Publication Date
6-1-2023
Journal
Neurorehabilitation and Neural Repair
Abstract
BACKGROUND: Vagus Nerve Stimulation (VNS) paired with rehabilitation improved upper extremity impairment and function in a recent pivotal, randomized, triple-blind, sham-controlled trial in people with chronic arm weakness after stroke.
OBJECTIVE: We aimed to determine whether treatment effects varied across candidate subgroups, such as younger age or less injury.
METHODS: Participants were randomized to receive rehabilitation paired with active VNS or rehabilitation paired with sham stimulation (Control). The primary outcome was the change in impairment measured by the Fugl-Meyer Assessment Upper Extremity (FMA-UE) score on the first day after completion of 6-weeks in-clinic therapy. We explored the effect of VNS treatment by sex, age (≥62 years), time from stroke (>2 years), severity (baseline FMA-UE score >34), paretic side of body, country of enrollment (USA vs UK) and presence of cortical involvement of the index infarction. We assessed whether there was any interaction with treatment.
FINDINGS: The primary outcome increased by 5.0 points (SD 4.4) in the VNS group and by 2.4 points (SD 3.8) in the Control group (
CONCLUSION: The response was similar across subgroups examined. The findings suggest that the effects of paired VNS observed in the VNS-REHAB trial are likely to be consistent in wide range of stroke survivors with moderate to severe upper extremity impairment.
Keywords
Humans, Middle Aged, Ischemic Stroke, Stroke Rehabilitation, Vagus Nerve Stimulation, Motor Disorders, Stroke, Upper Extremity, Recovery of Function, Treatment Outcome
Included in
Neurology Commons, Neurosciences Commons, Rehabilitation and Therapy Commons, Trauma Commons
Comments
PMID: 36226541