ClinicalTrials.gg
RecruitingNCT07610655tVNSUpdated May 28, 2026

Effects of Transcutaneous Vagal Nerve Stimulation on Post-Surgical Return to Consciousness, Delirium, and Depression

An interventional study of Transcutaneous vagal nerve stimulation and Sham (No Treatment) in Post Operative Delirium, Cognitive Impairment and Vagus Nerve Stimulation, sponsored by Northwestern University. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-28.

Sponsored by Northwestern University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2026; still recruiting 6 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study will examine whether noninvasive, transcutaneous vagal nerve stimulation (tcVNS) can help restore consciousness in patients in the operating room and the Post Anesthesia Care Unit (PACU). The study will also investigate if tcVNS can expedite discharge from the PACU and examine whether tcVNS administerd in the PACU helps reduce delirium and depression after surgery. The study will also evaluate whether tcVNS speeds cognitive recovery from emergence of anesthesia and surgery.

02

Conditions studied

  • Post Operative Delirium
  • Cognitive Impairment
  • Vagus Nerve Stimulation
  • Depression

Keywords

  • Anesthesia Care
  • Post Anesthesia Care
  • Post Surgical Care
  • Vagus Nerve Stimulation
  • Delirium
  • Cognitive Imparment
  • Depression
  • Hospital Length of Stay
03

In context

Emergence Delirium

751 studies on the registry are indexed under Emergence Delirium; 262 are open to participants now.

This study's planned enrollment of 40 is below the median of 120 across 464 interventional studies indexed under Emergence Delirium.

Browse Emergence Delirium studies →

Lead sponsor

Northwestern University is the lead sponsor of 1,423 studies on the registry; 198 are open to participants now.

Of its 105 completed or terminated interventional studies of FDA-regulated products, 78 (74%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Aged > 18 years of age
  2. Patients undergoing lumbar surgery for degenerative disc disease or spinal stenosis involving two or more levels
  3. (MoCA) score ≥ 18 - accept mild
  4. Ability to use a keyboard
  5. Able to understand and communicate in English
  6. Be able to consent independently
  7. Women of child-bearing age must be comfortable confirming a negative pregnancy prior to participating in the study.
  8. Must not be involved in any other research intervention study testing neurobehavioral functioning

Exclusion criteria

Exclusion Criteria:

  1. Age \< 18 years of age
  2. History of vagotomy (cutting the vagus nerve)
  3. History of bradycardia, heart block, prolonged syndrome, brugada syndrome, heart failure with less than 35% and/or symptoms
  4. \< 18
  5. History of seizure disorder or intracranial hemorrhage
  6. Patients with carotid stenosis
  7. Patients with aneurysms
  8. Other neurological diagnoses or a diagnosis of severe psychiatric disorder (e.g., psychosis) or a reported childhood learning disability
  9. Pregnancy, breastfeeding
  10. Active addiction history
  11. adhesive allergy
  12. Severe aphasia, preventing subject from understanding the protocol and giving written consent
  13. Patients will be excluded postoperatively if there is neck swelling at the proposed site of left tcVNS.
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
40 participants (estimated)

Study arms

  • Active comparator
    tcVNS Stimulation (Intervention)

    Transcutaneous vagal nerve stimulation (tcVNS)

    Device: Transcutaneous vagal nerve stimulation

  • Sham comparator
    Sham tcVNS stimulation (Control)

    Sham transcutaneous vagal nerve stimulation (Sham tcVNS)

    Device: Sham (No Treatment)

Interventions

  • DeviceTranscutaneous vagal nerve stimulation

    The tcVNS device utilized in this study is not an implanted device, but rather is solely operated outside of the body by affixing it around the patient's ear. The device delivers stimulation of the vagus nerve at designated intensity, interval, and frequency.

  • DeviceSham (No Treatment)

    The stimulator is flipped upside down so that the participant does not receive stimulation of the vagal nerve.

06

What researchers measure

Primary outcomes

  1. Aim 1: Primary Endpoint 1: Determine if administering auricular tcVNS enhances the speed of recovery of anesthesia.

    Time in minutes to a Patient State Index (PSI) (Sedline Sedation Monitor) score of 85. The PSI is a quantitative score derived from 4 channel EEG monitoring of the frontal and prefrontal cortex for assessing level of consciousnes during sedation and general anesthesia. The score ranges from 0 (EEG supression) -100 (fully awake). A PSI range of 25-50 indicates optimal hypnotic state for general anesthesia

    Time frame: 24 Hours

  2. Aim1:Primary Endpoint 2 : Richmond Agitation Sedation Scale (RASS Score)

    The Richmond Agitation-Sedation Scale (RASS) is a 10-point validated scale used to measure patient sedation levels in post-anesthesia care unit, ranging from +4 (combative) to -5 (unarousable). A score of 0 is "alert and calm".Measured on arrival to PACU then at 10,15,30,45,60 minutes after admission to PACU.

