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Lookup NU author(s): Dr Hilmar SigurdssonORCiD, Heather Hunter, Dr Lisa AlcockORCiD, Harvey Bramley, Philip Brown, Dr Giovanni Palermo, Professor Mark BakerORCiD, Professor John-Paul TaylorORCiD, Professor Lynn RochesterORCiD, Professor Alison YarnallORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2025. The Author(s). BACKGROUND: Gait and cognitive impairments are hallmark features of Parkinson's disease (PD) that significantly impact quality of life. These deficits arise from both dopaminergic and non-dopaminergic mechanisms, including cholinergic dysfunction. Transcutaneous cervical vagus nerve stimulation (tcVNS) is a non-invasive neuromodulatory technique that may enhance cholinergic function and has potential therapeutic relevance for individuals with PD. However, its feasibility, acceptability, adherence, and safety in a domiciliary setting remain unclear. We conducted a single-centre, double-blind, parallel, sham-controlled, randomised proof-of-concept study. OBJECTIVES: The primary objective was to assess the feasibility, acceptability, adherence, and safety of home-based tcVNS. The secondary objective was to explore preliminary effects on gait and cognitive function. METHODS: Thirty-three participants with PD were randomised to either active (n = 16) or sham (n = 17) tcVNS and self-administered two stimulations twice daily for 12 weeks, followed by a 24-week post-intervention follow-up. RESULTS: Retention was high (93.9%), with two participants withdrawing from the sham group for reasons unrelated to the intervention. No serious adverse events were reported during the intervention period. Mild adverse events led to discontinuation of tcVNS use in three active and two sham participants. tcVNS had minimal effects on gait and cognition, although small, non-significant improvements in step length variability were observed. CONCLUSIONS: This study represents the longest tcVNS intervention trial in PD to date and supports the feasibility, acceptability, and safety of domiciliary tcVNS. While preliminary findings suggest tcVNS may have therapeutic potential, larger trials are needed to establish its effectiveness for improving gait and cognitive function in PD.
Author(s): Sigurdsson HP, Hunter H, Alcock L, Maughan EE, Bramley H, Brown P, Palermo G, Baker MR, Taylor J-P, Rochester L, Yarnall AJ
Publication type: Article
Publication status: Published
Journal: Journal of Neurology
Year: 2025
Volume: 272
Issue: 10
Online publication date: 09/10/2025
Acceptance date: 28/09/2025
Date deposited: 20/10/2025
ISSN (print): 0340-5354
ISSN (electronic): 1432-1459
Publisher: Springer Nature
URL: https://doi.org/10.1007/s00415-025-13430-4
DOI: 10.1007/s00415-025-13430-4
Data Access Statement: Data will be made available to academic researchers following a reasonable request.
PubMed id: 41068419
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