Approximately two-thirds of individuals suffer from mobility issues following a stroke (Stephan et al., 2021). Physiotherapy is critical for supporting individuals in regaining their mobility (Ernst, 1990). Although physiotherapy is very helpful for patients, this can take several months, where individuals must “re-learn” how to use their limbs, slowly re-gaining strength, balance and coordination. Recent advances in vagus nerve stimulation may help speed up this process for patients to help them regain their mobility sooner.

The Food and Drug Administration (FDA) recently approved the use of an implantable vagus nerve stimulator to support rehabilitation following a stroke. King’s College London also recently launched a trial testing an innovative treatment involving a removable earpiece that delivers vagus nerve stimulation.  The innovative treatment involves wearing a removable earpiece which does not involve undergoing an invasive surgery. The treatment aims to improve mobility and support rehabilitation in patients following a stroke. Unlike implantable vagus nerve stimulators, the treatment can be delivered without requiring a hospital admission which is likely to be more cost-effective and acceptable to patients. 

The treatment involves vagus nerve stimulation, where electrical impulses are delivered to the vagus nerve, extending from the lower part of the brain to the stomach. The treatment involves wearing a small earpiece designed to stimulate the vagus nerve whilst patients complete rehabilitation exercises. Further research is needed to understand the mechanism of action of this treatment approach. However, it is thought that stimulating the vagus nerve during physiotherapy may help the brain re-wire itself after a stroke. A recent meta-analysis showed that this approach appears to be highly efficacious, where both invasive and non-invasive vagus nerve stimulators improve motor impairment, consistently outperforming control conditions (Abdullahi et al., 2023). However, larger studies are needed and it remains to be seen whether delivering vagus nerve stimulation using a removal earpiece will lead to a clinical benefit that is comparable to recently licensed implantable vagus nerve stimulators.

Link to article: https://www.bbc.co.uk/news/articles/crmzyr7nx1lo

References

Abdullahi, A., Wong, T.W.L. & Ng, S.S.M. Effects and safety of vagus nerve stimulation on upper limb function in patients with stroke: a systematic review and meta-analysis. Sci Rep 13, 15415 (2023). https://doi.org/10.1038/s41598-023-42077-2

Ernst E. A review of stroke rehabilitation and physiotherapy. Stroke. 1990 Jul;21(7):1081-5. doi: 10.1161/01.str.21.7.1081. PMID: 2195716.

Stephan KM, Pérennou D. Mobility After Stroke: Relearning to Walk. 2021 Jan 15. In: Platz T, editor. Clinical Pathways in Stroke Rehabilitation: Evidence-based Clinical Practice Recommendations (2021). Available from: https://www.ncbi.nlm.nih.gov/books/NBK585593/ doi: 10.1007/978-3-030-58505-1_8