with rehabilitation training for upper limb motor dysfunction after ischemic stroke. Methods A retrospective analysis was conducted on the data from patients with upper limb motor dysfunction after ischemic stroke who were admitted between April and December 2024.All patients underwent left cervical iVNS implantation and completed standardized rehabilitation training.The stimulation parameters were set at a frequency of 30 Hz,a pulse width of 100 μs,with a daily cumulative stimulation duration of 30 minutes for a total treatment duration of 3 months.The upper limb motor function and muscle tone of patients were assessed using the Fugl-Meyer motor assessment-upper extremity(FMA-UE)and the modified Ashworth scale(MAS),respectively before surgery,1 month after surgery,and 3 months after surgery.Additionally,the Hamilton anxiety scale(HAMA)and the Hamilton depression scale(HAMD)were used to assess patients'anxiety and depression status before surgery and 3 months after surgery.Treatment-related adverse events were also recorded.Descriptive statistical methods were used for data analysis. Results A total of five male patients aged 41-73 years were included in this study,all of whom had upper limb motor dysfunction after ischemic stroke.Preoperative FMA-UE scores ranged from 0 to 52,and MAS grades ranged from 0 to 3.Some patients presented with mild to moderate anxiety and depression.Follow-up results showed that four patients with mild to moderate upper limb motor dysfunction had increased FMA-UE scores and decreased MAS grades at 1 month and 3 months after surgery compared with preoperative values,and their HAMA and HAMD scores showed a decreasing trend at 3 months after surgery,suggesting improvements in upper limb motor function,muscle tone,anxiety and depression status.Some of these patients also exhibited improvements in hand fine motor function.One patient with complete paralysis at baseline(preoperative FMA-UE score=0)showed limited improvement in upper limb motor function during follow-up.No severe adverse events such as infection,hematoma,or arrhythmia were observed during treatment. Conclusions In this study,iVNS combined with rehabilitation training showed feasibility and preliminary safety.Its efficacy showed a trend toward improvement in patients with mild to moderate symptoms,while those with severe symptoms had limited benefits.关键词
侵入性迷走神经电刺激/缺血性卒中/上肢运动功能障碍/康复训练Key words
Invasive vagus nerve stimulation/Ischemic stroke/Upper limb motor dysfunction/Rehabilitation training分类
医药卫生引用本文复制引用
栾伟,魏达,马超,张华伟,李铁民,彭玉涛,刘长青..侵入性迷走神经电刺激联合康复训练治疗缺血性卒中后上肢运动功能障碍的可行性、疗效与安全性研究[J].中国卒中杂志,2025,20(9):1097-1103,7.基金项目
北京市自然科学基金-大兴创新联合基金(L256041)北京慢性病防治与健康教育研究会、中关村人才协会医工领域"未来人才"培养计划(MBZX202502-0055)北京朝阳医院2024年度金种子科研基金(CYJZ202427) （L256041）
