Background New treatments are urgently needed for individuals with Mild Cognitive Impairment (MCI) - in particular for those with amnestic MCI, of whom a high proportion have underlying Alzheimer's Disease (AD). Transcutaneous Vagus Nerve Stimulation (tVNS) is a non-invasive neuro-modulatory treatment which has not been extensively examined in older adults with amnestic MCI. Methods A single site, single-blind, randomised three-arm crossover pilot trial of acute (60 minutes) tVNS (baseline, sham or active stimulation) was conducted a Regional Specialist Memory Service. Forty participants (age 71.7 ±6.9; 22/40 male) with diagnosed amnestic MCI were recruited. Given the links between AD and neuro-cardiovascular instability, potential adverse effects of active tVNS were assessed using beat-to-beat peripheral (Blood Pressure (BP) and Heart Rate [HR]) and central (via Near Infra-red Spectroscopy) haemodynamic responses to Active Stand (AS). Cognition was assessed between 21.3 ±4.9 and 60.5 ±4.4 minutes using a domain-specific cognitive performance battery with results analysed using mixed-effects linear regression. Results In older adults with amnestic MCI, tVNS was safe, tolerable and acceptable with 98% of participants stating they would use the device again. There was no significant effect on BP, or HR responses to AS and cerebral oxygenation remained stable during AS. After tVNS stimulation, performance on tests of spatial navigation were significantly improved compared to both baseline (ß= -8.76; [-14.91, -2.56]; p=0.01) and sham (ß= -4.15; [-7.32, -0.99]; p=0.01) conditions. Conclusion tVNS is a safe and tolerable treatment modality in older adults with amnestic MCI. Future studies should explore sustained effects and feasibility of domiciliary use.

中文翻译：

---

研究经皮迷走神经刺激治疗遗忘型轻度认知障碍


背景 轻度认知障碍 (MCI) 患者迫切需要新的治疗方法，尤其是遗忘性 MCI 患者，其中很大一部分患有潜在的阿尔茨海默病 (AD)。经皮迷走神经刺激 (tVNS) 是一种非侵入性神经调节治疗方法，尚未在患有遗忘性 MCI 的老年人中得到广泛研究。方法 在区域专家记忆服务中心进行了一项单中心、单盲、随机三臂交叉急性（60 分钟）tVNS（基线、假刺激或主动刺激）试验。招募了 40 名被诊断为遗忘性 MCI 的参与者（年龄 71.7 ±6.9；22/40 男性）。鉴于 AD 和神经心血管不稳定之间的联系，使用逐次外周血流动力学（血压 (BP) 和心率 [HR]）和中枢血流动力学（通过近红外光谱）评估主动 tVNS 的潜在副作用对 Active Stand (AS) 的响应。使用特定领域认知性能电池在 21.3 ±4.9 至 60.5 ±4.4 分钟之间评估认知能力，并使用混合效应线性回归分析结果。结果 对于患有遗忘性 MCI 的老年人，tVNS 是安全、可耐受且可接受的，98% 的参与者表示他们会再次使用该设备。对 AS 的血压或 HR 反应没有显着影响，并且在 AS 期间脑氧合保持稳定。 tVNS 刺激后，与基线 (ß= -8.76; [-14.91, -2.56]; p=0.01) 和假手术 (ß= -4.15; [-7.32, -0.99]) 相比，空间导航测试的表现均显着提高；p=0.01）条件。结论 tVNS 对于患有遗忘性 MCI 的老年人来说是一种安全且可耐受的治疗方式。未来的研究应探讨家庭使用的持续影响和可行性。