Vagal Nerve Stimulation To Enhance Cognition and Learning
Evaluation of Vagus Nerve Stimulation Paired With Cognitive Training to Enhance Learning and Memory and Neural Plasticity in Post-Stroke Patients
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Stroke survivors frequently experience persistent cognitive, memory, and language-related difficulties that can affect independence and quality of life. VNS paired with rehabilitation has been shown to enhance motor recovery after stroke, and paired stimulation may support experience-dependent neural plasticity. This study extends that approach to cognitive and language learning by pairing VNS with structured foreign-language vocabulary training.
Eligible participants will be adults with prior stroke who are scheduled to receive, or have received, clinically indicated Vivistim VNS implantation for rehabilitation and who are able to participate in the language-learning intervention. Participants will be randomized to active VNS or sham stimulation during daily language-learning sessions over approximately six weeks. The active stimulation group will receive programmed VNS paired with language-learning stimuli; the sham group will undergo the same language-learning procedures with stimulation amplitude set to zero or otherwise configured according to the sham protocol. Participants will be blinded to group assignment when feasible.
The neuroimaging sub-study will include MRI/fMRI at up to three time points: pre-surgery baseline, when feasible before clinically indicated implantation; post-surgery/pre-language-training baseline; and post-training. The post-surgery/pre-training scan is the key baseline for the language-learning intervention, particularly for participants who already have the device implanted. MRI sessions will include structural MRI, resting-state fMRI, and a task-based foreign-word semantic matching paradigm. The primary task-based fMRI contrast will examine changes in neural responses to future-trained versus trained foreign words compared with never-trained foreign words. Resting-state analyses will examine changes in functional connectivity across language, memory, salience/arousal, frontoparietal cognitive control, and stroke recovery networks. A brief optional 0-back/1-back working-memory fMRI task may be included if scan time and participant tolerance allow.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
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New York
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Stony Brook, New York, Forenede Stater, 11790
- Stony Brook University Hospital
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Adults aged 22 years or older
- History of stroke
- Implanted with a Vivistim™ VNS device
- Monolingual in English
- Home-dwelling and independent in activities of daily living
- No prior language training in the selected language of learning
- Tolerated 6 weeks of movement therapy at 0.8 mA without incident and has used the device for at-home stimulation without incident
- Willing and able to participate in a six-week at-home intervention
- Clinically stable, without major concurrent medical conditions that would interfere with study participation
Exclusion Criteria:
- Severe aphasia
- Unable to read and/or write in English
- Significant uncorrected hearing or visual impairment
- Unable to commit to 6 weeks of therapy
- Pregnancy
- Prisoner or ward of the state
- Any medical condition that, in the investigator's judgment, would make participation unsafe
- Younger than 22 years of age
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Aktiv komparator: VNS Group
Group that was implanted with VNS and will receive stimulations
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Subjects previously implanted with VNS will undergo second language acquisition
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Sham-komparator: Sham Group
Group that will receive sham stimulations
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Subjects previously implanted with VNS will undergo second language acquisition
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in Foreign-Language Vocabulary Learning Accuracy
Tidsramme: Baseline and 6 weeks
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Vocabulary learning will be assessed using trained foreign-language vocabulary items.
The outcome is the percentage of trained vocabulary items correctly recalled, recognized, or translated.
Scores range from 0% to 100%, with higher scores indicating better vocabulary learning.
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Baseline and 6 weeks
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Change in Foreign-Language Sentence Learning Accuracy
Tidsramme: Baseline and 6 weeks
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Sentence learning will be assessed using trained short foreign-language sentences.
The outcome is the percentage of trained sentence items correctly understood, completed, recalled, or translated.
Scores range from 0% to 100%, with higher scores indicating better sentence learning.
|
Baseline and 6 weeks
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in Global Cognition on the Montreal Cognitive Assessment (MoCA)
Tidsramme: 6 weeks
|
Global cognition will be measured using the Montreal Cognitive Assessment total score.
Scores range from 0 to 30, with higher scores indicating better cognitive function.
