scholarly journals Response by Kimberley and Dawson Regarding Article, “Vagus Nerve Stimulation Paired With Upper Limb Rehabilitation After Chronic Stroke: A Blinded Randomized Pilot Study”

Stroke ◽  
2019 ◽  
Vol 50 (2) ◽  
Author(s):  
Teresa J Kimberley ◽  
Jesse Dawson
Keyword(s):  
Pilot Study ◽  
Vagus Nerve ◽  
Upper Limb ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Chronic Stroke ◽  
Upper Limb Rehabilitation ◽  
Limb Rehabilitation

scholarly journals Vagus Nerve Stimulation Paired With Upper Limb Rehabilitation After Chronic Stroke

Stroke ◽  
2018 ◽  
Vol 49 (11) ◽  
pp. 2789-2792 ◽  
Author(s):  
Teresa J. Kimberley ◽  
David Pierce ◽  
Cecília N. Prudente ◽  
Gerard E. Francisco ◽  
Nuray Yozbatiran ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Upper Limb ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Chronic Stroke ◽  
Upper Limb Rehabilitation ◽  
Limb Rehabilitation

scholarly journals An Exploratory Study of Predictors of Response to Vagus Nerve Stimulation Paired with Upper-Limb Rehabilitation After Ischemic Stroke

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
David Alexander Dickie ◽  
Teresa Jacobson Kimberley ◽  
David Pierce ◽  
Navzer Engineer ◽  
W. Brent Tarver ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Vagus Nerve ◽  
Upper Limb ◽  
Nerve Stimulation ◽  
Exploratory Study ◽  
Vagus Nerve Stimulation ◽  
Brain Mri ◽  
Phase Iii ◽  
Upper Limb Rehabilitation ◽  
Limb Rehabilitation

Abstract We have previously shown the safety and feasibility of vagus nerve stimulation (VNS) paired with upper-limb rehabilitation after ischemic stroke. In this exploratory study, we assessed whether clinical and brain MRI variables predict response to treatment. We used data from two completed randomised and blinded clinical trials (N = 35). All participants had moderate to severe upper-limb weakness and were randomised to 6-weeks intensive physiotherapy with or without VNS. Participants had 3 T brain MRI at baseline. The primary outcome was change in Fugl-Meyer Assessment, upper-extremity score (FMA-UE) from baseline to the first day after therapy completion. We used general linear regression to identify clinical and brain MRI predictors of change in FMA-UE. VNS-treated participants had greater improvement in FMA-UE at day-1 post therapy than controls (8.63 ± 5.02 versus 3.79 ± 5.04 points, t = 2.83, Cohen’s d = 0.96, P = 0.008). Higher cerebrospinal fluid volume was associated with less improvement in FMA-UE in the control but not VNS group. This was also true for white matter hyperintensity volume but not after removal of an outlying participant from the control group. Responders in the VNS group had more severe arm impairment at baseline than responders to control. A phase III trial is now underway to formally determine whether VNS improves outcomes and will explore whether these differ in people with more severe baseline upper-limb disability and cerebrovascular disease.

scholarly journals Safety, Feasibility, and Efficacy of Vagus Nerve Stimulation Paired With Upper-Limb Rehabilitation After Ischemic Stroke

Stroke ◽  
2016 ◽  
Vol 47 (1) ◽  
pp. 143-150 ◽  
Author(s):  
Jesse Dawson ◽  
David Pierce ◽  
Anand Dixit ◽  
Teresa J. Kimberley ◽  
Michele Robertson ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Vagus Nerve ◽  
Upper Limb ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Upper Limb Rehabilitation ◽  
Limb Rehabilitation

scholarly journals Transcutaneous Auricular Vagus Nerve Stimulation with Upper Limb Repetitive Task Practice May Improve Sensory Recovery in Chronic Stroke

2019 ◽  
Vol 28 (12) ◽  
pp. 104348 ◽  
Author(s):  
Sheharyar Sajjad Baig ◽  
Konstantinos Falidas ◽  
Peter J. Laud ◽  
Nicola Snowdon ◽  
Muhammad Umar Farooq ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Upper Limb ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Chronic Stroke ◽  
Task Practice ◽  
Sensory Recovery

scholarly journals Transcutaneous Vagus Nerve Stimulation Combined with Robotic Rehabilitation Improves Upper Limb Function after Stroke

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Fioravante Capone ◽  
Sandra Miccinilli ◽  
Giovanni Pellegrino ◽  
Loredana Zollo ◽  
Davide Simonetti ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Upper Limb ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Robotic Rehabilitation ◽  
Double Blind ◽  
Upper Limb Function ◽  
Transcutaneous Vagus Nerve Stimulation

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.

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