Impaired use of the arm and hand are a major source of disability for people after a stroke. In the Brain Recovery Lab we are examining novel ways to enhance recovery after stroke. This clinical trial aims to investigate the effectiveness of vagus nerve stimulation (VNS) used with rehabilitation movements to improve upper limb (arm) function after a stroke. Up to 120 people will participate in the overall study, with about 10 of the people in the study participating at this site.
Participants will undergo a six-week session of intensive rehabilitation therapy. The therapy sessions will include traditional rehabilitation exercises, but the patient will receive nerve stimulation while they are performing the exercises.
In order to receive the stimulation, patients are implanted with a device called a vagus nerve stimulator. It is similar to a cardiac pacemaker, but the stimulation lead is attached to the vagus nerve in the neck. The vagus is one of the 12 cranial nerves (nerves that provide information between the body and brain). Evidence from prior clinical trials suggests that paring vagus nerve stimulation (VNS) with rehabilitation can increase the rate at which the brain relearns tasks. Vagus nerve stimulation is not a new therapy, it has been used to treat epilepsy for over 20 years.
If you suffered a stroke more than 9 months ago and it caused weakness in your arm that limits your ability to do activities, you may qualify for this study.
Multimodal Dystonia Study
In this study we are investigating how the brain controls different muscles. People with focal dystonia experience involuntary muscle contractions in their vocal cords, hand, neck or other muscles. People without the diagnosis of this disorder are also being recruited to serve as healthy controls in comparison to people with focal dystonia. We are studying the brain with two different types of measures to try to understand the difference between people with focal dystonia and healthy people.
This study is exploring a procedure called transcranial magnetic brain stimulation (TMS) combined with brain imaging techniques. TMS causes magnetic fields in the brain to form electrical currents. The weak stimulation allows researchers to measure the excitability of portions of the brain. A brain navigation system will use MRI pictures of your brain like a map to target specific areas in the brain. The purpose of the study is to use MRI to determine the structure of the brain while also using TMS to measure the excitability of the brain. Using this information, differences between healthy subjects and those diagnosed with focal dystonia may be identified and lead to a better understanding of the disorder.