Two decades of vagus nerve stimulation for stroke: a bibliometric analysis

 The research is out there, just write up protocols on it!

That has to be pure incompetency of the mentors and senior researchers! Let's see how long vagus nerve stimulation has been out there. And do the non-invasive types.

• vagus nerve (67 posts to July 2012)

• • paired vagus nerve stimulation (2 posts to April 2022)

Two decades of vagus nerve stimulation for stroke: a bibliometric analysis

Jiao Deng¹Zhen Yang²Qing Mei Wang³Zhi Gang Lv^1*

• ¹Department of Rehabilitation Medicine, Changzhou Hospital of Traditional Chinese Medicine, Changzhou, China
• ²Physical Activity, Sports & Health Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
• ³Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Boston, MA, United States

Background: Stroke is a major global health concern, imposing significant medical and social burdens. Vagus nerve stimulation (VNS), an emerging neuromodulation technology, has shown potential in the treatment of stroke. This bibliometric analysis aims to explore the knowledge structure and research trends in the field of VNS for stroke from 2004 to 2024.

Methods: Publications were retrieved from the Web of Science Core Collection. CiteSpace and VOSviewer were used to conduct bibliometric analyses, including author productivity, institutional contributions, and emerging research themes etc.

Results: A total of 191 eligible publications were analysed. Kilgard, M. P., and Hays, S. A. were the most prolific authors, each contributing 26 publications. The USA (96 publications), China (69 publications), and Scotland (17 publications) were the most prolific countries. The University of Texas at Dallas (33 publications) was the most prolific institution, followed by Chongqing Medical University (19 publications) and the University of Glasgow (15 publications). Future research is expected to focus on: (1) neurophysiological mechanisms of VNS in stroke recovery; (2) synergistic effects of VNS with other rehabilitation therapies; (3) comparative efficacy of non-invasive transauricular VNS versus invasive VNS; (4) safety and effectiveness of VNS for post-stroke functional impairments beyond motor rehabilitation; and (5) optimisation of VNS parameters for stroke treatment.

Conclusion: The field of VNS for stroke has experienced steady growth over the past two decades. This bibliometric analysis provides valuable insights to guide future research, clinical applications, and policy developments.(Stop with the analysis paralysis and just create protocols! My God the fucking stupidity in the stroke medical world is mind-boggling!)

1 Introduction

Globally, stroke has been recognized as the second leading cause of death and the third leading cause of disability (1). Evidence from the Global Burden of Disease study shows that the number of patients with strokes increased by 70% from 1990 to 2019 (2), with a rising incidence among young and middle-aged people under 55-years-old. Moreover, The Lancet Neurology Commission estimate that global stroke-related deaths will increase by 50% from 2020 to 2050, with the number of people living with disabilities expected to rise by about 30% (3). As the aging population increasing, the burden of stroke will escalate significantly, presenting serious challenges to governments and healthcare globally. However, despite continuous advancements in rehabilitation treatments, effectively restoring patients’ functional abilities remains a major issue in stroke management.

Recently, vagus nerve stimulation (VNS), as an innovative neuromodulation technology, has shown potential in stroke rehabilitation by stimulating the vagus nerve to regulate central nervous system function. In 2021, the US Food and Drug Administration (FDA) approved the application of VNS combined with rehabilitation exercises for the treatment of chronic stroke (4). VNS can be administered through either invasive or non-invasive approaches. Invasive VNS (iVNS) involves costly surgery to implant electrodes in the left cervical vagus nerve, which are then stimulated by a pulse generator. Non-invasive VNS, also known as transauricular VNS (tVNS), typically includes transcutaneous VNS via the ear (taVNS) or cervical VNS (tcVNS) (5). Ventureyra (6) first identified tVNS as a novel non-invasive brain modulation technology. tVNS involves the using low-frequency pulse currents to stimulate the auricular branch of the vagus nerve. Moreover, safety, cost-effectiveness, easy to administer, and high acceptability are the advantages of tVNS (7). Recently, a recent randomized controlled trial found that the relative growth of ischemic lesions on 24-h diffusion-weighted magnetic resonance imaging (MRI) was 63% in the tVNS group, while it was 184% in the sham stimulation group (p = 0.109). This suggests that tVNS has a neuroprotective effect in acute stroke (8). Moreover, other studies have shown that taVNS combined with motor rehabilitation can enhance motor function (9), proprioception, and light touch sensation (10) in chronic stroke patients.

Bibliometric analysis holds a significant place in medical research, primarily due to its ability in generating broad evidence synthesis in a specific research field. In the research evolution framework, studies can be categorized into two types: original research and evidence synthesis. Evidence synthesis can be further divided into two forms: deep synthesis (i.e., systematic reviews and meta-analyses) (11) and broad synthesis (i.e., bibliometric analysis) (12). Deep synthesis is typically used to address specific research questions, for example, focusing on the effectiveness of a particular intervention on certain health-related outcomes, thus providing a precise conclusion. In contrast, broad synthesis is suited for analysing the overall knowledge structure of a research field and predicting future research trends.

In the field of stroke, while there have been numerous deep syntheses on VNS technology, there is a lack of broad synthesis as bibliometric analyses. Therefore, it is necessary to conduct a comprehensive bibliometric analysis in the field of VNS for stroke. The current study aims to provide a deep understanding of current research hotspots, trends, and the overall knowledge structure. This work will not only identify key research directions and potential gaps but also serve as a valuable reference for future research collaborations (13).

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