Closed-loop vagus nerve stimulation aids recovery from spinal cord injury
- Michael P. Kilgard
- Joseph D. Epperson
- Emmanuel A. Adehunoluwa
- Chad Swank
- Amy L. Porter
- David T. Pruitt
- Holle L. Gallaway
- Christi Stevens
- Jaime Gillespie
- Dannae Arnold
- Mark B. Powers
- Rita G. Hamilton
- Richard C. Naftalis
- Michael L. Foreman
- Jane G. Wigginton
- Seth A. Hays
- Robert L. Rennaker
2025-05-21
Decades of research have demonstrated that recovery from serious neurological injury will require synergistic therapeutic approaches. Rewiring spared neural circuits after injury is a long-standing goal of neurorehabilitation 1,2 . We hypothesized that combining intensive, progressive, task-focused training with real-time closed-loop vagus nerve stimulation (CLV) to enhance synaptic plasticity 3 could increase strength, expand range of motion and improve hand function in people with chronic, incomplete cervical spinal cord injury. Here we report the results from a prospective, double-blinded, sham-controlled, randomized study combining gamified physical therapy using force and motion sensors to deliver sham or active CLV (ClinicalTrials.gov identifier NCT04288245). After 12 weeks of therapy composed of a miniaturized implant selectively activating the vagus nerve on successful movements, 19 people exhibited a significant beneficial effect on arm and hand strength and the ability to perform activities of daily living. CLV represents a promising therapeutic avenue for people with chronic, incomplete cervical spinal cord injury.