Vagus Nerve Stimulation

The vagus nerve is 1 of 12 pairs of cranial nerves that connect the brain to different parts of the body. You have one vagus nerve on each side of the body, running from the brainstem, through the neck and into the abdomen.

It serves as the main communication pathway between the brain, neck, heart, lungs and abdomen, sending signals that help regulate important body functions, including:

• Heart rate
• Digestion
• Breathing
• Other vital functions

Because the vagus nerve plays such a big role in controlling these systems, stimulating it can have significant effects on the body.

Vagus nerve stimulation (VNS) is a mild electrical stimulation of the brain through the Vagus nerve via a small implantable device. The stimulation helps the brain form new pathways, which can improve movement in people recovering from a stroke. A person generally cannot feel the pulses generated by the device.

The Food and Drug Administration has approved vagus nerve stimulation devices to treat epilepsy, depression and motor function in ischemic stroke survivors. You will need a referral from your primary care physician to receive VNS.

The University of Kansas Health System is the first hospital in the Kansas City area to provide VNS for ischemic stroke survivors with Vivistim® – a device that requires work with rehabilitation to help stroke survivors regain motor control in their hand and arm more than 6 months poststroke.

To be considered for VNS therapy for stroke, you must have had an ischemic stroke and be at least 6 months poststroke. You must also be experiencing moderate to severe impairment in your hand or arm. In addition, you must have participated in conventional rehabilitation and physical therapy but continue to have significant limitations in the use of your hand or arm.

The role of the VNS device is dependent on the condition it is being used to treat or affect.

VNS works in ischemic stroke survivors by sending impulses to specific locations in the brain or by helping the brain develop new pathways during exercise. These stroke survivors have hit a plateau in their recovery where they are no longer seeing increased abilities in using their hand or arm. VNS is used in conjunction with intensive rehabilitation in ischemic stroke survivors who are at least 6 months poststroke to improve use of their hands and arms.

Vagus nerve stimulation provides several benefits for ischemic stroke survivors:

• VNS enhances the brain’s neuroplasticity, which promotes the brain’s ability to relearn motor tasks.
• In clinical trials, patients experienced 2 to 3 times greater improvement in hand and arm function as compared to only undergoing traditional rehabilitation.
• VNS therapy is personalized to each person, focusing on task-specific therapy based on individual goals.

For people who are using VNS after an ischemic stroke, the stimulator is used during rehabilitation exercises and at-home activities. The device is activated and gently stimulates the vagus nerve, giving the brain a little boost to help strengthen and create new neural pathways. This acts like a bridge that bypasses the area of the brain damaged by the stroke.