    Time frame: 1 Hour

  3. Aim 2: Primary Endpoint 1: Post Anesthesia Care Unit Discharge (PACU)

    Admission time to the PACU to discharge from PACU in minutes elapsed.

    Time frame: 3 Hours

  4. Aim 2: Primary Endpoint 2: Discharge from Hospital

    Time from Post Anesthesia Care Unit discharge to discharge from the hospital in days/minutes

    Time frame: From PACU discharge (average of two hours post-surgical end time) to study completion (average of two days)

  5. Aim 3: Primary Endpoint 1: Post Anesthesia Care Unit delirium

    Comparison between active and sham tcVNS on delirium scores in the PACU at 30, 45 and 60 minutes after admission to the PACU. The 3D Confusion Assessment Method (3D CAM) will be administered at 30, 45 and 60 minutes after admission to PACU. The 3D CAM diagnostic tool scores delirium based on four core features, where Feature 1 (Acute Change) AND Feature 2 (Inattention) MUST be present, plus either Feature 3 (Disorganized Thinking) or Feature 4 (Altered Consciousness). It offers a severity score (3D-CAM-S) ranging from 0-20, with higher scores indicating more severe symptoms (0/20 low 20/20 high

    Time frame: From PACU arrival to one hour post-PACU arrival

  6. Aim 3: Primary Endpoint 1a: Post Anesthesia Care Delirium

    Delirium scores 30 days after discharge from the hospital. The 3D Confusion Assessment Method (3D CAM) will be administered 30 days after discharge from the hospital. The 3D CAM diagnostic tool scores delirium based on four core features, where Feature 1 (Acute Change) AND Feature 2 (Inattention) MUST be present, plus either Feature 3 (Disorganized Thinking) or Feature 4 (Altered Consciousness). It offers a severity score (3D-CAM-S) ranging from 0-20, with higher scores indicating more severe symptoms (0/20 low 20/20 high

    Time frame: 30 Days after discharge

  7. Aim3:Primary Endpoint 1b: PHQ-9

    The Patient Health Questionnaire Nine (PHQ-9) is a 9-question survey used to measure patient depression potential, ranging 1-27 (1 low possibility of depression to 27 highest potential for depression. Tested at baseline, post operative day 1 and 30 days post discharge from hospital.

    Time frame: 30 days

Secondary outcomes

  1. Aim 3: Secondary Endpoint 1:EEG Monitoring Data

    Continuous EEG monitoring data to be evaluated for patterns associated with delirium (polymorphiic delta waves, generalized slowing quantified as delta range vs alpha range power

    Time frame: From pre-surgical EEG placement (i.e. approximately 30 minutes before surgery) through study completion (an average of 2 days)

  2. The Montreal Cognitive Assessment (MoCA) evaluations

    The MoCA includes measures of memory recll, visuospatial processing, executive functions, attention, language, abstract reasoning and orientation to time and place. Administered baseline and post operative day 2. 0-30 point scale, 26 and above is normal, 18-25 mild cognitive dysfunction, 10-17 is moderate dysfunction and 0-10 is severe dysfunction.

    Time frame: 48 hours

  3. SF-36 Survey

    The 36-Item Short Form Survey (SF-36) is a self-reported patient outcome measure that assesses physical and mental health across eight domains, including functioning, pain, and vitality. Score ranges from 0 low to 100 high. The higher the score the better the overall health. Administered at baseline and 30 days after discharge.

    Time frame: 30 days

  4. Neuro Qol Cognition Function Short Form

    This is a brief self-report tool used to measure perceived difficulties in everyday cognitive tasks. It is a portion of of the Quality of Life in Neurological Disorders (Neuro-QoL). he short form uses T-scores, which standardize results against a reference population (typically the U.S. general population).There are 8 questions. A T-score of 50 represents the average for the reference population. A high score indicates better perceived cognitive function. Completed at baseline and 30 days.

    Time frame: 30 Days

  5. Neuro- QOL

    Neuro-QoL(Quality of Life in Neurological Disorders) is a measurement system that evaluates and monitors the physical, mental, and social effects experienced by adults who may have neurological conditions. Tested at baseline and 30 days.

    Time frame: 30 Days

  6. DRS-R-98

    The Delirium Rating Scale (DRS-R-98) is a tool for assessing symptom severity and diagnosing delirium in clinical settings. This sixteen-item scale in a thirteen-item severity section and three diagnostic items, tracking changes over a twenty-four-hour period. The 16-item, clinician-rated tool used to diagnose and measure the severity of delirium. It consists of 13 severity items (scored 0-3) and 3 diagnostic items (scored 0-2 or 0-3), with a maximum total score of 46. Higher scores indicate more severe delirium, with scores of15 or greater than or greater than 17.5 often indicating delirium. Assessed at Day 1 and day 2 post operative.

