Electrophysiological And Clinical Observation Of Percutaneous Auricular Point Vagus Nerve Stimulation On Upper Limb Motor Dysfunction In Patients With Stroke

Objective In this study,the changes of amplitude and latency of motor evoked potentials of abductor pollicis brevis and first dorsal interosseous muscle were used to observe the effect of percutaneous auricular point vagus nerve stimulation on motor cortex excitability in patients with upper limb motor dysfunction after cerebral infarction.The upper limb motor function scale was used to evaluate it’s clinical effect.Explore the effects of percutaneous auricular point vagus nerve stimulation on motor cortex excitability and neuromuscular function in patients with upper limb dysfunction after cerebral infarction from the aspects of electrophysiology and clinical effect.To seek a treatment idea and scheme with high feasibility,remarkable curative effect,good repeatability and easy operation for the clinical treatment of upper limb motor dysfunction after stroke,and provide clinical basis for percutaneous auricular point vagus nerve stimulation to be widely promoted.MethodsIn this study,66 patients with ischemic stroke were randomly divided into vagus nerve stimulation group(n = 33)and routine treatment group(n = 33).Routine treatment group: on the basis of routine treatment in the internal medicine of basic diseases,general acupuncture was performed,and percutaneous auricular point vagus nerve pseudo-stimulation was performed during needle retention,and rehabilitation treatment was carried out by the same rehabilitation therapist immediately after acupuncture.Vagus nerve stimulation group: on the basis of the conventional treatment group,the percutaneous auricular point vagus nerve pseudo-stimulation was changed to percutaneous vagus nerve stimulation,the stimulation frequency was 20Hz(7s)and 4Hz(3s),the two alternating,the output pulse width was 0.2ms,the stimulation intensity was suitable for patients to tolerate and without pain,the treatment time was 20 minutes;both groups were treated once a day,five times a week for 4 weeks.The changes of the latency and amplitude of motor evoked potentials of abductor pollicis brevis and the first interosseous dorsal muscle were analyzed before treatment and 4 weeks after treatment.The upper limb function rating scale FMA-UE and WMFT were analyzed.Results1.Motor evoked potential(MEP)of abductor pollicis brevis: the amplitude of MEP of abductor pollicis brevis in both groups was increased compared with before treatment(P <0.01),and the latency of MEP of abductor pollicis brevis was shortened compared with before treatment(P < 0.01).Moreover,the amplitude(P < 0.01)and latency(P < 0.05)of vagus nerve stimulation group were better than those of conventional treatment group.2.Motor evoked potential(MEP)of dorsal interosseus first muscle: the amplitude of MEP of dorsal interosseus first muscle was increased in both groups compared with before treatment(P < 0.01),and the latency of MEP of dorsal interosseus first muscle was shortened compared with before treatment(P < 0.01).Moreover,the amplitude(P < 0.01)and latency(P < 0.01)of vagus nerve stimulation group were better than those of conventional treatment group.3.FMA-UE score: Compared with before treatment,FMA-UE score in both groups increased(P < 0.01).After treatment,it was found that the vagus nerve stimulation group was better than the conventional treatment group(P < 0.01).4.WMFT score: Compared with before treatment,WMFT score increased in both groups(P< 0.01),and vagus nerve stimulation group was better than conventional treatment group(P <0.01).Conclusions1.The changes of amplitude and latency of motor evoked potential of abductor pollicis brevis and dorsal interosseous muscle of the first were observed to show the effect of percutaneous auricular point vagus nerve stimulation on motor cortical pathway in patients with ischemic stroke.to provide objective basis for percutaneous auricular point vagus nerve stimulation to improve the neuromuscular function of the upper limb.2.Percutaneous auricular point vagus nerve stimulation can improve the scores of FMA-UE and WMFT of the upper limb function rating scale,and promote the recovery of upper limb motor function.