SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Neurorehabilitation
Efficacy of Transcutaneous Auricular Vagus Nerve Stimulation in Post-Stroke Upper Limb Dysfunction: A Systematic Review and Meta-Analysis of Randomized Trials
Provisionally accepted
- 1Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui, China
- 2OuHai District Third People’s Hospital, Wenzhou, China
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Abstract Background: Stroke frequently causes upper limb motor deficits that impair recovery and quality of life. Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising adjunct in post-stroke rehabilitation, but its effectiveness and safety remain unclear. We conducted a systematic review and meta-analysis to assess the value of taVNS in upper limb motor dysfunction after stroke. Methods: We searched PubMed, Embase, Cochrane Central, CNKI, and Wanfang from inception to August 2025 for randomized controlled trials (RCTs) of taVNS in post-stroke upper limb dysfunction. Data extraction was performed independently, and meta-analyses were conducted using Review Manager 5.4.1 and Stata 16. Heterogeneity was assessed with the I² statistic, with subgroup and sensitivity analyses to explore sources. Study quality was appraised using the PEDro scale, trial bias with the Cochrane RoB 2 tool, and overall methodological quality, reporting, and evidence certainty with AMSTAR 2, ROBIS, PRISMA 2020, and GRADE. Results: A total of 18 randomized controlled trials involving 1,009 participants were included. All studies were assessed using the Cochrane Handbook version 5.1 and the PEDro scale, and the extracted data were synthesized in a meta-analysis. Pooled results indicated that taVNS significantly improved upper limb motor function after stroke. Specifically, significant effects were observed for the Fugl-Meyer Assessment–Upper Extremity (FMA-UE) (MD = 5.32, 95% CI [0.19, 6.45], P < 0.001, I² = 82.45%), Action Research Arm Test (ARAT) (MD = 6.37, 95% CI [4.15, 8.59], P < 0.001, I² = 0%), Wolf Motor Function Test (WMFT) (MD = 1.98, 95% CI [0.62, 2.91], P < 0.001, I² = 91.99%), and Modified Barthel Index (MBI) (MD = 6.28, 95% CI [0.73, 9.83], P < 0.001, I² = 71.28%). Conclusion: This meta-analysis indicates that taVNS improves upper limb function and daily living ability after stroke, supporting its role as a rehabilitation adjunct. Further rigorous trials are required to confirm long-term benefits and define optimal protocols.
Keywords: Transcutaneous auricular vagus nerve stimulation, Vagus Nerve, Stroke, Motor function, Meta-analysis
Received: 15 Sep 2025; Accepted: 18 Nov 2025.
Copyright: © 2025 Liu, Zheng, Qi, Lin, Zhang, Lin and YE. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Changzhou YE, 459741138@qq.com
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