Vagus nerve stimulation (VNS) paired with rehabilitation has demonstrated the ability to aid in upper limb recovery after stroke. The Food and Drug Administration (FDA) approved the Vivistim system in 2021. Our study describes a single center experience with VNS paired with rehabilitation.

This was a single center study of patients who received VNS paired with intensive rehabilitation after ischemic stroke between October 2022-September 2024. Patients with hemorrhagic stroke, those with a history of vagotomy and those who did not have access to rehabilitation after Vivistim implantation were excluded. Outcomes of interest were upper extremity Fugl-Meyer scores (FMA-UE) after completion of rehabilitation and patient satisfaction with their recovery.

18 patients underwent VNS paired with rehabilitation. The mean age of the cohort was 60.4, SD (13.0) and 83.3 % (n = 15) were male. 50 % of the cohort (n = 9) had private insurance and the other 50 % (n = 9) had Medicare. Duration from physician referral to Vivistim implantation demonstrated a significant decrease over time (correlation coefficient= −.615, P < 0.01). There was an 8.9-point increase in FMA-UE scores from the first therapy session to the end of the protocol (95 % CI: 5.87–12.01, P < .001). Of 15 patients who completed telephonic follow-up, 8 reported being able to identify when the device was activated and 8 reported having a significant improvement in their quality of life from their post-stroke baseline.

We report improvement in baseline FMA-UE scores with paired VNS for post-stroke recovery. Future research could help streamline the process of VNS implantation by developing a better understanding of patient-reported outcomes at long term follow-up to provide patients with expected goals of recovery over time.