Vannemreddy Prasad S, Cummings Mark, Bahrii Romana V, Slavin Konstantin V
Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA.
Brain Plasticity Laboratory, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA.
Brain Sci. 2025 Mar 27;15(4):346. doi: 10.3390/brainsci15040346.
Cerebrovascular accident (CVA) or stroke is a devastating neurological condition with dismal prognosis associated with recurrent episodes that further damage the neuronal networks, thus disabling neuronal plasticity. Vagus nerve stimulation (VNS) has been used in clinical practice to treat epilepsy for several decades and is well accepted as a safe procedure devoid of serious adverse events. Bailey and Bremer demonstrated that VNS has the capabilities to stimulate neuronal pathways that enhance the recovery of damaged cerebral function. Further studies have strengthened these observations, while technology has improved the tolerability of implants, resulting in VNS applications for epilepsy. Several animal models on neural plasticity have improved our understanding of VNS and its ability to provide neuromodulation to improve recovery in stroke patients. The closed-loop stimulation of the vagus nerve with individualized stimulation parameters combined with physical therapy appears to be an attractive option today. VNS is also being tested as a noninvasive trans-cutaneous modality to further improve patient acceptance and tolerability. However, the implantation of VNS is yielding desirable outcomes and appears to be a more reliable treatment for stroke rehabilitation in clinical trials.
脑血管意外（CVA）或中风是一种严重的神经系统疾病，预后不佳，与反复发作相关，这些发作会进一步损害神经网络，从而使神经元可塑性丧失。迷走神经刺激（VNS）已在临床实践中用于治疗癫痫数十年，并且作为一种没有严重不良事件的安全方法而被广泛接受。贝利和布雷默证明，VNS有能力刺激神经元通路，促进受损脑功能的恢复。进一步的研究强化了这些观察结果，同时技术提高了植入物的耐受性，从而使VNS应用于癫痫治疗。一些关于神经可塑性的动物模型增进了我们对VNS及其为中风患者提供神经调节以改善恢复能力的理解。如今，结合个性化刺激参数的迷走神经闭环刺激与物理治疗似乎是一个有吸引力的选择。VNS也正在作为一种非侵入性经皮方式进行测试，以进一步提高患者的接受度和耐受性。然而，VNS植入正在产生理想的结果，并且在临床试验中似乎是一种更可靠的中风康复治疗方法。
