INTRODUCTION: Postoperative cognitive dysfunction (POCD) is common in the perioperative period among older adults and has been linked to inflammatory responses, neural injury-related biomarkers, and mood changes. Evidence for safe, feasible, and effective non-pharmacological interventions remains limited. This prospective, double-blind, randomized controlled trial evaluated the association between transcutaneous auricular vagus nerve stimulation (taVNS) and postoperative cognitive test performance, and examined concomitant changes in inflammatory and neural injury-related biomarkers and mood. MATERIALS AND METHODS: A total of 103 older adults scheduled for elective laparoscopic gastrointestinal tumor resection were consecutively enrolled and randomly assigned to taVNS or sham stimulation; 99 participants completed follow-up and were included in the primary analysis. Cognitive function was assessed preoperatively and at postoperative day 1, day 7, month 1, and month 3 using the Montreal Cognitive Assessment (MoCA). Serum interleukin-1β (IL-1β) and S100β were measured preoperatively and on postoperative day 7. Mood was assessed preoperatively and on postoperative day 7 using the 24-item Hamilton Depression Scale (HAMD-24). RESULTS: From postoperative day 7 onward, MoCA scores were higher in the taVNS group than in the sham group (p = 0.01), with differences maintained at postoperative months 1 and 3 (absolute between-group differences of 2.06 and 2.97 points, respectively; both p < 0.01). RM ANOVA and ANCOVA indicated significant main effects of time and a significant group × time interaction. On postoperative day 7, the taVNS group showed lower postoperative IL-1β and S100β levels than the control group (both p < 0.001) and a smaller worsening in HAMD-24 scores. ΔMoCA was negatively correlated with ΔIL-1β (r = -0.425), ΔS100β (r = -0.248), and ΔHAMD-24 (r = -0.234). Ex…
**Проблема.** Послеоперационная когнитивная дисфункция у пожилых связывается с воспалением и нейрональным повреждением; безопасные немедикаментозные вмешательства ограничены.
**Дизайн.** Двойное слепое РКИ: 103 пациента пожилого возраста после лапароскопической резекции опухолей ЖКТ рандомизировали в группу transcutaneous auricular vagus nerve stimulation (taVNS) или «sham»; 99 завершили наблюдение. Когницию оценивали MoCA до операции и на 1‑й, 7‑й день, через 1 и 3 месяца. IL‑1β и S100β измеряли до операции и на 7‑й день. Настроение — HAMD‑24.
**Результаты.** Начиная с 7‑го дня MoCA была выше при taVNS (p=0.01); разница сохранялась через 1 и 3 месяца (межгрупповые различия 2.06 и 2.97 балла; обе p<0.01). На 7‑й день IL‑1β и S100β были ниже при taVNS (оба p<0.001), а ухудшение по HAMD‑24 было меньшим. Изменение MoCA отрицательно коррелировало с изменениями IL‑1β (r=-0.425), S100β (r=-0.248) и HAMD‑24 (r=-0.234).
**Значение.** taVNS может быть перспективной профилактикой ПОКД, потенциально через **снижение воспаления и маркеров нейронального повреждения**; важны репликации в других хирургических популяциях и оценка клинически значимых исходов.
**Источник:** DOI: https://doi.org/10.1016/j.jgo.2026.103049 ; PubMed: https://pubmed.ncbi.nlm.nih.gov/42456197/ (PMID 42456197).