Clinical Study Of Transcutaneous Auricular Vagus Nerve Stimulation Assisted With Levodopa In The Treatment Of Parkinson’s Disease

ObjectiveIn this study,by observing the clinical efficacy of taVNS in adjuvant treatment of Parkinson’s disease dyskinesia,assessing the efficacy of taVNS on PD,and providing new treatment methods for PD patients.MethodsAccording to the randomized controlled trial(RCT)method,53 PD patients were randomly divided into taVNS group with 28 cases and non-vagus nerve stimulation group with 25 cases.The trial course of treatment was 8 weeks.During the treatment period,both groups were given conventional basic treatment with levodopa.The taVNS group stimulated the auricular boat area,which was equivalent to auricular points,liver and kidney points.The ear boat area of the non-vagus nerve stimulation group is equivalent to the ear point wrist and elbow points.The second and third parts of the Movement Disorder Society sponsored revision of the Unified Parkinson’s Disease Rating Scale(MDS-UPDRS)before and after treatment,and the HY staging scale(Hoehn-Yahr stage,H-Y),Parkinson’s Disease Questionnaire-39,PDQ-39,and the Diagnosis and Efficacy Evaluation Criteria for Senile Fibrillation in Traditional Chinese Medicine(Trial),Autonomic Nerve Function Scale(the scale for outcomes in PD for autonomic symptoms,SCOPA-AUT)to be evaluated and recorded.Results1.Effect on motor function:After 8 weeks of treatment in the taVNS group,the MDS-UPDRSⅢ score was significantly lower than the MDS-UPDRSⅢ score before treatment(P<0.05),and the MDS-UPDRSⅢ score of the non-vagus nerve stimulation group after 8 weeks of treatment did not change significantly(P>0.05),there was no statistical difference in the difference of MDS-UPDRSⅢ before and after treatment between the two groups(P>0.05);After treatment in the taVNS group,the scores of the traditional Chinese medicine senile tremor syndrome evaluation standard table were significantly lower than before treatment(P<0.001),there was no statistically significant difference between the scores of the traditional Chinese medicine senile tremor syndrome evaluation standard table for the treatment of the ear boat non-vagus nerve stimulation group and the scores before the treatment(P>0.05),the difference between the taVNS group and the non-vagus nerve stimulation group before and after treatment was statistically significant(P<0.001);There was no significant difference in the H-Y grade between the taVNS group and the ear boat non-vagus nerve stimulation group after 8 weeks of treatment compared with the H-Y grade before treatment(P>0.05).2.Effect on quality of life:The PDQ-39 score of the aVNS group after treatment was significantly lower than that before treatment(P<0.05),and the PDQ-39 scores of the non-vagus nerve stimulation group in the ear boats had statistically significant differences after treatment compared with those before treatment(P<0.05),the difference between the two groups before and after treatment is statistically significant(P<0.001);For MDS-UPDRSⅡ,the score after treatment in the taVNS group was significantly different from the score before treatment(P<0.05),and the score after treatment in the ear boat non-vagus nerve stimulation group was not significantly different from before treatment(P>0.05),the difference between before and after treatment was statistically significant(P<0.001).3.Effect on autonomic nerve function:After 8 weeks of treatment in the taVNS group,the SCOPA-AUT score was significantly lower than before treatment(P<0.001),and the SCOPA-AUT score after treatment in the ear boat non-vagus nerve stimulation group was not statistically significant(P>0.05),the difference between before and after treatment was statistically significant(P<0.001).ConclusionsTaVNS assisted levodopa therapy can improve the dyskinesia,quality of daily life and autonomic nerve dysfunction of Parkinson’s patients,especially in improving the quality of daily life and autonomic dysfunction,which means it is worthy of further clinical promotion.