Parkinson Hastalığının Klinik ve Moleküler Biyobelirteçlerinde İnvaziv Olmayan Vagus Sinir Stimülasyonunun Etkisi

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Non-invasive vagus nerve stimulation (nVNS) is an established neurostimulation therapy used in the treatment of epilepsy, migraine and cluster headache. In this randomized, double-blind, sham-controlled trial we explored the role of nVNS in the treatment of gait and other motor symptoms in Parkinson’s disease (PD) patients. In a subgroup of patients, we measured selected neurotrophins, inflammatory markers and oxidative stress in serum. Thirty-three PD patients with freezing of gait (FOG) were randomised to either nVNS or sham. After baseline assessments, patients were instructed to deliver six 2 minute stimulations (12 minutes/day) of the nVNS/sham device for one month at home. Patients were then re-assessed. After a one-month washout period, they were allocated to the alternate treatment arm and the same process was followed. Significant improvements in key gait parameters (speed, stance time and step length) were observed with nVNS. While serum tumor necrosis factor- α decreased, glutathione and brain-derived neurotrophic factor levels increased significantly (p < 0.05) after nVNS treatment. Here we present the first evidence of the efficacy and safety of nVNS in the treatment of gait in PD patients, and propose that nVNS can be used as an adjunctive therapy in the management of PD patients, especially those suffering from FOG. Clinical trial registration number ISRCTN14797144 Date of Registration: 11 May, 2020

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