Observational studyFrontiers in neurology2026
Upper extremity motor outcomes during paired vagus nerve stimulation in chronic ischemic stroke: a retrospective single-health-system cohort study.
Observational study in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Persistent upper extremity (UE) impairment after stroke is a major cause of long-term disability, and treatment options in the chronic phase are limited. In randomized trials, vagus nerve stimulation paired with task-specific rehabilitation (Paired VNS) produced greater improvement in UE function and activity than the same rehabilitation with sham stimulation, leading to FDA approval in 2021. Methods: We conducted a retrospective, observational cohort study of adults with chronic stroke and persistent UE deficits who underwent Vivistim implantation and participated in a Paired VNS program delivered across 5 outpatient clinics within our health system. The primary outcome was change in Fugl-Meyer Assessment-Upper Extremity (FMA-UE) from baseline (Paired VNS therapy initiation) to end of the intended Paired VNS therapy protocol (18 sessions). A ≥6-point improvement defined a clinically meaningful response. Adverse events were a secondary safety outcome, ascertained from routine clinical documentation and not systematically collected beyond early postoperative follow-up. Results: 32 patients underwent device implantation; 28 (88%) completed the intended protocol within the health system and had paired FMA-UE assessments available for the primary analysis. Ages ranged from 34 to 81 years (mean 62.1) and the median time since stroke was 3.0 years (IQR 1.7-4.2). FMA-UE scores improved for all 28 local completers. The mean increase of 9.43 points was statistically significant (95% CI 7.20-11.66; Conclusions: In this retrospective single-health-system cohort, Paired VNS was associated with significant improvement in FMA-UE scores among 28 local completers. The findings are directionally consistent with prior trial evidence.
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