Left Vagus Stimulation Modulates Contralateral Subthalamic β Power Improving the Gait in Parkinson's Disease

Abstract Background Transcutaneous vagus nerve stimulation (VNS) showed early evidence of efficacy for the gait treatment of Parkinson's disease (PD). Objectives Providing data on neurophysiological and clinical effects of transauricular VNS (taVNS). Methods Ten patients with recording deep brain stimulation (DBS) have been enrolled in a within participant design pilot study, double‐blind crossover sham‐controlled trial of taVNS. Subthalamic local field potentials (β band power), Unified Parkinson's Disease Rating Scales (UPDRS), and a digital timed‐up‐and‐go test (TUG) were measured and compared with real versus sham taVNS during medication‐off/DBS‐OFF condition. Results The left taVNS induced a reduction of the total β power in the contralateral (ie, right) subthalamic nucleus and an improvement of TUG time, speed, and variability. The taVNS‐induced β reduction correlated with the improvement of gait speed. No major clinical changes were observed at UPDRS. Conclusions taVNS is a promising strategy for the management of PD gait, deserving prospective trials of chronic neuromodulation. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.