Newswise – PHILADELPHIA – Stroke affects nearly 14 million people worldwide each year and can frequently lead to loss of mobility. Patients can regain some function with intensive rehabilitation therapy for the first few months after a stroke, but this recovery often plateaus and patients are left with a “new normal.” To combat this plateau, Jefferson Health surgeons recently became the 5e in the United States to implant a new FDA-approved device that improves the effectiveness of rehabilitation therapy and helps reboot recovery to improve a stroke survivor’s superior mobility.
“For some stroke patients, paired vagus nerve stimulation may offer a pathway to better quality of life and greater independence,” says Robert Rosenwasser, MD, president of the Vickie and Jack Farber Institute for Neuroscience – Jefferson Health, and Professor Osterholm and Chairman of the Department of Neurological Surgery at Thomas Jefferson University. “Jefferson is leading the charge in providing patients with access to the best care and the most effective medical technology at all stages of stroke care and recovery.”
The device, called Vivistim, is placed under the skin in the upper chest and stimulates the vagus nerve in the neck, which sends signals to the brain leading to an additional release of neurotransmitters. Vagus nerve stimulation (VNS) is a widely studied option for several neurological conditions and is also FDA-approved to treat specific cases of depression and epilepsy. The results of a triple-blind randomized controlled clinical trial published in The Lancet, show that combining VNS therapy with postoperative rehabilitation can generate two to three times more hand and arm function for stroke survivors than rehabilitation therapy alone. Mobility and control improved even in patients who were years away from their stroke, at a time when little improvement in mobility is expected from further rehabilitation.
Jefferson’s first patient, who suffered a stroke two years ago, was operated on by Dr. Reid Gooch, assistant professor of neurosurgery, in late October and recently began rehabilitation with a dedicated team of neurological occupational therapists at MossRehab.
“Jefferson is exploring many avenues to help restore function and daily abilities to post-stroke patients,” says neurologist Mijail Serruya, MD, PhD, co-director of the Center for Neurorestoration at the Farber Institute for Neuroscience. “Technologies that improve or increase the connection between the brain and paralyzed parts of the body hold promise. We seek to make innovative treatments available, whether developed in industry or here at our new center, to improve patient outcomes. »
During rehabilitation therapy, the device is activated to give a gentle pulse to the vagus nerve while the patient performs a specific task, such as reaching for a cup or cutting food. Stimulation helps reinforce automatic learning pathways so that these actions become easier to perform. Once in-clinic paired VNS therapy has been initiated, Vivistim can be used by the patient at home as directed by their rehabilitation specialist.
“Rehabilitation therapy is an essential part of stroke recovery,” says Alberto Esquenazi, MD, CMO of MossRehab and now part of Jefferson Health. “Together with our extremely hardworking patients, we can help restore the connections between the brain and limbs, ultimately helping patients improve their function. Technologies that help patients improve their function are incredibly valuable.”
“We commend the teams at Jefferson Health and MossRehab for considering the Vivistim System as part of the comprehensive care offered by their comprehensive stroke center to improve independence and quality of life for stroke survivors,” said Richard Foust, CEO of MicroTransponder, a medical company. device company that develops solutions to restore autonomy and dignity to people suffering from neurological diseases that alter sensory and motor functions. “VNS Paired Therapy addresses an unmet need for people with chronic impairment after stroke. It is therefore an important step for survivors that Vivistim programs are being implemented here and across the country. »
Involved in this initiative: Neurosurgery: Robert Rosenwasser, Reid Gooch, Pascal Jabbour, Stavrapoula Tjoumakaris, Chengyuan Wu, Nabeel Herial, Nancy Tworek; Neurology: Robin Dharia, Diana Tzeng, Elan Miller, Shaista Alam, Lisa Bowman, Rodney Bell; Rehabilitation: Steve Williams, Alberto Esquenazi, Davis Berzin; Neurorestoration Center: Mijail Serruya, Ashwini Sharan, Joe Kardine, Dana Johnson, Gabrielle Carpino, Erica Jones, Alessandro Napoli, Phyo Thuta Aung, Rachel Zarin, Nabila Shawki, Daniel Verbit, Michelle Mattera Keon.