Newswise – PHILADELPHIA – Stroke affects nearly 14 million people worldwide each year, and can often cause loss of mobility. Patients may be able to regain some function with intensive rehabilitation therapy in the first few months after a stroke, but this recovery is often progressive and patients are left with a ‘new normal.’ To combat this plateau, the surgeons at Jefferson Health recently became 5th center in the United States to install a new FDA-approved device that improves the effectiveness of rehabilitation therapy and helps restart recovery to promote higher mobility in stroke survivors.
“For some patients after a stroke, regenerating the paired vagus nerve may provide a path to a better life and greater independence,” said Robert Rosenwasser, MD, president of the Vickie and Jack Farber Institute for Neuroscience – Jefferson Health, and Osterholm Professor. and Chair of the Department of Neurosurgery at Thomas Jefferson University. “Jefferson is a leader in providing patients with access to the best care and best-in-class medical technology in all phases 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 that lead to an increased release of neurotransmitters. Vagus nerve stimulation (VNS) is a widely researched technique for several neurological conditions and is also approved by the FDA to treat certain conditions of depression and epilepsy. Results of a triple-blind, randomized controlled clinical trial published in The Lancet, show that pairing VNS therapy with postoperative rehabilitation can produce two to three times greater hand and arm function in stroke survivors than rehabilitation therapy alone. Mobility and control are improved even in patients who have been several years out of stroke, at a time when little improvement in movement is expected from further rehabilitation.
The first Jefferson 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 multiple ways to help restore daily functioning in post-stroke patients,” said neurologist Mijail Serruya, MD, PhD, co-director of the Center for Neurorestoration at the Farber Institute for Neuroscience. “Technologies that improve or enhance communication between the brain and the disabled body parts are promising. We want to make new treatments – whether developed in industry, or here at our new facility, available to improve patient outcomes.”
During rehabilitation therapy, the device is turned on to deliver a gentle pulse to the vagus nerve while the patient performs a task, such as reaching for a cup, or cutting food. Stimulation helps strengthen automatic learning processes so that these actions become easier to perform. After integrated VNS Therapy is initiated in the clinic, Vivistim can be used by the patient at home as directed by their rehabilitation specialist.
“Rehabilitation therapy is an important aspect of stroke recovery,” said Alberto Esquenazi, MD, CMO of MossRehab and now part of Jefferson Health. “Together, with our most active patients, we can help re-establish the connection between the brain and the organ, ultimately helping patients improve their performance. Technologies that help patients achieve improved performance are incredibly important.”
“We applaud the Jefferson Health and MossRehab teams for envisioning the Vivistim System as part of the comprehensive care provided by their stroke center to improve independence and quality of life for survivors,” said Richard Foust, CEO of MicroTransponder, a medical doctor. a device company that creates solutions to restore independence and dignity to people who suffer from neurological conditions that impair their senses and motor function. “Paired VNS Therapy addresses an unmet need for those with chronic disability after stroke, so it’s a milestone for survivors that Vivistim programs are being developed here and across the country.”
He participated in this program: 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; Update: Steve Williams , Alberto Esquenazi, Davis Berzin,; Center for Neurorestoration: 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.