Noninvasive Vagus Nerve Stimulation in Parkinson's Disease: A Systematic Review

Negin Eissazade; Shayan Eghdami; Mohammad Rohani; Atra Ajdari; Seyed-Mohammad Fereshtehnejad; Alfonso Fasano; Tara Khoeini

doi:10.1016/j.neurom.2025.01.012

Noninvasive Vagus Nerve Stimulation in Parkinson's Disease: A Systematic Review

Neuromodulation. 2025 Mar 6:S1094-7159(25)00025-X. doi: 10.1016/j.neurom.2025.01.012. Online ahead of print.

Authors

Negin Eissazade¹, Shayan Eghdami², Mohammad Rohani³, Atra Ajdari⁴, Seyed-Mohammad Fereshtehnejad⁵, Alfonso Fasano⁶, Tara Khoeini⁷

Affiliations

¹ Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Brain and Cognition Clinic, Institute for Cognitive Science Studies, Tehran, Iran; Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
² Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Brain and Cognition Clinic, Institute for Cognitive Science Studies, Tehran, Iran.
³ Skull Base Research Center, Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran; Department of Neurology, School of Medicine, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
⁴ Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-Analysis Expert Group, Universal Scientific Education and Research Network, Tehran, Iran.
⁵ Movement Disorders Clinic, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
⁶ Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; Division of Neurology, University of Toronto, Toronto, ON, Canada; Division of Neuroscience, Krembil Brain Institute, Toronto, ON, Canada.
⁷ Department of Neurology, School of Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran. Electronic address: tara.khoeini@gmail.com.

PMID: 40057881
DOI: 10.1016/j.neurom.2025.01.012

Abstract

Background: While pharmacologic interventions remain the mainstay of Parkinson's disease (PD) treatment, alternative approaches such as vagus nerve stimulation (VNS) have drawn attention for their potential in managing PD symptoms.

Objective: We aimed to conduct a systematic review to comprehensively evaluate the safety and efficacy of VNS for motor and nonmotor symptoms of PD.

Materials and methods: A systematic search was conducted across PubMed, Scopus, Cochrane Library, and Web of Science for relevant journal articles published up to October 2024. The findings were descriptively reported to evaluate the overall safety and efficacy of VNS in addressing both motor and nonmotor features of PD.

Results: A total of 12 journal articles with data from 287 participants were included. Ten studies reported that VNS significantly improved gait characteristics. Category fluency significantly declined in one study. Additionally, nonsignificant changes were observed in gastroenteric symptoms, fatigue, and both sympathetic and parasympathetic cardiac activity, with each of these outcomes reported in a separate study.

Conclusions: Noninvasive VNS demonstrated favorable safety and efficacy for gait impairments in patients with PD, indicating its potential as a versatile intervention capable of addressing multiple aspects of the disease pathology. However, further research is necessary to reveal the underlying mechanisms, optimize stimulation parameters, and assess the long-term safety and efficacy of VNS as a therapeutic strategy for PD.

Keywords: Parkinsonism; Parkinson’s disease; treatment; vagus nerve stimulation.

Publication types

Review