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6 weeks
|
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Change in Verbal Learning on the Rey Auditory Verbal Learning Test
Tidsramme: 6 weeks
|
Verbal learning will be measured as the total number of words recalled across Rey Auditory Verbal Learning Test learning trials.
Scores range from 0 to 75, with higher scores indicating better verbal learning.
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6 weeks
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Change in Delayed Verbal Memory on the Rey Auditory Verbal Learning Test
Tidsramme: 6 weeks
|
Delayed verbal memory will be measured as the number of words recalled after a delay on the Rey Auditory Verbal Learning Test.
Scores range from 0 to 15, with higher scores indicating better delayed verbal memory.
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6 weeks
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Change in Verbal Learning on the Hopkins Verbal Learning Test-Revised
Tidsramme: 6 weeks
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Verbal learning will be measured as the total number of words recalled across Hopkins Verbal Learning Test-Revised immediate recall trials.
Scores range from 0 to 36, with higher scores indicating better verbal learning.
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6 weeks
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Change in Delayed Verbal Memory on the Hopkins Verbal Learning Test-Revised
Tidsramme: 6 weeks
|
Delayed verbal memory will be measured as the number of words recalled after a delay on the Hopkins Verbal Learning Test-Revised.
Scores range from 0 to 12, with higher scores indicating better delayed verbal memory.
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6 weeks
|
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Change in Language Function on the Western Aphasia Battery
Tidsramme: 6 weeks
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Language function will be measured using the Western Aphasia Battery Aphasia Quotient.
Scores range from 0 to 100, with higher scores indicating better language function.
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6 weeks
|
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Change in Story Recall on the Automatic Story Recall Test
Tidsramme: 6 weeks
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Story recall will be measured using the Automatic Story Recall Test score.
Scores will be reported as the percentage of story content correctly recalled, ranging from 0% to 100%, with higher scores indicating better story recall.
|
6 weeks
|
|
Change in Working Memory on the Digit Span Task
Tidsramme: 6 weeks
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Working memory will be measured using the Digit Span Task total raw score.
Scores range from 0 to 48 if using the WAIS-IV Digit Span version, with higher scores indicating better working memory.
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6 weeks
|
Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in Resting-State Functional Connectivity Between Language and Memory Networks
Tidsramme: Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention
|
Resting-state functional connectivity between predefined language and memory networks will be measured.
The outcome will be reported as change in Fisher z-transformed correlation coefficients between these networks.
Higher values indicate stronger functional connectivity.
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Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention
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Change in Resting-State Functional Connectivity Between Language and Salience/Arousal Networks
Tidsramme: Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention
|
Resting-state functional connectivity between predefined language and salience/arousal networks will be measured.
The outcome will be reported as change in Fisher z-transformed correlation coefficients between these networks.
Higher values indicate stronger functional connectivity.
|
Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention
|
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Change in Resting-State Functional Connectivity Between Language and Default Mode Networks
Tidsramme: Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention
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Resting-state functional connectivity between predefined language and default mode networks will be measured.
The outcome will be reported as change in Fisher z-transformed correlation coefficients between these networks.
Higher values indicate stronger functional connectivity.
|
Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention
|
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Change in Resting-State Functional Connectivity Between Language and Frontoparietal Cognitive-Control Networks
Tidsramme: Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention
|
Resting-state functional connectivity between predefined language and frontoparietal cognitive-control networks will be measured.
The outcome will be reported as change in Fisher z-transformed correlation coefficients between these networks.
Higher values indicate stronger functional connectivity.
|
Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention
|
|
Change in Task-Based fMRI Activation During Foreign-Word Processing
Tidsramme: Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention.
|
Task-based fMRI activation will be measured during presentation of trained, future-trained, and never-trained foreign words.
The outcome will be reported as change in blood-oxygen-level-dependent activation, measured by contrast estimate or percent signal change, for trained and future-trained words compared with never-trained words.
Higher values indicate greater task-related activation.
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Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention.
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
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Sidst verificeret
Mere information
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Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- IRB2025-00209
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