Vagal Nerve Stimulation Shows Promise in Alzheimer Disease

 From practiceupdate.com. Published in Neurology.

 THURSDAY, July 11, 2024 (HealthDay News) -- Auricular transcutaneous vagal nerve stimulation was associated with improved cognition in patients with mild cognitive impairment caused by Alzheimer disease, according to research findings presented at the Congress of the European Academy of Neurology, held from June 29 to July 2 in Helsinki.

“The foundation leading to this study was the results of our many years of research on animals, for the first time confirming the achievement of the hippocampal theta rhythm as an effect of vagus nerve stimulation,” Adam Broncel, M.D., Ph.D., from Neuromedical in Lodz, Poland, told Elsevier’s PracticeUpdate. “As is well known, the hippocampus plays a key role in the process of memory consolidation.

 Broncel and colleagues conducted a randomized, double-blind, placebo-controlled trial of 51 patients with Alzheimer disease. Thirty-five patients were randomly assigned to the treatment arm and 16 patients were randomly assigned to the placebo arm. Patients in the treatment arm underwent a 12-week treatment period with auricular transcutaneous vagal nerve stimulation using the Vguard device. Twenty patients went on to an extension period for an additional 12 weeks. After another 24 weeks, 15 patients underwent a cognitive evaluation.

 The researchers found statistically significant improvement in cognition in the active treatment arm compared with the placebo arm, including on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (P < 0.01). The treatment arm also experienced improvements in the Mini-Mental Status Examination, Color Trial Test, and Verbal Memory Probing. After 24 weeks of no treatment, the cognitive improvement observed in the 15 patients during the treatment phase returned to baseline.

 “The most important finding of this study is the significant improvement in patients’ cognitive status. This result is groundbreaking for several reasons,” Broncel told Elsevier’s PracticeUpdate. “First, none of the previously known therapeutic methods for dementia disorders have shown such a high level of efficacy. Second, improvement was observed after only a few weeks of treatment. Third, the method is safe and does not carry the risk of severe side effects.

 “The method has the potential to fundamentally change the approach to treating cognitive disorders in Alzheimer’s disease, including memory disorders. It represents a groundbreaking shift in the treatment of patients with this diagnosis due to the lack of other effective treatment methods.”

 Broncel noted these results require a series of additional studies. “Future research will help answer several additional questions,” he told Elsevier’s PracticeUpdate, “such as the effect of vagus nerve stimulation in cases of advanced dementia, the optimal duration of therapy, and the use of stimulation in dementia diseases of different etiologies.”