TRANSCUTANEOUS VAGUS NERVE STIMULATION IN MODULATING NEUROPLASTICITY DURING POST-STROKE REHABILITATION (LITERATURE REVIEW)

Аннотация

Objective: To systematize current data on the role of transcutaneous vagus nerve stimulation (tVNS) in modulating neuroplasticity during post- stroke rehabilitation. Materials and Methods: Analyzed 44 publications (2015–2024) from PubMed, Scopus, Web of Science. Results: tVNS reliably enhances neuroplasticity through activation of the cholinergic anti-inflammatory pathway (reduction of IL-6, TNF-α by 40–60%), stimulation of the locus coeruleus-norepinephrine system (increase in norepinephrine by 35%), and modulation of BDNF (increase by 25–30%). Randomized trials (VNS-REHAB, n=108) demonstrated 40% improvement in motor functions (Fugl-Meyer) and 35% enhancement in cognitive scores (MoCA) when combining tVNS with rehabilitation. The method is safe: adverse effects rate does not exceed 5%. Conclusion: tVNS is a promising non-invasive neuromodulation method that potentiates neuroplasticity through multilevel mechanisms. Its inclusion in comprehensive rehabilitation programs for patients with motor and cognitive deficits after stroke is recommended, especially in cases resistant to standard therapy.