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Nerve stimulation helps patients regain arm function up to a decade after a stroke

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Jennifer Johnson McEwen

A recent study in The Lancet reports that a combination of Vagus nerve stimulation (VNS) and rehabilitation therapy, including physical and occupational therapy, can lead to a significant improvement in arm function months or even years after a stroke.

Emory University was part of the multi-center, double-blinded, randomized controlled trial that enrolled 108 subjects from nine months to up to 10 years post-stroke with moderate to severe arm weakness. Subjects in the study were randomized to either the paired VNS group (intense physical therapy paired with active VNS) or control group (intense physical therapy paired with sham VNS) and did six weeks of in-clinic therapy followed by three months of home-based therapy.

The Lancet study reports that patients receiving paired VNS therapy showed two to three times the improvement in upper extremity motor impairment and function compared to controls that received intense rehabilitation alone.

“These major findings are the result of years of important research that could greatly improve the lives of stroke survivors, allowing them to reclaim arm function years after having a stroke. This is vital because, even though therapy can help, full recovery is often not possible and becomes even less achievable the more time passes after a stroke,” says Emory principal investigator Steven L. Wolf, PhD, PT, Emory University School of Medicine, professor in the Department of Rehabilitation Medicine; professor, Department of Medicine; associate professor, Department of Cell Biology; professor, Nell Hodgson School of Nursing.

Wolf says this research could also open the door for additional studies in which VNS can be paired with other therapeutics using procedures developed in this study.

The vagus nerve is a cranial nerve that runs from the brain through the face and thorax to the abdomen. In VNS, a pacemaker-like electrical pulse generator is implanted in the chest. The generator remotely stimulates the nerve with single pulses synchronized to the initiation of each movement.