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

• 成果类型: Article
• 署名作者: Kilgard, Michael P.; Epperson, Joseph D.; Adehunoluwa, Emmanuel A.; Swank, Chad; Porter, Amy L.; Pruitt, David T.; Gallaway, Holle L.; Stevens, Christi; Gillespie, Jaime; Arnold, Dannae; Powers, Mark B.; Hamilton, Rita G.; Naftalis, Richard C.; Foreman, Michael L.; Wigginton, Jane G.; Hays, Seth A.; Rennaker, Robert L.
• 署名单位: University of Texas System; University of Texas Dallas; University of Texas System; University of Texas Dallas; University of Texas System; University of Texas Dallas; Baylor University Medical Center; Baylor Scott & White Health; Baylor University Medical Center; Baylor University; Baylor University Medical Center; Baylor University; Baylor University Medical Center; Baylor University
• 刊物名称: Nature
• ISSN/ISSBN: 0028-2831
• DOI: 10.1038/s41586-025-09028-5
• 发表日期: 2025-07-24
• 关键词: dependent neural plasticity; clinical-trials; rehabilitation; stroke; motor; minorities; inclusion; outcomes

摘要

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 neurorehabilitation1,2. We hypothesized that combining intensive, progressive, task-focused training with real-time closed-loop vagus nerve stimulation (CLV) to enhance synaptic plasticity3 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.