Paresis Clinical Trial
Official title:
Transcutaneous Auricular Vagus Nerve Stimulation: Motor Learning & Mechanisms
Vagus nerve stimulation (VNS) is thought to activate neural pathways that release chemicals which promote plasticity and learning. Previous work has shown that the auricular branch of the vagus nerve innervates landmarks on the external ear. Work from the PI's laboratory has shown that electrical current applied to the external ear modulates physiological indexes of brain states implicated in the therapeutic effects of VNS. The broad objective of this project is to better understand physiological mechanisms modulated by auricular stimulation to support possible therapeutic effects in the form of motor learning.
Status | Recruiting |
Enrollment | 110 |
Est. completion date | August 5, 2028 |
Est. primary completion date | April 3, 2028 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years to 75 Years |
Eligibility | Inclusion Criteria: ALL PROSPECTIVE SUBJECTS: 1. 18-75 years of age PROSPECTIVE SUBJECTS DIAGNOSED WITH STROKE: 2. Diagnosis of a single stroke resulting in hand impairment 3. Diagnosis of stroke at least six months prior to the time of participation Exclusion Criteria: ALL PROSPECTIVE SUBJECTS: 1. History of vestibular disorders or dizziness 2. Difficulty maintaining alertness and/or remaining still 3. Pregnant or expecting to become pregnant 4. Diagnosis of neurological and/or musculoskeletal disorder(s) (other than stroke) that affect movement 5. Ocular disease and/or impairment in more than one eye 6. History of seizure and/or epilepsy 7. Implants, devices, or foreign objects in the brain/body that are incompatible with MRI 8. Body size that is incompatible with MRI scanner dimensions 9. Anyone already enrolled and actively participating in another greater than minimal risk study. PROSPECTIVE SUBJECTS DIAGNOSED WITH STROKE: 10. Other impairments secondary to stroke (e.g., attention, cognition, etc.) that would interfere with the ability to understand study goals or follow simple instructions, as judged by the investigators. |
Country | Name | City | State |
---|---|---|---|
United States | VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA | Pittsburgh | Pennsylvania |
Lead Sponsor | Collaborator |
---|---|
VA Office of Research and Development |
United States,
Butt MF, Albusoda A, Farmer AD, Aziz Q. The anatomical basis for transcutaneous auricular vagus nerve stimulation. J Anat. 2020 Apr;236(4):588-611. doi: 10.1111/joa.13122. Epub 2019 Nov 19. — View Citation
Dawson J, Liu CY, Francisco GE, Cramer SC, Wolf SL, Dixit A, Alexander J, Ali R, Brown BL, Feng W, DeMark L, Hochberg LR, Kautz SA, Majid A, O'Dell MW, Pierce D, Prudente CN, Redgrave J, Turner DL, Engineer ND, Kimberley TJ. Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): a randomised, blinded, pivotal, device trial. Lancet. 2021 Apr 24;397(10284):1545-1553. doi: 10.1016/S0140-6736(21)00475-X. — View Citation
Follesa P, Biggio F, Gorini G, Caria S, Talani G, Dazzi L, Puligheddu M, Marrosu F, Biggio G. Vagus nerve stimulation increases norepinephrine concentration and the gene expression of BDNF and bFGF in the rat brain. Brain Res. 2007 Nov 7;1179:28-34. doi: 10.1016/j.brainres.2007.08.045. Epub 2007 Aug 25. — View Citation
Roosevelt RW, Smith DC, Clough RW, Jensen RA, Browning RA. Increased extracellular concentrations of norepinephrine in cortex and hippocampus following vagus nerve stimulation in the rat. Brain Res. 2006 Nov 13;1119(1):124-32. doi: 10.1016/j.brainres.2006.08.048. Epub 2006 Sep 7. — View Citation
Safi S, Ellrich J, Neuhuber W. Myelinated Axons in the Auricular Branch of the Human Vagus Nerve. Anat Rec (Hoboken). 2016 Sep;299(9):1184-91. doi: 10.1002/ar.23391. Epub 2016 Jul 12. — View Citation
Urbin MA, Lafe CW, Simpson TW, Wittenberg GF, Chandrasekaran B, Weber DJ. Electrical stimulation of the external ear acutely activates noradrenergic mechanisms in humans. Brain Stimul. 2021 Jul-Aug;14(4):990-1001. doi: 10.1016/j.brs.2021.06.002. Epub 2021 Jun 18. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Force Control Change | Subjects will be tested on the same task used for training that involves controlling finger forces. | Pre, 1-week Post, 1-month Post |
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