Vagus Nerve Stimulation and Upper Limb Rehabilitation
- 101 Downloads
Purpose of Review
This article will review the evidence for the use of vagus nerve stimulation to drive the growth of new neural pathways during upper limb rehabilitation and improve functional recovery after stroke.
Approximately 85 % of patients with stroke present with arm weakness and 60 % of stroke survivors with poorly functioning arms at 1 week do not recover meaningful function by 6 months. The mainstay of current treatment is intensive, task-specific and repetitive rehabilitation therapy or occasionally methods such as constraint-induced movement therapy and robotic therapy. The effects of these treatments are modest, and recent studies have suggested that augmentation of neuroplasticity is required to more fully recover motor function.
Novel treatments are needed to improve recovery of upper limb function after stroke. We will review the evidence for the use of vagal nerve stimulation paired with rehabilitation drive neuroplasticity specific to upper limb function.
KeywordsVagus nerve Stroke Rehabilitation Epilepsy Tinnitus
Compliance with Ethics Guidelines
Conflict of Interest
Jesse Dawson reports conference travel reimbursement from Microtransponder Inc. Frances McGrane declares that she has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Recently published papers of particular interest have been highlighted as: •• Of major importance
- 8.•• Engineer ND, Riley JR, Seale JD, Vrana WA, Shetake JA, Sudanagunta SP, et al. Reversing pathological neural activity using targeted plasticity. Nature. 2011;470:101–4. This indicated that vagus nerve stimulation paired with a stimulus could be used to drive neuroplasticity specific to that stimulus.Google Scholar
- 15.•• Dawson J, Pierce D, Dixit A, Kimberley TJ, Robertson M, Tarver B, Hilmi O, McLean J, Forbes K, Kilgard MP, Rennaker RL, Cramer SC, Walters M, Engineer N. Safety, feasibility, and efficacy of vagus nerve stimulation paired with upper-limb rehabilitation after ischemic stroke. Stroke. 2016 Jan;47(1):143–50. This is the only in-human evaluation of the use of vagus nerve stimulation paired with upper limb rehabilitation in stroke.Google Scholar
- 16.Borland MS, Vrana WA, Moreno NA, Fogarty EA, Buell EP, Sharma P, et al. Cortical Map Plasticity as a Function of Vagus Nerve Stimulation Intensity. [published online ahead of print September 9 2015]. Brain Stimulation 2015. http://www.brainstimjrnl.com/article/S1935-861X(15)01125-0/pdf. Accessed 15 Oct 2015.