scholarly journals Vagus nerve stimulation paired with tactile training improved sensory function in a chronic stroke patient

2018 ◽  
Vol 42 (2) ◽  
pp. 159-165 ◽  
Author(s):  
Michael P. Kilgard ◽  
Robert L. Rennaker ◽  
Jen Alexander ◽  
Jesse Dawson
Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Navid Khodaparast ◽  
Reema Casavant ◽  
Andrea Ruiz ◽  
Robert L Rennaker ◽  
Michael P Kilgard

Background: Stroke is the leading cause of serious long-term disability. Currently, there is no effective treatment for chronic stroke patients. Neuroplasticity within motor circuitry is believed to support recovery of function after stroke. We have developed a method using vagus nerve stimulation (VNS) paired with motor training to drive robust, specific plasticity in the motor cortex. Our recent studies indicated that VNS paired with rehab training significantly enhances recovery of forelimb function after cortical ischemic stroke. To further the translation potential of our therapy, we accessed the hypothesis that delivering VNS paired with rehab may improve functional recovery in rats that demonstrated chronic forelimb impairments. Methods: All female Sprague Dawley rats were trained on the Isometric Pull Task, which quantifiably measures forelimb force generation. Rats that achieved 5 consecutive days of over 85% hit rate on this task were given a unilateral cortical-subcortical ischemic lesion via injections of a vasoconstrictive peptide, endothelin-1. Following the lesion, rats returned to their home cage, and did not begin rehab training until 5 weeks post-lesion. Upon return, post-lesion forelimb impairment was accessed with the same task parameters used during pre-lesion training, which allowed for a direct comparison of performance. Rats were assigned to balanced treatment groups based on post-lesion baseline hit rate. Treatment groups consisted of VNS delivered during rehab training (Paired VNS; n=10), VNS delivered two hours after rehab training (Delayed VNS; n=10), and rehab training without VNS (Rehab; n=10). Results: At five weeks post-lesion, the unilateral ischemic insult significantly worsened performance in all three groups compared to pre-lesion (Paired VNS: 29.8 ± 5.7%, paired t-test, P < 0.001; Delayed VNS: 24.6 ± 2.7%, P < 0.001; Rehab: 30.4 ± 4.7%, P < 0.001). Following our therapy, the Paired VNS group demonstrated significantly better performance than both control groups (Paired VNS: 81.6 ± 2.3%, P < 0.01; Delayed VNS: 53.2 ± 6.5%, P < 0.01; Rehab: 49.8 ± 6.8%, P < 0.01). Conclusion: Our results indicate that VNS paired with rehab training can further enhance recovery of forelimb function in chronically impaired rats.


2019 ◽  
Vol 28 (12) ◽  
pp. 104348 ◽  
Author(s):  
Sheharyar Sajjad Baig ◽  
Konstantinos Falidas ◽  
Peter J. Laud ◽  
Nicola Snowdon ◽  
Muhammad Umar Farooq ◽  
...  

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Fioravante Capone ◽  
Sandra Miccinilli ◽  
Giovanni Pellegrino ◽  
Loredana Zollo ◽  
Davide Simonetti ◽  
...  

The efficacy of standard rehabilitative therapy for improving upper limb functions after stroke is limited; thus, alternative strategies are needed. Vagus nerve stimulation (VNS) paired with rehabilitation is a promising approach, but the invasiveness of this technique limits its clinical application. Recently, a noninvasive method to stimulate vagus nerve has been developed. The aim of the present study was to explore whether noninvasive VNS combined with robotic rehabilitation can enhance upper limb functionality in chronic stroke. Safety and efficacy of this combination have been assessed within a proof-of-principle, double-blind, semirandomized, sham-controlled trial. Fourteen patients with either ischemic or haemorrhagic chronic stroke were randomized to robot-assisted therapy associated with real or sham VNS, delivered for 10 working days. Efficacy was evaluated by change in upper extremity Fugl–Meyer score. After intervention, there were no adverse events and Fugl–Meyer scores were significantly better in the real group compared to the sham group. Our pilot study confirms that VNS is feasible in stroke patients and can produce a slight clinical improvement in association to robotic rehabilitation. Compared to traditional stimulation, noninvasive VNS seems to be safer and more tolerable. Further studies are needed to confirm the efficacy of this innovative approach.


Stroke ◽  
2018 ◽  
Vol 49 (11) ◽  
pp. 2789-2792 ◽  
Author(s):  
Teresa J. Kimberley ◽  
David Pierce ◽  
Cecília N. Prudente ◽  
Gerard E. Francisco ◽  
Nuray Yozbatiran ◽  
...  

2019 ◽  
Vol 28 (4) ◽  
pp. 1381-1387
Author(s):  
Ying Yuan ◽  
Jie Wang ◽  
Dongyu Wu ◽  
Dahua Zhang ◽  
Weiqun Song

Purpose Severe dysphagia with weak pharyngeal peristalsis after dorsal lateral medullary infarction (LMI) requires long-term tube feeding. However, no study is currently available on therapeutic effectiveness in severe dysphagia caused by nuclear damage of vagus nerve after dorsal LMI. The purpose of the present investigation was to explore the potential of transcutaneous vagus nerve stimulation (tVNS) to improve severe dysphagia with weak pharyngeal peristalsis after dorsal LMI. Method We assessed the efficacy of 6-week tVNS in a 28-year-old woman presented with persisting severe dysphagia after dorsal LMI who had been on nasogastric feeding for 6 months. tVNS was applied for 20 min twice a day, 5 days a week, for 6 weeks. The outcome measures included saliva spitted, Swallow Function Scoring System, Functional Oral Intake Scale, Clinical Assessment of Dysphagia With Wallenberg Syndrome, Yale Pharyngeal Residue Severity Rating Scale, and upper esophagus X-ray examination. Results After tVNS, the patient was advanced to a full oral diet without head rotation or spitting. No saliva residue was found in the valleculae and pyriform sinuses. Contrast medium freely passed through the upper esophageal sphincter. Conclusion Our findings suggest that tVNS might provide a useful means for recovery of severe dysphagia with weak pharyngeal peristalsis after dorsal LMI. Supplemental Material https://doi.org/10.23641/asha.9755438


2021 ◽  
Vol 3 (1) ◽  
pp. e14-e15
Author(s):  
Mark C Genovese ◽  
Yaakov A Levine ◽  
David Chernoff

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