Closed-Loop Vagus Nerve Stimulation for Mobility Impairment

Not yet recruiting at 3 trial locations
AP
Overseen ByAmy Porter
Age: 18 - 65
Sex: Any
Trial Phase: Academic
Sponsor: The University of Texas at Dallas

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method to help individuals with mobility issues from chronic spinal cord injuries improve their walking. The treatment, called Closed-Loop Vagus Nerve Stimulation (CLV), uses a device to stimulate the vagus nerve, part of the nervous system, while participants perform lower limb rehab exercises. Two groups participate: one receives the treatment immediately, while the other begins with a placebo before switching to the actual treatment. Ideal participants have had a spinal cord injury for over a year, resulting in difficulty walking. As an unphased trial, this study offers participants the chance to contribute to groundbreaking research that could lead to new treatments for spinal cord injuries.

What prior data suggests that the ReWire system is safe for individuals with mobility impairments?

A previous study reported no serious side effects or unexpected problems with closed-loop vagus nerve stimulation (CLV), indicating the treatment was generally safe. Some participants experienced minor side effects such as hoarseness, coughing, or a slight tingling sensation. These side effects were mild and not a major concern. Overall, current research suggests the treatment is well-tolerated.12345

Why are researchers excited about this trial?

Researchers are excited about Closed-Loop Vagus Nerve Stimulation (CLV) for mobility impairment because it offers a novel way to enhance neural pathways directly involved in movement. Unlike traditional treatments that often rely on medications or physical therapy, CLV uses a device to stimulate the vagus nerve, potentially improving brain plasticity and aiding recovery. This method is unique for its real-time feedback mechanism, adjusting stimulation based on the body's responses, which could lead to more personalized and effective therapy for those with mobility challenges.

What evidence suggests that the ReWire system is effective for improving mobility in individuals with spinal cord injury?

Studies have shown that closed-loop vagus nerve stimulation (CLV) can significantly aid recovery after a spinal cord injury. One study found that 19 participants experienced stronger arms and hands and found everyday tasks easier. Another study also reported significant improvements in arm and hand function for those with spinal cord injuries. This trial will include one group receiving CLV immediately and another receiving a sham treatment initially, followed by CLV. This technique stimulates the vagus nerve, which can help reconnect nerve pathways and improve movement. Early results suggest that CLV might be a promising method to enhance mobility and support recovery from spinal cord injuries.15678

Who Is on the Research Team?

JW

Jane Wigginton, MD

Principal Investigator

The University of Texas at Dallas

RH

Rita Hamilton, DO

Principal Investigator

Baylor University Medical Center (BUMC)

CS

Chad Swank, PhD

Principal Investigator

Spaulding Rehabilitation Hospital, Mass General Brigham

RR

Robert Rennaker, PhD

Principal Investigator

The University of Texas at Dallas

SH

Seth Hays, PhD

Principal Investigator

The University of Texas at Dallas

MF

Michael Foreman, MD

Principal Investigator

Urgent Surgery Associates, PA

Are You a Good Fit for This Trial?

This trial is for adults with long-term, partial spinal cord injuries who have trouble walking or moving due to their injury. Participants should be able to take part in rehabilitation sessions and not have other major health issues that could interfere with the study.

Inclusion Criteria

Willingness and ability to comply with all study procedures and protocol requirements for the duration of the study
I have had a partial spinal cord injury affecting my legs for at least 12 months.
In otherwise good general health as determined by medical history and physical examination
See 6 more

Exclusion Criteria

I am not pregnant or breastfeeding and will use reliable birth control during the study.
Current or past medical or non-medical conditions or situations that may pose significant risk, affect study completion, or impact data integrity as judged by Site PI
I do not have mental or cognitive issues that would prevent me from joining the study.
See 14 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Pre-therapy

Informed consent, baseline assessment, pre-operative evaluation, surgical implantation of the ReWire system, post-surgical assessment, and randomization

4 weeks
Multiple visits (in-person)

Double-blind Treatment

Participants undergo up to 18 sessions of lower limb rehabilitation paired with either active CLV or sham stimulation

14 weeks
18 sessions (in-person)

Open-label Treatment

All participants receive up to an additional 18 sessions of CLV

8 weeks
18 sessions (in-person)

Follow-up

Final assessment conducted approximately 4 weeks from the previous assessment and cessation of CLV

4 weeks
1 visit (in-person)

Long-term Follow-up

Long-term assessment of safety performed twice annually for up to 2 years from the date of implantation

Up to 2 years

What Are the Treatments Tested in This Trial?

Interventions

  • Closed-Loop Vagus Nerve Stimulation (CLV)

Trial Overview

The study is testing a device called ReWire that gives electrical stimulation to the vagus nerve during leg rehab exercises. Some participants will get real stimulation (CLV), while others will receive sham (inactive) treatment for comparison.

How Is the Trial Designed?

2

Treatment groups

Experimental Treatment

Placebo Group

Group I: CLV (Immediate start group)Experimental Treatment1 Intervention
Group II: Sham (Delayed start group)Placebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

The University of Texas at Dallas

Lead Sponsor

Trials
71
Recruited
108,000+

National Institute of Neurological Disorders and Stroke (NINDS)

Collaborator

Trials
1,403
Recruited
655,000+

Citations

Closed-loop vagus nerve stimulation aids recovery from ...

19 people exhibited a significant beneficial effect on arm and hand strength and the ability to perform activities of daily living.

2.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/41054846/

Closed-Loop Vagus Nerve Stimulation Delivered With a ...

Analysis of the primary outcome showed a nature and rate of adverse events similar to or below conventional vagus nerve stimulation devices. ...

Closed-Loop Vagus Nerve Stimulation (CLV) for Recovery of ...

The purpose of this study is to evaluate the safety, feasibility, and preliminary effectiveness of the ReWire system, which delivers vagus ...

VNS Clinical Trial Shows Improvements for Spinal Cord Injuries

This approach, called closed-loop vagus nerve stimulation (CLV), produced meaningful improvements in arm and hand function in these individuals.

(PDF) Closed-loop vagus nerve stimulation aids recovery ...

19 people exhibited a significant beneficial effect on arm and hand strength and the ability to perform activities of daily living.

Closed-loop vagus nerve stimulation aids recovery from spinal ...

On average, the eight responders lost 23 ± 4% of their disability as measured by GRASSP. Future studies are needed to determine whether greater ...

Safety and Feasibility of Paired Vagus Nerve Stimulation ...

Safety and feasibility measures are the primary outcomes of this study. Safety measures will include the incidence of surgical and VNS therapy-related events.

Safety and feasibility of paired vagus nerve stimulation with ...

No serious adverse events, unanticipated adverse device effects, or unresolved surgery-related complications were observed.