CClinicalTrials.gg
TerminatedNCT03292159Updated Sep 21, 2021

Transcutaneous Vagus Nerve Stimulation for Motor Recovery After Stroke

A Phase 1/2 interventional study of Active RAVANS concurrent with arm motor training and Inactive RAVANS concurrent with arm motor training in Stroke and Upper Extremity Paresis, sponsored by Massachusetts General Hospital. Terminated at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-09-21.

Sponsored by Massachusetts General Hospital · Phase 1/2, Interventional, and Treatment

Why this study was terminated
funding not continued
Phase
Phase 1/2
Study type
Interventional
Enrollment
6
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study will evaluate the safety and effectiveness of Respiratory-gated Auricular Vagal Afferent Nerve Stimulation (RAVANS) for improving motor recovery after stroke. Subacute stroke patients will receive RAVANS or sham stimulation concurrent with arm motor training during 10 intervention sessions occurring daily for 30 minutes over 2 weeks. The safety and improvements in arm motor function after the intervention will be compared in patients receiving RAVANS to those receiving sham stimulation.

Read the detailed description

This study will evaluate the safety, feasibility and effectiveness of Respiratory-gated Auricular Vagal Afferent Nerve Stimulation (RAVANS) for improving motor recovery after stroke. Subacute stroke patients will be randomized to RAVANS or sham stimulation groups. Patients will receive RAVANS or sham stimulation concurrent with arm motor training during 10 sessions occurring daily for 30 minutes over 2 weeks. Safety will be compared in patients receiving RAVANS to those receiving sham stimulation. Feasibility will be evaluated by recruitment into the study and retention of enrolled patients. Changes in arm motor function will be compared between RAVANS and sham stimulation groups from baseline to immediately after the intervention period and to function at 3-months after stroke.

02

Conditions studied

  • Stroke
  • Upper Extremity Paresis

Keywords

  • stroke
  • vagus nerve stimulation
  • upper extremity paresis
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Supratentorial ischemic or hemorrhagic stroke incurred 4-30 days prior;
  • Contralesional UL motor impairment defined by NIHSS item 5 score 1 or 2 (scale 0-4);
  • Age ≥ 18;
  • Able to provide written informed consent.

Exclusion criteria

Exclusion Criteria:

  • Implanted electronic device (e.g., pacemaker, neurostimulator);
  • Pregnancy;
  • Major psychiatric or medical condition that could interfere with study participation;
  • Medical condition affecting left ear that could interfere with delivering RAVANS (e.g., wound, infection, malignancy, hypoesthesia);
  • Significant pre-existing disability of stroke-affected UL in activities of daily living due to prior stroke or other medical cause defined by Stroke Impact Scale item 7 (SIS-hand) mean score \< 4 (scale: 0-5);
  • History of seizure during year before stroke or > 1 post-stroke seizure;
  • Significant cognitive or language impairment that would interfere with informed consent or study participation;
  • Severe dysphagia;
  • Bradycardia defined as resting heart rate \< 50 bpm;
  • Nonsustained ventricular tachycardia;
  • Cardiac conduction disorder (i.e., bundle branch block, heart block, long Q-T syndrome);
  • History of asystole;
  • History of recurrent vaso-vagal syncope;
  • Hypotension defined as blood pressure \< 90/60 mmHg.
04

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
6 participants (actual)

Study arms

  • Experimental
    RAVANS

    Device: Active RAVANS concurrent with arm motor training

  • Sham comparator
    Sham stimulation

    Device: Inactive RAVANS concurrent with arm motor training

Interventions

  • DeviceActive RAVANS concurrent with arm motor training

    Patient receives non-painful, sensory-level stimulation to the skin of left outer ear, where nerve endings of the auricular branch of the vagus nerve reside, while participating in arm motor training

  • DeviceInactive RAVANS concurrent with arm motor training

    Patient does not receive stimulation delivered to the skin of left outer ear while participating in arm motor training

05

What researchers measure

Primary outcomes

  1. Upper extremity motor impairment

    Change in upper extremity subtest of Fugl Meyer Assessment (FMA-UE) score

    Time frame: Baseline to just after 10 intervention sessions, and baseline to 3 months post-stroke

Secondary outcomes

  1. Upper extremity motor function

    Change in Action Research Arm Test (ARAT) score

    Time frame: Baseline to just after 10 intervention sessions, and baseline to 3 months post-stroke

  2. Grip force control

    Change in accuracy, variability and temporal structure of performance on a grip force control task

    Time frame: Baseline to just after 10 intervention sessions, and baseline to 3 months post-stroke

  3. Upper extremity disability

    Change in hand subtest of Stroke Impact Scale (SIS-hand) score

    Time frame: Baseline to 3 months post-stroke

  4. Mood state, anxiety and depression

    Change in Hospital Anxiety and Depression Scale (HADS) scores

    Time frame: Baseline to 3 months post-stroke

06

Study locations

1 site
  • Spaulding Rehabilitation Hospital
    Boston, Massachusetts 02129, United States
07

Registry details

Key details

Study ID
NCT03292159
Lead sponsor
Massachusetts General Hospital
Collaborators
Dana Foundation, Spaulding Rehabilitation Hospital
Responsible party
Judith Schaechter (Assistant Professor, Department of Radiology, Harvard Medical School, Massachusetts General Hospital) — Principal investigator
First posted
Sep 25, 2017
Start date
May 17, 2018
Primary completion
Nov 20, 2018
Completion
Nov 20, 2018
Last update
Sep 21, 2021

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is terminated, as verified in Sep 2021. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion