Investigation of the Effectiveness of Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) and Vestibular Rehabilitation in Patients with Unilateral Vestibular Hypofunction
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Outcome Measurements
2.3.1. Demographic Information Form
2.3.2. LOS
2.3.3. m-CTSIB
2.3.4. Static Balance Tests
2.3.5. DVA
2.3.6. VAS
2.3.7. TSK
2.3.8. HADS
2.3.9. DHI
2.4. Treatment Programs
2.4.1. Vestibular Rehabilitation Group (Group 1, n = 20)
2.4.2. Vestibular Rehabilitation Group Combined with taVNS (Group 2, n = 20)
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Limitations
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Group 1 (n = 20) | Group 2 (n = 20) | ||
---|---|---|---|
Gender (n/%) | Female | 16/80 | 7/35 |
Male | 4/20 | 13/65 | |
Age (mean ± SD) | 46.40 ± 13.28 | 45.00 ± 13.21 | |
Cigarettes (n/%) | Yes | 4/20 | 10/50 |
No | 16/80 | 10/50 | |
Alcohol (n/%) | Yes | 0 | 2/10 |
No | 20/100 | 18/90 |
Definition | Exercises | |
---|---|---|
Vestibular adaptation exercises | VOR*1 VOR*2 The VOR response is developed by activating the adaptation mechanism. Head movements are made during visual fixation. Includes saccadic and pursuit eye movements. |
|
Oculomotor exercises | Develops the visual system. Includes saccadic and pursuit eye movements. |
|
Static and dynamic balance exercises | This includes balance exercises in which the support area, support surface, arm position, head and eye movements are varied. |
|
Posture exercises | This includes exercises especially for the neck, shoulder, and back muscles. |
|
Walking exercises | It includes walking and balance exercises with different tasks. |
|
Group 1 | Group 2 | p | |||||||
---|---|---|---|---|---|---|---|---|---|
Before Treatment | After Treatment | p | Before Treatment | After Treatment | p | ||||
LOS | MV (°/s) | Forward | 4.55 ± 0.8 | 4.59 ± 0.55 | 0.883 | 4.66 ± 0.59 | 4.91 ± 0.75 | 0.250 | 0.260 |
Right Forward | 4.42 ± 0.8 | 4.71 ± 0.89 | 0.290 | 4.97 ± 0.84 | 5.04 ± 0.68 | 0.646 | 0.788 | ||
Right | 3.67 ± 0.87 | 3.94 ± 0.58 | 0.166 | 3.92 ± 0.59 | 4.07 ± 1.04 | 0.444 | 0.255 | ||
Right Backward | 2 ± 0.51 | 2.16 ± 0.81 | 0.585 | 2.14 ± 0.73 | 2.31 ± 0.83 | 0.513 | 0.684 | ||
Backward | 1.1 ± 0.32 | 1.16 ± 0.26 | 0.739 | 1.14 ± 0.35 | 1.21 ± 0.35 | 0.581 | 0.488 | ||
Left Backward | 1.99 ± 0.46 | 2.11 ± 0.51 | 0.475 | 2.4 ± 0.51 | 2.29 ± 0.71 | 0.485 | 0.946 | ||
