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Share in the Pinterest researchers develop a new approach to restore the movement after stroke. PM Pictures / Getty Images
In the United States someone has a stroke every 40 seconds. This adds about 795,000 cases every year.
While the mortality rate of strokes is high - a person dies every 4 minutes - many people survive, but with permanent damage. About 80% of the people who had a stroke lose some arm function.Although the physical rehabilitation of the posthub-hazardous physical rehabilitation can help, for most people, the benefit is limited, and progress often slows down and finally stops.
A new study reports that a combination of VNS and rehabilitation generates a significant improvement in the arm function in the years after a stroke.
Dr. Charles Yu Liu of the USC Neurorestoration Center of Keck Medicine at the University of Southern California (USC) in Los Angeles and the lead of the study, said, said
"This is incredibly exciting news for those involved in stroke rehabilitation and functional restoration and represents a unique crossing between neurosurgery and neurorehabilat."
He added: "These study results are the first of their kind and open up new opportunities for stroke patients, so they can reclaim more arm function years after a stroke."
Research is published in the Lancet .
"Vagus" is Latin for "hiking", and it describes the brain nerve, which runs all the way from the brainstem, to the colon. The vagus nerve is a sensory nerve, but it is also involved in the engine function.
Electrical stimulation of the vagus nerve is a usual treatment for epilepsy.
The value of VNS in the treatment of depression is also examined.
In VNS, surgeons implant in the chest a pacemaker-like electric pulse generator with a wire connected to the left VAGUSNERV. The generator stimulates the nerve with electrical pulses that pauses regularly to leave the nerve edition. The electricity goes through the vagus nerve to the brain.
The multin-clinical, international research of the USC team participated in 108 participants, each of which generated a moderate to heavy crushes over a period of 9 months to ten years after a stroke. The study was randomized and blind triple.
The researchers implanted VNS devices in all participants. From them, 53 received the VNS treatment to stimulate the organizational potential of the brain. For the remaining 55 participants, the implanted device has never been activated - it served as placebo for this control group.
After implantation and the actual or light VNS, all persons were given 6 weeks in clinical physiotherapy to restore the arm function.
This intense therapy included six types of tasks:
After the rehabilitation period, the authors of the study tested the arm function of the participants.
You write, "[P] divisors assigned to [VNS], which were paired with rehabilitation, clinically showed improvements in motor impairment and function compared to the participants assigned to rehabilitation and illumination stimulation. "
twice as double the number of people in the VNS group showed an improvement in the arm function compared to the in the control group on day 90 after completion of the in-clinic therapy.
Almost half of the VNS group showed significant improvement.
Dr.liu noticed, "The results were not only clinically sensible, the fact that these patients were at least 9 months after the attack, and in some cases indicates the possibility that meaningful improvements even years after a stroke can be achieved can."
The researchers are planning for a long-term explanatory paper to evaluate the durability of the arm movement gains.In addition, the study has examined the effects of only a limited history of combined UNS and rehabilitation. Dr. Liu said today Medical News "There is no reason to believe that additional sessions, ie at home, would not lead to further improvements. Undoubtedly, however, every treatment paradigm will eventually achieve a plateau." The researchers suspect that VNS triggers the release of brain-neuromodulators to strengthen the engine circuits of the brain, whereby their movement is restored.
"For too long," Dr. Liu, "lifting patients have confronted limited options for recovery. This new treatment means a breakthrough that might be eligible for many lift patients, and also represents an approach that will certainly be explored for many other functional restoration applications for many other functional restoration applications in the future."
If you are asked if the findings of the study suggest other possible applications for VNS, Dr. Liu:
"In my view, the nervous system has three broad categories of phenotypes: sensorimotry, cognitives and autonomous. In each of them we have every reason to assume that the right combination of the right kind of neuromodulation and the task-specific practice will lead to better results. "
He went on to say, "Almost immediately, it would certainly be reasonably to combine VNS with other types of rehabilitation therapies for other information. "
others are already in the process to explore these possibilities, he added.
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