ArticleArchives of physical medicine and rehabilitation2024
Distal Versus Proximal Arm Improvement After Paired Vagus Nerve Stimulation Therapy After Chronic Stroke.
Article in Archives of physical medicine and rehabilitation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative efficacy of brain-computer interface-coupled robotic rehabilitation, robot-assisted therapy, and motor imagery for upper-limb motor recovery after stroke: a systematic review and network meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- Dissociable effects of β-tACS on spectral power and network organization for proximal versus distal upper-limb recovery in subacute stroke: double-blind, randomized, sham-controlled trial with high-density EEG.Journal of neuroengineering and rehabilitation · 2026Trial
- Clinical and neurophysiological effects of manual acupuncture for upper-limb motor dysfunction after ischemic stroke: a three-arm randomized controlled trial.Frontiers in neurology · 2026Trial
- Vagus Nerve Stimulation for Neuromodulation: Evolution from Bench to Bedside.Neurology international · 2026Article
- Rehabilitation paired with vagus nerve stimulation for motor function of chronic ischemic stroke patients in China: Study protocol of a multicenter randomized controlled trial (Repair Study).Neuroprotection (Chichester, England) · 2026Article
- Paired vagus nerve stimulation for post-stroke shoulder motor recovery: corticospinal-C5 motor network plasticity and rehabilitation applications.Frontiers in neurology · 2026Review
- Vagus nerve stimulation for stroke rehabilitation: Neural substrates, neuromodulatory effects and therapeutic implications.The Journal of physiology · 2025Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo evaluate differences in upper-extremity (UE) segment-specific (proximal or distal segment) recovery after vagus nerve stimulation (VNS) paired with UE rehabilitation (Paired-VNS) compared with rehabilitation with sham-VNS (Control). We also assessed whether gains in specific UE segments predicted clinically meaningful improvement.
designThis study reports on a secondary analysis of Vagus nerve stimulation paired with rehabilitation for UE motor function after chronic ischemic stroke (VNS-REHAB), a randomized, triple-blinded, sham-controlled pivotal trial. A Rasch latent regression was used to determine differences between Paired-VNS and Controls for distal and proximal UE changes after in-clinic therapy and 3 months later. Subsequently, we ran a random forest model to assess candidate predictors of meaningful improvement. Each item of the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and Wolf Motor Function Test (WMFT) was evaluated as a predictor of response to treatment.
settingNineteen stroke rehabilitation centers in the USA and UK.
participantsDataset included 108 participants (N=108) with chronic ischemic stroke and moderate-to-severe UE impairments.
interventionsNot applicable.
main outcome measuresFMA-UE and WMFT.
resultsDistal UE improvement was significantly greater in the Paired-VNS group than in Controls immediately after therapy (95% confidence interval, 0.27-0.73; P≤.001) and after 3 months (95% confidence interval, 0.16-0.75; P=.003). Both groups showed similar improvement in proximal UE at both time points. A subset of both distal and proximal items from the FMA-UE and WMFT were predictors of meaningful improvement.
conclusionsPaired-VNS improved distal UE impairment in chronic stroke to a greater degree than intensive rehabilitation alone. Proximal improvements were equally responsive to either treatment. Given that meaningful UE recovery is predicted by improvements across both proximal and distal segments, Paired-VNS may facilitate improvement that is otherwise elusive.
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