Left | 3.59 ± 0.66 | 3.7 ± 0.8 | 0.626 | 4.01 ± 0.59 | 4.18 ± 0.63 | 0.350 | 0.178 | ||
Left Forward | 4.76 ± 0.83 | 4.99 ± 0.87 | 0.266 | 4.95 ± 0.72 | 5.43 ± 0.91 | 0.020 * | 0.068 | ||
EP (%) | Forward | 70.45 ± 19.7 | 73 ± 11.75 | 0.659 | 77.15 ± 12.11 | 84.05 ± 10.17 | 0.081 | 0.059 | |
Right Forward | 77.8 ± 16.87 | 81.95 ± 17.42 | 0.433 | 88.2 ± 19.56 | 90.05 ± 14.17 | 0.590 | 0.734 | ||
Right | 72.4 ± 18.99 | 77.25 ± 12.53 | 0.309 | 76.75 ± 14.92 | 80.8 ± 9.34 | 0.227 | 0.311 | ||
Right Backward | 69.25 ± 25.2 | 79.55 ± 18.79 | 0.088 | 73.45 ± 18.79 | 79 ± 17.29 | 0.259 | 0.337 | ||
Backward | 70.95 ± 20.12 | 79.9 ± 18.51 | 0.088 | 68.5 ± 21.41 | 76.4 ± 20.66 | 0.191 | 0.242 | ||
Left Backward | 71.85 ± 21.22 | 79.3 ± 17.71 | 0.238 | 80.4 ± 14.38 | 79.05 ± 13.74 | 0.743 | 0.763 | ||
Left | 72.5 ± 13.96 | 76.1 ± 14.4 | 0.446 | 79.2 ± 9.33 | 80.35 ± 11.71 | 0.709 | 0.733 | ||
Left Forward | 86.2 ± 20.22 | 89.9 ± 19.58 | 0.409 | 89.1 ± 16.56 | 93.75 ± 16.79 | 0.160 | 0.383 | ||
MXE (%) | Forward | 79.45 ± 15.46 | 80.7 ± 11.31 | 0.755 | 82.95 ± 13.25 | 89.75 ± 7.4 | 0.070 | 0.054 | |
Right Forward | 87.45 ± 9.96 | 88.65 ± 11.59 | 0.684 | 93.65 ± 17.29 | 94.8 ± 12.35 | 0.779 | 0.735 | ||
Right | 80.05 ± 15.04 | 81.45 ± 8.96 | 0.709 | 82.55 ± 10.46 | 82.65 ± 7.75 | 0.965 | 0.973 | ||
Right Backward | 74.4 ± 22.7 | 83.8 ± 17.88 | 0.032 * | 82.9 ± 12.23 | 90.75 ± 9.84 | 0.004 ** | 0.031 * | ||
Backward | 86.45 ± 32.74 | 85.6 ± 13.82 | 0.727 | 79.4 ± 18.5 | 86.9 ± 14.8 | 0.097 | 0.165 | ||
Left Backward | 77.1 ± 16.87 | 84.5 ± 14.76 | 0.154 | 86.6 ± 8.85 | 87.1 ± 10.08 | 0.801 | 0.868 | ||
Left | 80.6 ± 12.12 | 126.95 ± 195.11 | 0.239 | 81.65 ± 8.68 | 84.1 ± 8.33 | 0.275 | 0.368 | ||
Left Forward | 91 ± 17.86 | 95.75 ± 15.23 | 0.303 | 93.65 ± 13.19 | 97.9 ± 11.57 | 0.098 | 0.286 | ||
RT (s) | Forward | 1.25 ± 0.3 | 1.17 ± 0.36 | 0.147 | 1.18 ± 0.49 | 0.92 ± 0.41 | 0.044 * | 0.317 | |
Right Forward | 1.01 ± 0.39 | 0.98 ± 0.23 | 0.501 | 0.99 ± 0.25 | 0.92 ± 0.27 | 0.286 | 0.267 | ||
Right | 0.95 ± 0.22 | 0.88 ± 0.27 | 0.881 | 0.95 ± 0.18 | 0.93 ± 0.16 | 0.709 | 0.946 | ||
Right Backward | 1.2 ± 0.32 | 0.95 ± 0.33 | 0.014 * | 0.86 ± 0.42 | 0.88 ± 0.17 | 0.616 | 0.329 | ||
Backward | 1.04 ± 0.24 | 0.96 ± 0.26 | 0.376 | 0.95 ± 0.23 | 0.9 ± 0.11 | 0.267 | 0.154 | ||
Left Backward | 1 ± 0.27 | 0.86 ± 0.26 | 0.079 | 0.99 ± 0.2 | 0.9 ± 0.2 | 0.014 * | 0.072 | ||
