Michael P Kilgard1,2, Robert L Rennaker1,3,2, Jen Alexander4, Jesse Dawson4. 1. School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA. 2. Texas Biomedical Device Center, Richardson, TX, USA. 3. Department of Bioengineering, Erik Jonsson School of Engineering and Computer Science, University of Texas at Dallas, Richardson, TX, USA. 4. Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Western Infirmary, Glasgow, UK.
Abstract
BACKGROUND: Recent studies indicate that vagus nerve stimulation (VNS) paired with rehabilitation can enhance neural plasticity in the primary sensory and motor cortices, improve forelimb function after stroke in animal models and improve motor function in patients with arm weakness after stroke. OBJECTIVE: To gain "first-in-man" experience of VNS paired with tactile training in a patient with severe sensory impairment after stroke. METHODS: During the long-term follow-up phase of a clinical trial of VNS paired with motor rehabilitation, a 71-year-old man who had made good motor recovery had ongoing severe sensory loss in his left hand and arm. He received VNS paired with tactile therapy in an attempt to improve his sensory function. During twenty 2-hour sessions, each passive and active tactile event was paired with a 0.5 second burst of 0.8 mA VNS. Sensory function was measured before, halfway through, and after this therapy. RESULTS: The patient did not report any side effects during or following VNS+Tactile therapy. Quantitative measures revealed lasting and clinically meaningful improvements in tactile threshold, proprioception, and stereognosis. After VNS+Tactile therapy, the patient was able to detect tactile stimulation to his affected hand that was eight times less intense, identify the joint position of his fingers in the affected hand three times more often, and identify everyday objects using his affected hand seven times more often, compared to baseline. CONCLUSIONS: Sensory function significantly improved in this man following VNS paired with tactile stimulation. This approach merits further study in controlled clinical trials.
BACKGROUND: Recent studies indicate that vagus nerve stimulation (VNS) paired with rehabilitation can enhance neural plasticity in the primary sensory and motor cortices, improve forelimb function after stroke in animal models and improve motor function in patients with arm weakness after stroke. OBJECTIVE: To gain "first-in-man" experience of VNS paired with tactile training in a patient with severe sensory impairment after stroke. METHODS: During the long-term follow-up phase of a clinical trial of VNS paired with motor rehabilitation, a 71-year-old man who had made good motor recovery had ongoing severe sensory loss in his left hand and arm. He received VNS paired with tactile therapy in an attempt to improve his sensory function. During twenty 2-hour sessions, each passive and active tactile event was paired with a 0.5 second burst of 0.8 mA VNS. Sensory function was measured before, halfway through, and after this therapy. RESULTS: The patient did not report any side effects during or following VNS+Tactile therapy. Quantitative measures revealed lasting and clinically meaningful improvements in tactile threshold, proprioception, and stereognosis. After VNS+Tactile therapy, the patient was able to detect tactile stimulation to his affected hand that was eight times less intense, identify the joint position of his fingers in the affected hand three times more often, and identify everyday objects using his affected hand seven times more often, compared to baseline. CONCLUSIONS: Sensory function significantly improved in this man following VNS paired with tactile stimulation. This approach merits further study in controlled clinical trials.
Entities:
Keywords:
Vagal nerve stimulation; motor function; neuromodulation; neuroplasticity; upper extremity
Authors: Vishnoukumaar Sivaji; Dane W Grasse; Seth A Hays; Jesse E Bucksot; Rahul Saini; Michael P Kilgard; Robert L Rennaker Journal: J Neurosci Methods Date: 2019-03-05 Impact factor: 2.390
Authors: Michael J Darrow; Tabarak M Mian; Miranda Torres; Zainab Haider; Tanya Danaphongse; Armin Seyedahmadi; Robert L Rennaker; Seth A Hays; Michael P Kilgard Journal: Behav Brain Res Date: 2020-09-21 Impact factor: 3.332
Authors: Eric C Meyers; Nimit Kasliwal; Bleyda R Solorzano; Elaine Lai; Geetanjali Bendale; Abigail Berry; Patrick D Ganzer; Mario Romero-Ortega; Robert L Rennaker; Michael P Kilgard; Seth A Hays Journal: Nat Commun Date: 2019-12-19 Impact factor: 17.694
Authors: Sean L Thompson; Georgia H O'Leary; Christopher W Austelle; Elise Gruber; Alex T Kahn; Andrew J Manett; Baron Short; Bashar W Badran Journal: Front Neurosci Date: 2021-07-13 Impact factor: 4.677