Transcutaneous auricular vagus nerve stimulation improves cognitive decline by alleviating intradialytic cerebral hypoxia in hemodialysis patients: A fNIRS pilot study
Meng-Huan Wang,
Yi-Jie Jin,
Meng-Fei He,
An-Nan Zhou,
Mei-Ling Zhu,
Feng Lin,
Wen-Wen Li,
Zhong-Li Jiang
Affiliations
Meng-Huan Wang
Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China; Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, 211100, China
Yi-Jie Jin
Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China; Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, 211100, China
Meng-Fei He
Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China; Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, 211100, China
An-Nan Zhou
Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211100, China
Mei-Ling Zhu
Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211100, China
Feng Lin
Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China; Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, 211100, China
Wen-Wen Li
Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211100, China; Corresponding author. Sir Run Run Hospital, Nanjing Medical University, 109 Longmian Road, Nanjing, 211112, China.
Zhong-Li Jiang
Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China; Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, 211100, China; Corresponding author. Sir Run Run Hospital, Nanjing Medical University, 109 Longmian Road, Nanjing, 211112, China.
Cognitive impairment is common in hemodialysis patients, possibly due to inadequate cerebral blood flow during hemodialysis. No effective non-pharmacological interventions are available. This study investigates the impact of hemodialysis-induced cerebral hypoxia on cognitive decline in hemodialysis patients and the potential of transcutaneous auricular vagus nerve stimulation (taVNS) as a non-pharmacological intervention. A randomized controlled trial with 36 participants showed that cognitive performance and cerebral oxygenation in the dorsolateral prefrontal cortex (DLPFC) significantly declined in the sham group. In contrast, taVNS improved cognitive function by increasing cerebral oxygenation, with significant correlations to reaction times and MoCA scores. The study suggests that Hemodialysis-induced cerebral hypoxia may contribute to persistent cognitive decline in MHD patients. However, taVNS could be an effective intervention to prevent cognitive impairment in hemodialysis patients by alleviating cerebral hypoxia.