Left | 0.95 ± 0.35 | 0.94 ± 0.15 | 0.629 | 0.88 ± 0.27 | 0.87 ± 0.19 | 0.055 | 0.227 | ||
Left Forward | 1.43 ± 2.13 | 0.96 ± 0.11 | 0.324 | 1.01 ± 0.33 | 0.99 ± 0.16 | 0.871 | 0.875 | ||
DC (%) | Forward | 83.35 ± 12 | 79.8 ± 10.07 | 0.165 | 81.1 ± 10.49 | 79.95 ± 13.84 | 0.837 | 0.914 | |
Right Forward | 68.55 ± 14.04 | 67.95 ± 16.87 | 0.914 | 73.85 ± 11.61 | 73 ± 13.47 | 0.629 | 0.989 | ||
Right | 69.6 ± 11.35 | 70.75 ± 14.6 | 0.499 | 76.9 ± 12.74 | 76.6 ± 9.39 | 0.935 | 0.933 | ||
Right Backward | 64.2 ± 14.41 | 63.6 ± 15.83 | 0.908 | 62.15 ± 19.05 | 67.3 ± 14.02 | 0.422 | 0.310 | ||
Backward | 62.95 ± 23.87 | 72.55 ± 19.59 | 0.260 | 76 ± 16.43 | 70.2 ± 16.95 | 0.324 | 0.228 | ||
Left Backward | 68.25 ± 15.78 | 67.25 ± 14.92 | 0.823 | 69.05 ± 14.28 | 67.85 ± 14.85 | 0.867 | 0.560 | ||
Left | 74.7 ± 17.81 | 76.5 ± 12.32 | 0.763 | 70.25 ± 14.52 | 71.6 ± 13.88 | 0.735 | 0.765 | ||
Left Forward | 70.6 ± 17.15 | 73.3 ± 12.24 | 0.643 | 74.25 ± 10.71 | 72.7 ± 11.56 | 0.685 | 0.662 | ||
m-CTSIB (mm/s) | Hard | EO | 9.47 ± 2.17 | 8.93 ± 2 | 0.161 | 11.09 ± 3.2 | 9.48 ± 2.01 | 0.045 * | 0.065 |
EC | 13.55 ± 5.59 | 12.22 ± 4.11 | 0.205 | 14.63 ± 5.55 | 11.39 ± 4.06 | 0.004 ** | 0.016 * | ||
Soft | EO | 12.95 ± 3.37 | 11.94 ± 3.07 | 0.062 | 12.29 ± 2.34 | 11.85 ± 2 | 0.372 | 0.532 | |
EC | 21.38 ± 8.5 | 18.74 ± 7.4 | 0.179 | 22.27 ± 8.72 | 16.28 ± 5.01 | 0.002 ** | 0.019 * |
Group 1 | Group 2 | p | |||||||
---|---|---|---|---|---|---|---|---|---|
Before Treatment | After Treatment | p | Before Treatment | After Treatment | p | ||||
Tandem (s) | EO | 28.73 ± 3.07 | 30 ± 0 | 0.068 | 26.7 ± 8.11 | 30 ± 0 | 0.109 | ||
EC | 14.27 ± 8.25 | 26.13 ± 5.92 | 0.000 ** | 16.85 ± 13.28 | 27.96 ± 4.7 | 0.003 ** | 0.377 | ||
OLS (s) | Hard EO | Right foot | 23.64 ± 9.54 | 28.41 ± 5.07 | 0.008 ** | 25.98 ± 9.24 | 29.18 ± 2.73 | 0.068 | 0.917 |
Left foot | 25.84 ± 9.03 | 28.56 ± 4.45 | 0.043 * | 23.8 ± 10.49 | 28.65 ± 3.28 | 0.028 * | 0.486 | ||
Hard EC | Right foot | 9.14 ± 8.69 | 20.44 ± 9.8 | 0.000 ** | 10.06 ± 8.32 | 25.42 ± 7.75 | 0.000 ** | 0.101 | |
Left foot | 8.28 ± 7.56 | 19.24 ± 10.32 | 0.000 ** | 8.81 ± 7.74 | 23.05 ± 8.7 | 0.000 ** | 0.216 | ||
Soft EO | Right foot | 19.86 ± 11.37 | 27.12 ± 5.61 | 0.003 ** | 25.12 ± 7.75 | 28.21 ± 4.24 | 0.018 * | 0.579 | |
Left foot | 19.2 ± 12.49 | 26.95 ± 6.41 | 0.004 ** | 21.74 ± 9.84 | 28.4 ± 4.24 | 0.003 ** | 0.283 | ||
