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Vagal Nerve Stimulation To Enhance Cognition and Learning

17. juli 2026 oppdatert av: Sima Mofakham, Stony Brook University

Evaluation of Vagus Nerve Stimulation Paired With Cognitive Training to Enhance Learning and Memory and Neural Plasticity in Post-Stroke Patients

The purpose of this study is to find out whether pairing vagus nerve stimulation (VNS) with cognitive training can improve memory and language learning in people who have previously used VNS therapy for movement rehabilitation after a stroke. VNS has been previously used to support motor recovery after stroke, but its effect on cognitive learning is not yet fully understood. This study is enrolling individuals who already have a VNS device implanted and have successfully completed VNS-assisted movement therapy. The investigators aim to explore whether continuing to use the device during a language learning program may also support memory and cognitive improvement. This is a research study, which means the use of VNS for cognitive enhancement is experimental and not currently part of standard treatment. An exploratory MRI/fMRI component also will assess whether VNS-paired language learning is associated with changes in task-based activation and resting-state functional connectivity in language, memory, salience/arousal, and frontoparietal cognitive-control networks. The information learned may help guide future approaches to stroke rehabilitation and cognitive recovery.

Studieoversikt

Status

Påmelding etter invitasjon

Forhold

Intervensjon / Behandling

Detaljert 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.

Studietype

Intervensjonell

Registrering (Antatt)

20

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • New York
      • Stony Brook, New York, Forente stater, 11790
        • Stony Brook University Hospital

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: VNS Group
Group that was implanted with VNS and will receive stimulations
Enhet: VNS for Cognition
Subjects previously implanted with VNS will undergo second language acquisition
Sham-komparator: Sham Group
Group that will receive sham stimulations
Enhet: VNS for Cognition
Subjects previously implanted with VNS will undergo second language acquisition

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Foreign-Language Vocabulary Learning Accuracy
Tidsramme: Baseline and 6 weeks
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.
Baseline and 6 weeks
Change in Foreign-Language Sentence Learning Accuracy
Tidsramme: Baseline and 6 weeks
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

Resultatmål
Tiltaksbeskrivelse
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.
6 weeks
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.
6 weeks
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.
6 weeks
Change in Verbal Learning on the Hopkins Verbal Learning Test-Revised
Tidsramme: 6 weeks
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.
6 weeks
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.
6 weeks
Change in Language Function on the Western Aphasia Battery
Tidsramme: 6 weeks
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.
6 weeks
Change in Story Recall on the Automatic Story Recall Test
Tidsramme: 6 weeks
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
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.
6 weeks

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
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.
Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention
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
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
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
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.
Pre-surgery baseline, post-surgery/pre-training baseline, and immediately after the 6-week language-training intervention.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Stony Brook University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

17. november 2025

Primær fullføring (Antatt)

1. desember 2026

Studiet fullført (Antatt)

1. desember 2026

Datoer for studieregistrering

Først innsendt

26. juni 2026

Først innsendt som oppfylte QC-kriteriene

17. juli 2026

Først lagt ut (Faktiske)

22. juli 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

22. juli 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

17. juli 2026

Sist bekreftet

1. januar 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • IRB2025-00209

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

IPD-delingstidsramme

Within one year of study completion

IPD-deling Støtteinformasjonstype

  • STUDY_PROTOCOL
  • ICF

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Ja

produkt produsert i og eksportert fra USA

Ja

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