Advancing Upper Limb Motor Recovery in Acute Ischemic Stroke With Transcutaneous Auricular Vagus Nerve Stimulation

OBJECTIVE: To assess the efficacy and safety of transcutaneous auricular vagus nerve stimulation (taVNS) for acute ischemic stroke upper limb rehabilitation. DESIGN: Randomized controlled trial with taVNS and control groups. SETTING: Hospital. PARTICIPANTS: Sixty patients (N=60) diagnosed with acute ischemic stroke. INTERVENTIONS: The taVNS group received daily 30-minute taVNS sessions followed by conventional rehabilitation, versus the control group receiving sham stimulation with rehabilitation. Both groups received 5 weekly sessions over 2 weeks. MAIN OUTCOME MEASURES: Pre and postintervention assessments included the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), the National Institutes of Health Stroke Scale (NIHSS), and the Modified Barthel Index (MBI). Heart rate, blood pressure changes, and adverse reactions were recorded throughout the treatment period. RESULTS: Both groups demonstrated comparable baseline FMA-UE, NIHSS, and MBI scores (P>.05). Postintervention, the taVNS group exhibited marked improvements in FMA-UE and MBI, alongside significant NIHSS reduction compared with controls (all P<.05). Heart rate and blood pressure changes were stable throughout the 2-week treatment period, with no significant daily changes (P>.05). CONCLUSIONS: This study supports the efficacy and safety of taVNS in acute ischemic stroke, demonstrating significant improvements in motor recovery, neurologic function, and independence in activities of daily living. By priming the nervous system for subsequent training, the noninvasive strategy acts synergistically with rehabilitation to enhance outcomes. These findings position taVNS as a promising adjunctive intervention for early stroke care.