{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:32:50Z","timestamp":1791484370094,"version":"4.3.4"},"reference-count":105,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The vagus nerve (VN), the principal component of the parasympathetic branch of the autonomic nervous system (ANS), mediates bidirec communication between the central nervous system (CNS) and peripheral organs. Vagus nerve stimulation (VNS), delivered through invasive (iVNS) or non\u2010invasive (transcutaneous cervical [tcVNS] and transcutaneous auricular [taVNS]), exerts multimodal effects on multiple circuits and neurotransmitters, and is currently under investigation in movement disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This systematic review evaluates the therapeutic potential of VNS in movement disorders (MDs), with a focus on Parkinson's disease (PD), parkinsonism, tremor and essential tremor (ET), cervical dystonia (CD), and Tourette's syndrome (TS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Web of Science, and Scopus was conducted for studies published between 2020 and 2025, following Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses 2020 guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010two studies met the inclusion criteria: 22 on PD or parkinsonism (14 clinical and 8 preclinical on PD, 1 clinical on multisystem atrophy), 6 on tremor and ET (4 clinical, 2 preclinical), 2 clinical studies on CD, and 1 clinical study on TS. Across conditions, VNS was reported to improve motor and non\u2010motor, enhance synaptic plasticity, modulate neurotransmitter activity relevant to MDs (GABA, norepinephrine, dopamine, and acetylcholine), and reduce neuroinflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Current evidence supports the multimodal effect of VNS in MDs, particularly in PD, where the most consistent benefits were observed. Non\u2010invasive taVNS represents a promising, safer alternative to iVNS. Larger randomized controlled trials with standardized protocols are needed to validate efficacy, optimize stimulation parameters, and determine long\u2010term clinical and biological impact. \u00a9 2025 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.70044","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T11:37:17Z","timestamp":1759232237000},"page":"2559-2577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Vagus Nerve Stimulation in Movement Disorders, from Principles to a Systematic Review of Evidence"],"prefix":"10.1002","volume":"40","author":[{"given":"Francesca","family":"Proietti","sequence":"first","affiliation":[{"name":"Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine University Campus Bio\u2010Medico of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6354-3278","authenticated-orcid":false,"given":"Matteo Maria","family":"Ottaviani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Universit\u00e0 Politecnica delle Marche  Ancona Italy"},{"name":"Department of Neurosurgery Azienda Ospedaliera di Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Burchi","sequence":"additional","affiliation":[{"name":"Scuola Superiore di Scienze dell'Educazione \u201cSan Giovanni Bosco\u201d, aggregata alla Facolt\u00e0 di Scienze dell'Educazione Universit\u00e0 Pontificia Salesiana  Rome Italy"},{"name":"Parasym  London United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6080-7007","authenticated-orcid":false,"given":"Giorgio","family":"Vivacqua","sequence":"additional","affiliation":[{"name":"Department of Microscopic and Ultrastructural Anatomy Campus Biomedico University of Roma  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Anzini","sequence":"additional","affiliation":[{"name":"Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine University Campus Bio\u2010Medico of Rome  Rome Italy"},{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo Antonio","family":"Ricciuti","sequence":"additional","affiliation":[{"name":"UOC Neurosurgery Azienda Ospedaliera San Camillo Forlanini  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fioravante","family":"Capone","sequence":"additional","affiliation":[{"name":"Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine University Campus Bio\u2010Medico of Rome  Rome Italy"},{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaughan G.","family":"Macefield","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Di Lazzaro","sequence":"additional","affiliation":[{"name":"Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine University Campus Bio\u2010Medico of Rome  Rome Italy"},{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9885-3666","authenticated-orcid":false,"given":"Massimo","family":"Marano","sequence":"additional","affiliation":[{"name":"Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine University Campus Bio\u2010Medico of Rome  Rome Italy"},{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-024-00803-1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63327-9.00010-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/1673-5374.353490"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1838(80)90003-x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.15691"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcibr1100496"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1990.tb05848.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.45.2.224"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1996.00550110128021"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000168899.11598.00"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2012.04305.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0006-3223(99)00304-2"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.05.025"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.07.028"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-006-0049-4"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12611"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP271539"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2024.12.1191"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2017.08.008"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11064-018-2639-z"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbr.2019.112080"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2020.06.078"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines9070789"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm-22-5366"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2023.03.003"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuint.2024.105871"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-007-0723-4"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27662"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27664"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