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NCT Number: NCT07719829

Paired VNS For TBI Rehabilitation

This study is evaluating whether pairing vagus nerve stimulation (VNS) with structured upper limb rehabilitation therapy can improve arm and hand function in individuals with moderate to severe traumatic brain injury (TBI).

Many people who survive a TBI experience long-term weakness, poor coordination, and difficulty using one arm or hand. These motor impairments can significantly affect independence and quality of life. Traditional rehabilitation can help, but recovery is often incomplete.

Vagus nerve stimulation (VNS) is an FDA-approved therapy for certain neurological conditions and involves a small device implanted under the skin in the chest with a lead connected to the vagus nerve in the neck. The device delivers mild electrical pulses to the nerve. In this study, VNS will be paired with goal-directed upper limb rehabilitation exercises. The stimulation is delivered during specific movements in therapy sessions. This "paired stimulation" approach is designed to enhance neuroplasticity - the brain's ability to reorganize and form new connections - which may improve motor recovery.

The VNS device used in this study is FDA-approved for other conditions. However, its use paired with rehabilitation for upper limb recovery after traumatic brain injury is investigational.

Participants in this study will:

Undergo surgical implantation of the VNS device.

Participate in structured upper limb rehabilitation therapy sessions where stimulation is paired with specific movements.

Complete follow-up visits and assessments to measure changes in arm and hand function, strength, dexterity, and overall recovery.

The main goal of the study is to determine whether paired VNS and rehabilitation improves upper limb motor function compared to rehabilitation alone. Safety will also be closely monitored, including surgical outcomes and any device-related effects.

This study may help determine whether VNS paired with rehabilitation is a safe and effective way to enhance motor recovery after traumatic brain injury. Findings from this research could contribute to improved treatment strategies for individuals living with long-term motor impairments following TBI.

Participation is voluntary. All participants will be carefully evaluated to determine eligibility, and informed consent will be obtained before enrollment.

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Key information

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 22-80 years
  • History of severe TBI (initial GCS ≤ 8)
  • Regained consciousness with capacity to consent to the study
  • At least six months since injury
  • Full recovery of consciousness with command following (mGCS = 6)
  • Ongoing motor impairment with dependence in activities of daily living (modified Rankin Scale, mRS = 3-4)
  • Clinically stable for VNS implantation

Exclusion criteria

  • No capacity to consent to the study
  • History of stroke
  • History of cognitive disorder or other neurodegenerative disorder
  • History of epilepsy treated by VNS
  • History of brain tumors (primary or metastatic)
  • Requires diathermy
  • Pregnant
  • Previously implanted vagus nerve stimulator
  • Extensive prior neck surgery preventing dissection of the vagus nerve
  • History of severe spasticity, vagus nerve damage, or hearing loss

Treatment and study plan

VNS for TBI group

Device

Group will be implanted with VNS device for chronic TBI

Primary outcomes

  1. Number of Participants With Device- or Procedure-Related Adverse Events

    Time frame: 6 Weeks

    Adverse events related to VNS device implantation or stimulation will be recorded and graded using CTCAE v5.0.

  2. Change in Upper Limb Range of Motion as Assessed by SeeMe Movement Analysis

    Time frame: 6 Weeks

    Video-based kinematic analysis of upper limb range of motion, comparing baseline (pre-surgery) to post-training (6 weeks after VNS-paired rehabilitation).

Secondary outcomes

  1. Change in Disability Rating Scale (DRS) Score

    Time frame: 1 Year

    RS score (range 0 [no disability] to 29 [extreme vegetative state]; lower scores indicate better outcome). Magnitude of change will be used to estimate effect size for power calculation in a future multicenter randomized trial.

  2. Change in Coma Recovery Scale-Revised (CRS-R) Score

    Time frame: 6 Weeks

    CRS-R total score (range 0-23; higher scores indicate better neurobehavioral function), comparing baseline to post-training.

  3. Change in Wolf Motor Function Test (WMFT) Performance Time

    Time frame: 6 Weeks

    Time (seconds) to complete standardized WMFT tasks; lower time indicates better function. Comparing baseline to post-training.

  4. Change in Fugl-Meyer Assessment Upper Extremity (FMA-UE) Score

    Time frame: 6 Weeks

    FMA-UE score (range 0-66; higher scores indicate better motor function), comparing baseline to post-training.

  5. Change in Motor Activity Log (MAL) Score

    Time frame: 1 Year

    MAL Amount of Use and Quality of Movement subscales (range 0-5 each; higher scores indicate better real-world arm use).

  6. Change in EQ-5D-5L Index Score

    Time frame: 1 Year

    EQ-5D-5L index score (range 0 [death] to 1 [full health]; higher scores indicate better quality of life).

Study contacts

Contact information is provided by the study sponsor or research team.

Sima Mofakham, PhD

CONTACT

[email protected]

631-444-1278

Sponsors and collaborators

Lead sponsor

Stony Brook University

Other

Registry information

Acronym: VNS for TBI

Important dates

Study start
2027
Primary completion
2030
Study completion
2031
First posted
Jul 22, 2026
Registry last updated
Jul 22, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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