Vagus Nerve Stimulation and Upper Limb Rehabilitation
Tóm tắt
This article will review the evidence for the use of vagus nerve stimulation to drive the growth of new neural pathways during upper limb rehabilitation and improve functional recovery after stroke. Approximately 85 % of patients with stroke present with arm weakness and 60 % of stroke survivors with poorly functioning arms at 1 week do not recover meaningful function by 6 months. The mainstay of current treatment is intensive, task-specific and repetitive rehabilitation therapy or occasionally methods such as constraint-induced movement therapy and robotic therapy. The effects of these treatments are modest, and recent studies have suggested that augmentation of neuroplasticity is required to more fully recover motor function. Novel treatments are needed to improve recovery of upper limb function after stroke. We will review the evidence for the use of vagal nerve stimulation paired with rehabilitation drive neuroplasticity specific to upper limb function.
Tài liệu tham khảo
Ben-Menachem E, Manon-Espaillat R, Ristanovic R. Vagus nerve stimulation for treatment of partial seizures: 1. A controlled study of effect on seizures. First International Vagus Nerve Stimulation Study Group. Epilepsia. 1994;35:616–26.
Vagus nerve Stimulation Study Group. A randomised controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. Neurology. 1995;45:224–30.
Uthman BM, Wilder BJ, Penry JK. Treatment of epilepsy by stimulation of the vagus nerve. Neurology. 1993;43:1338–45.
Nichols JA, Nichols AR, Smirnakis SM, Engineer NS, Kilgard MP, Atzori M. Vagus nerve stimulation modulates cortical synchrony and excitability through the activation of muscarinic receptors. Neuroscience. 2011;189:207–14.
Flor H, Elbert T, Knecht S, Wienbruch C, Pantev C, Birbaumer N, Larbig W, Taub E. Phantom-limb pain as a perceptual correlate of cortical reorganization following arm amputation. Nature. 1995 Jun 8;375(6531):482–4.
Eggermont JJ, Roberts LE. The neuroscience of tinnitus. Trends Neurosci. 2004 Nov;27(11):676–82.
Møller AR. Tinnitus and pain. Prog Brain Res. 2007;166:47–53.
•• Engineer ND, Riley JR, Seale JD, Vrana WA, Shetake JA, Sudanagunta SP, et al. Reversing pathological neural activity using targeted plasticity. Nature. 2011;470:101–4. This indicated that vagus nerve stimulation paired with a stimulus could be used to drive neuroplasticity specific to that stimulus.
De Ridder D, Vanneste S, Engineer ND, Kilgard MP. Safety and efficacy of vagus nerve stimulation paired with tones for the treatment of tinnitus: a case series. Neuromodulation. 2014;17:170–9.
Lehtimäki J, Hyvärinen P, Ylikoski M, Bergholm M, Mäkelä JP, Aarnisalo A, Pirvola U, Mäkitie A, Ylikoski J. Transcutanous nerve stimulation in tinnitus: a pilot study. Acta Otolaryngol. 2013;144(4):378–82.
Porter BA, Khodaparast N, Fayyaz T, Cheung RJ, Ahmed SS, Vrana WA, Rennaker RL 2nd, Kilgard MP. Repeatedly pairing vagus nerve stimulation with a movement reorganizes primary motor cortex. Cereb Cortex. 2012;22(10):2365–74.
Khodaparast N, Hays SA, Sloan AM, Fayyaz T, Hulsey DR, Rennaker RL 2nd, et al. Vagus nerve stimulation delivered during motor rehabilitation improves recovery in a rat model of stroke. Neurorehabil Neural Repair. 2014;28:698–706.
Hays SA, Khodaparest N, Hulsey D, Ruiz A, Sloan AM, Rennaker RL 2nd, et al. Vagus nerve stimulation during rehabilitative training improves functional recovery after intracerebral hemorrhage. Stroke. 2014;45:3097–100.
Hays SA, Khodaparast N, Ruiz A, Sloan AM, Hulsey DR, Rennaker RL 2nd, et al. The timing and amount of vagus nerve stimulation during rehabilitative training affect post stroke recovery of forelimb strength. NeuroReport. 2014;25:676–82.
•• Dawson J, Pierce D, Dixit A, Kimberley TJ, Robertson M, Tarver B, Hilmi O, McLean J, Forbes K, Kilgard MP, Rennaker RL, Cramer SC, Walters M, Engineer N. Safety, feasibility, and efficacy of vagus nerve stimulation paired with upper-limb rehabilitation after ischemic stroke. Stroke. 2016 Jan;47(1):143–50. This is the only in-human evaluation of the use of vagus nerve stimulation paired with upper limb rehabilitation in stroke.
Borland MS, Vrana WA, Moreno NA, Fogarty EA, Buell EP, Sharma P, et al. Cortical Map Plasticity as a Function of Vagus Nerve Stimulation Intensity. [published online ahead of print September 9 2015]. Brain Stimulation 2015. http://www.brainstimjrnl.com/article/S1935-861X(15)01125-0/pdf. Accessed 15 Oct 2015.
Clark KB, Naritoku DK, Smith DC, Browning RA, Jensen RA. Enhanced recognition memory following vagus nerve stimulation in human subjects. Nat Neurosci. 1999;2:94–8.