Soft EC | Right foot | 5.78 ± 6.57 | 15.39 ± 9.92 | 0.000 ** | 5.85 ± 4.32 | 20.1 ± 8.57 | 0.000 ** | 0.079 | |
Left foot | 6.12 ± 7.71 | 15.23 ± 10.28 | 0.000 ** | 4.76 ± 3.4 | 18.06 ± 8.06 | 0.000 ** | 0.242 | ||
DVA | 0.35 ± 0.34 | 0.15 ± 0.26 | 0.003 ** | 0.53 ± 0.35 | 0.32 ± 0.4 | 0.013 * | 0.146 | ||
Dizziness | VAS | 7.33 ± 1.33 | 1.57 ± 1.08 | 0.000 ** | 6.24 ± 1.9 | 0.18 ± 0.46 | 0.000 ** | 0.000 ** | |
Fatigue | VAS | 7.38 ± 1.67 | 2.8 ± 1.3 | 0.000 ** | 7.36 ± 2.18 | 1.09 ± 1.3 | 0.000 ** | 0.000 ** | |
TSK | 50.2 ± 3.61 | 27.2 ± 1.74 | 0.000 ** | 49.3 ± 3.74 | 24.35 ± 1.73 | 0.000 ** | 0.000 ** | ||
HADS | 21.2 ± 5.18 | 13.1 ± 5.1 | 0.000 ** | 21.15 ± 5.86 | 7.9 ± 4.02 | 0.000 ** | 0.003 ** | ||
HADS-A | 11.9 ± 2.55 | 7.3 ± 2.6 | 0.000 ** | 11.8 ± 2.76 | 4.6 ± 2.37 | 0.000 ** | 0.001 ** | ||
HADS-D | 9.3 ± 3.06 | 5.8 ± 2.78 | 0.000 ** | 9.35 ± 3.5 | 3.3 ± 2.15 | 0.000 ** | 0.004 ** | ||
DHI | 58.4 ± 25.48 | 5.5 ± 7.37 | 0.000 ** | 82.1 ± 19.63 | 6 ± 6.62 | 0.000 ** | 0.761 |
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© 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Türk Kalkan, T.; Tarakçi, D.; Kiliç, G.; Çelikyurt, C. Investigation of the Effectiveness of Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) and Vestibular Rehabilitation in Patients with Unilateral Vestibular Hypofunction. Medicina 2025, 61, 872. https://doi.org/10.3390/medicina61050872
Türk Kalkan T, Tarakçi D, Kiliç G, Çelikyurt C. Investigation of the Effectiveness of Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) and Vestibular Rehabilitation in Patients with Unilateral Vestibular Hypofunction. Medicina. 2025; 61(5):872. https://doi.org/10.3390/medicina61050872
Chicago/Turabian StyleTürk Kalkan, Tuğba, Devrim Tarakçi, Gamze Kiliç, and Cengiz Çelikyurt. 2025. "Investigation of the Effectiveness of Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) and Vestibular Rehabilitation in Patients with Unilateral Vestibular Hypofunction" Medicina 61, no. 5: 872. https://doi.org/10.3390/medicina61050872
APA StyleTürk Kalkan, T., Tarakçi, D., Kiliç, G., & Çelikyurt, C. (2025). Investigation of the Effectiveness of Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) and Vestibular Rehabilitation in Patients with Unilateral Vestibular Hypofunction. Medicina, 61(5), 872. https://doi.org/10.3390/medicina61050872