Paired vagus nerve stimulation for treatment of upper extremity impairment after stroke

Dawson, J. and Abdul-Rahim, A. H. (2022) Paired vagus nerve stimulation for treatment of upper extremity impairment after stroke. International Journal of Stroke, 17(10), pp. 1061-1066. (doi: 10.1177/17474930221094684) (PMID:35377261)

Abstract

The use of a paired vagus nerve stimulation (VNS) system for the treatment of moderate to severe upper extremity motor deficits associated with chronic ischaemic stroke has recently been approved by the U.S Food and Drug Administration. This treatment aims to increase task specific neuroplasticity through activation of cholinergic and noradrenergic networks during rehabilitation therapy. A recent pivotal phase III trial showed that VNS paired with rehabilitation led to improvements in upper extremity impairment and function in people with moderate to severe arm weakness an average of three years after ischaemic stroke. The between group difference following six weeks of in-clinic therapy and 90 days of home exercise therapy was three points on the upper extremity Fugl Meyer score. A clinically meaningful response defined as a greater than or equal to six point improvement was seen in approximately half of people treated with VNS compared to approximately a quarter of people treated with rehabilitation alone. Further post-marketing research should aim to establish whether the treatment is also of use for people with intracerebral haemorrhage, in people with more severe arm weakness, and for other post stroke impairments. In addition, high quality randomised studies of non-invasive VNS are required.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Abdul-Rahim, Dr Azmil and Dawson, Professor Jesse
• Authors: Dawson, J., and Abdul-Rahim, A. H.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
• Journal Name: International Journal of Stroke
• Publisher: SAGE Publications
• ISSN: 1747-4930
• ISSN (Online): 1747-4949
• Published Online: 04 April 2022
• Copyright Holders: Copyright © 2022 World Stroke Organization
• First Published: First published in International Journal of Stroke 17(10): 1061-1066
• Publisher Policy: Reproduced in accordance with the publisher copyright policy