Vagus Nerve Stimulation Paired With Upper Limb Rehabilitation After Chronic Stroke

Teresa J. Kimberley, David Pierce, Cecília N. Prudente, Gerard E. Francisco, Nuray Yozbatiran, Patricia Smith, Brent Tarver, Navzer D. Engineer, David Alexander Dickie, Danielle K. Kline, Jane G Wigginton, Steven C. Cramer, Jesse Dawson

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8 Scopus citations

Abstract

Background and Purpose- We assessed safety, feasibility, and potential effects of vagus nerve stimulation (VNS) paired with rehabilitation for improving arm function after chronic stroke. Methods- We performed a randomized, multisite, double-blinded, sham-controlled pilot study. All participants were implanted with a VNS device and received 6-week in-clinic rehabilitation followed by a home exercise program. Randomization was to active VNS (n=8) or control VNS (n=9) paired with rehabilitation. Outcomes were assessed at days 1, 30, and 90 post-completion of in-clinic therapy. Results- All participants completed the course of therapy. There were 3 serious adverse events related to surgery. Average FMA-UE scores increased 7.6 with active VNS and 5.3 points with control at day 1 post-in-clinic therapy (difference, 2.3 points; CI, -1.8 to 6.4; P=0.20). At day 90, mean scores increased 9.5 points from baseline with active VNS, and the control scores improved by 3.8 (difference, 5.7 points; CI, -1.4 to 11.5; P=0.055). The clinically meaningful response rate of FMA-UE at day 90 was 88% with active VNS and 33% with control VNS ( P<0.05). Conclusions- VNS paired with rehabilitation was acceptably safe and feasible in participants with upper limb motor deficit after chronic ischemic stroke. A pivotal study of this therapy is justified. Clinical Trial Registration- URL: https://www.clinicaltrials.gov . Unique identifier: NCT02243020.

Original languageEnglish (US)
Pages (from-to)2789-2792
Number of pages4
JournalStroke
Volume49
Issue number11
DOIs
Publication statusPublished - Nov 1 2018

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Keywords

  • motor cortex
  • neuromodulation
  • plasticity
  • rehabilitation
  • stroke
  • upper extremity
  • vagus nerve

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Kimberley, T. J., Pierce, D., Prudente, C. N., Francisco, G. E., Yozbatiran, N., Smith, P., ... Dawson, J. (2018). Vagus Nerve Stimulation Paired With Upper Limb Rehabilitation After Chronic Stroke. Stroke, 49(11), 2789-2792. https://doi.org/10.1161/STROKEAHA.118.022279