Closed-loop vagus nerve stimulation aids recovery from spinal cord injury.

Kilgard, Michael P; Epperson, Joseph D; Adehunoluwa, Emmanuel A; Swank, Chad; Porter, Amy L; Pruitt, David T; Gallaway, Holle L; Stevens, Christi et al. · Nature · 2025

rct · Level II

Where this comes from

Abstract

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<sup>1,2</sup>. We hypothesized that combining intensive, progressive, task-focused training with real-time closed-loop vagus nerve stimulation (CLV) to enhance synaptic plasticity<sup>3</sup> 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.

Medical subject headings

Anatomy