Fig. 2

VNS can play a neuroprotective role through multiple strategies. VNS can activate the neural proliferation process via upregulation of the BDNF/TK pathway; it can activate α2-AR and change neural plasticity. VNS increases the level of GDF11, thus leading to an increase in microvessel density. In addition, VNS can at least partially inhibit the activation of the NF-κB pathway to protect vascular endothelial cells. VNS vagus nerve stimulation, BDNF brain-derived neurotrophic factor, TrkB tropomyosin-related kinase B, α2-AR α2 adrenergic receptor, GDF11 growth differentiation factor 11; NF-κB, nuclear factor kappa-B