目的：在这个随机分组中，双盲,假对照试验,我们探讨了20Hz经皮耳迷走神经刺激（taVNS）对帕金森病（PD）患者步态障碍的影响，并研究了潜在的神经机制。
方法：总共，纳入22例PD患者和14例健康对照。将PD患者随机(1:1)接受活性或假taVNS(与活性taVNS组位置相同,但不释放电流),每天两次,持续1周。同时,通过功能近红外光谱技术对所有受试者在正常行走过程中的双侧额叶和感觉运动皮质的激活进行了测量.
结果：PD患者在正常行走过程中步态不稳定，活动范围不足。主动taVNS改善步态特征，包括步长，跨步速度,步幅长度,完成7天治疗后，与假taVNS相比，步长变异性。在统一帕金森病评定量表III中没有发现差异，定时和去，Tinetti平衡,和步态得分。此外，PD患者左背外侧前额叶皮层氧合血红蛋白的相对变化较高，电机前区域,辅助电机区域,初级运动皮层，和初级体感皮层比HCs组在正常行走期间。taVNS治疗后，左侧初级体感皮层的血流动力学反应显着降低。
结论：taVNS可以减轻PD患者的步态障碍并重塑感觉运动整合。
In this randomized, double-blind, sham-controlled trial, we explored the effect of 20 Hz transcutaneous auricular vagus nerve stimulation (taVNS) on gait impairments in Parkinson\'s disease (PD) patients and investigated the underlying neural mechanism.
In total, 22 PD patients and 14 healthy controls were enrolled. PD patients were randomized (1:1) to receive active or sham taVNS (same position as active taVNS group but without releasing current) twice a day for 1 week. Meanwhile, all subjects were measured activation in the bilateral frontal and sensorimotor cortex during usual walking by functional near-infrared spectroscopy.
PD patients showed instable gait with insufficient range of motion during usual walking. Active taVNS improved gait characteristics including step length, stride velocity, stride length, and step length variability compared with sham taVNS after completion of the 7-day therapy. No difference was found in the Unified Parkinson\'s Disease Rating Scale III, Timed Up and Go, Tinetti Balance, and Gait scores. Moreover, PD patients had higher relative change of oxyhemoglobin in the left dorsolateral prefrontal cortex, pre-motor area, supplementary motor area, primary motor cortex, and primary somatosensory cortex than HCs group during usual walking. Hemodynamic responses in the left primary somatosensory cortex were significantly decreased after taVNS therapy.
taVNS can relieve gait impairments and remodel sensorimotor integration in PD patients.
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