2022.11.006"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29166"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29690"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29826"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2025.1560826"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.14309"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.06.083"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2023.1331575"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1210103"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.14744\/SEMB.2023.77200"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-192909"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2024.1499793"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8257(200101)16:1<84::aid-mds1010>3.0.co;2-s"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2004.03.021"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000172343.45110.79"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458507078399"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000094355.51119.d2"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2024.11.008"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1515\/bmt-2013-4033"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12621"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20949"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/cphy.c210042"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-3956(02)00013-4"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-3956(03)00074-8"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/jdn.10064"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2021.09.001"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1080\/00207454.2024.2449382"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301288"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2019.116119"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2022.06.017"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2024.11.012"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/7876507"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2011-1443"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-014-1299-7"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.16004"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00044"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23932"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-023-01595-5"},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2010.08.025"},{"key":"e_1_2_9_71_1","first-page":"SupplS1388","article-title":"Changes in the thalamocortical component of high frequency oscillations following botulinum toxin treatment in cervical dystonia","volume":"20","author":"Cruciani A","year":"2025","journal-title":"Clin Neurophysiol"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.5.859"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1088\/1741-2552\/abe6b9"},{"key":"e_1_2_9_74_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.3.452"},{"key":"e_1_2_9_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/0013-4694(52)90064-3"},{"key":"e_1_2_9_76_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.focus.20210023"},{"issue":"17","key":"e_1_2_9_77_1","first-page":"S317","article-title":"Review of non\u2010invasive vagus nerve stimulation (gammaCore): efficacy, safety, potential impact on comorbidities, and economic burden for episodic and chronic cluster headache","volume":"23","author":"Mwamburi M","year":"2017","journal-title":"Am J Manag Care"},{"key":"e_1_2_9_78_1","doi-asserted-by":"publisher","DOI":"10.1111\/joa.13122"},{"key":"e_1_2_9_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpsycho.2021.01.003"},{"key":"e_1_2_9_80_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12265-024-10544-4"},{"key":"e_1_2_9_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2023.05.011"},{"key":"e_1_2_9_82_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.023582"},{"key":"e_1_2_9_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2023.10.015"},{"key":"e_1_2_9_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2024.106083"},{"key":"e_1_2_9_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2023.105959"},{"key":"e_1_2_9_86_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2017.00338"},{"key":"e_1_2_9_87_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12629"},{"key":"e_1_2_9_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2018.08.010"},{"key":"e_1_2_9_89_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-102088"},{"key":"e_1_2_9_90_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(24)02168-5"},{"key":"e_1_2_9_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2014.11.018"},{"key":"e_1_2_9_92_1","doi-asserted-by":"publisher","DOI":"10.3758\/s13415-018-0596-2"},{"key":"e_1_2_9_93_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2016.12.005"},{"key":"e_1_2_9_94_1","doi-asserted-by":"publisher","DOI":"10.1006\/nlme.1995.1024"},{"key":"e_1_2_9_95_1","doi-asserted-by":"publisher","DOI":"10.1038\/4600"},{"key":"e_1_2_9_96_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00057.2020"},{"key":"e_1_2_9_97_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2021.709436"},{"key":"e_1_2_9_98_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2017.11.007"},{"key":"e_1_2_9_99_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.006654"},{"key":"e_1_2_9_100_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-12178-w"},{"key":"e_1_2_9_101_1","doi-asserted-by":"publisher","DOI":"10.1109\/NER49283.2021.9441131"},{"key":"e_1_2_9_102_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.13083"},{"key":"e_1_2_9_103_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP280077"},{"key":"e_1_2_9_104_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP282994"},{"key":"e_1_2_9_105_1","doi-asserted-by":"publisher","DOI":"10.1088\/1741-2552\/ac84ab"},{"key":"e_1_2_9_106_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP286423"}],"container-title":["Movement Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.70044","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mds.70044","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.70044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T06:00:29Z","timestamp":1783836029000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mds.70044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":105,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/mds.70044"],"URL":"https:\/\/doi.org\/10.1002\/mds.70044","archive":["Portico"],"relation":{},"ISSN":["0885-3185","1531-8257"],"issn-type":[{"value":"0885-3185","type":"print"},{"value":"1531-8257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]},"assertion":[{"value":"2025-07-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}