    Time frame: 48 hours

  7. DigitSpan Test

    Digit Span test measures auditory short-term memory and working memory capacity by asking participants to repeat sequences of digits in forward, reversed, or ordered sequences. It is used to measure cognitive processing, attention, and executive function, usually contains 5-9 digits. scoring typically awards one point for each correctly repeated sequence. Performed post operative day 1and 2.

    Time frame: 48 Hours

07

Study locations

1 of 1 sites recruiting
  • Northwestern University Feinberg School of Medicine
    Chicago, Illinois 60611, United States
    Recruiting
    • Jordan Wood, BS · Contactjordan.wood1@northwestern.edu · 312-695-0915
    • Bin Zhang, MS · Contactbin.zhang1@northwestern.edu · 312-695-7771
    • Charles Hogue, MD · Principal investigator
    • Ravindra A Gupta, MD · Sub investigator
    • John Bebawy, MD · Sub investigator
    • Eyal Kimchi, MD, PhD · Sub investigator
    • Jacqueline Morano, MD · Sub investigator
    • Jamie Uejima, MD · Sub investigator
    • Kimberly Klafta, MD · Sub investigator
08

References and documents

Publications

  • Assenza G, Tombini M, Lanzone J, Ricci L, Di Lazzaro V, Casciato S, Morano A, Giallonardo AT, Di Bonaventura C, Beghi E, Ferlazzo E, Gasparini S, Giuliano L, Pisani F, Benna P, Bisulli F, De Falco FA, Franceschetti S, La Neve A, Meletti S, Mostacci B, Sartucci F, Striano P, Villani F, Aguglia U, Avanzini G, Belcastro V, Bianchi A, Cianci V, Labate A, Magaudda A, Michelucci R, Verri A, Zaccara G, Pizza V, Tinuper P, Di Gennaro G; Epilepsy Study Group of the Italian Neurological Society. Antidepressant effect of vagal nerve stimulation in epilepsy patients: a systematic review. Neurol Sci. 2020 Nov;41(11):3075-3084. doi: 10.1007/s10072-020-04479-2. Epub 2020 Jun 10. PubMed 32524324 ↗
  • Ben-Menachem E, Revesz D, Simon BJ, Silberstein S. Surgically implanted and non-invasive vagus nerve stimulation: a review of efficacy, safety and tolerability. Eur J Neurol. 2015 Sep;22(9):1260-8. doi: 10.1111/ene.12629. Epub 2015 Jan 23. PubMed 25614179 ↗
  • Han S, Kim M, Kim H, Shin H, Youn I. Ketamine Inhibits Ultrasound Stimulation-Induced Neuromodulation by Blocking Cortical Neuron Activity. Ultrasound Med Biol. 2018 Mar;44(3):635-646. doi: 10.1016/j.ultrasmedbio.2017.11.008. Epub 2017 Dec 21. PubMed 29276137 ↗
  • Redgrave J, Day D, Leung H, Laud PJ, Ali A, Lindert R, Majid A. Safety and tolerability of Transcutaneous Vagus Nerve stimulation in humans; a systematic review. Brain Stimul. 2018 Nov-Dec;11(6):1225-1238. doi: 10.1016/j.brs.2018.08.010. Epub 2018 Aug 23. PubMed 30217648 ↗
  • Hachem LD, Wong SM, Ibrahim GM. The vagus afferent network: emerging role in translational connectomics. Neurosurg Focus. 2018 Sep;45(3):E2. doi: 10.3171/2018.6.FOCUS18216. PubMed 30173606 ↗
  • Rufener KS, Geyer U, Janitzky K, Heinze HJ, Zaehle T. Modulating auditory selective attention by non-invasive brain stimulation: Differential effects of transcutaneous vagal nerve stimulation and transcranial random noise stimulation. Eur J Neurosci. 2018 Sep;48(6):2301-2309. doi: 10.1111/ejn.14128. Epub 2018 Sep 9. PubMed 30144194 ↗
  • Ruffoli R, Giorgi FS, Pizzanelli C, Murri L, Paparelli A, Fornai F. The chemical neuroanatomy of vagus nerve stimulation. J Chem Neuroanat. 2011 Dec;42(4):288-96. doi: 10.1016/j.jchemneu.2010.12.002. Epub 2010 Dec 16. PubMed 21167932 ↗
  • George MS, Aston-Jones G. Noninvasive techniques for probing neurocircuitry and treating illness: vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). Neuropsychopharmacology. 2010 Jan;35(1):301-16. doi: 10.1038/npp.2009.87. PubMed 19693003 ↗
  • Weintraub S, Dikmen SS, Heaton RK, Tulsky DS, Zelazo PD, Bauer PJ, Carlozzi NE, Slotkin J, Blitz D, Wallner-Allen K, Fox NA, Beaumont JL, Mungas D, Nowinski CJ, Richler J, Deocampo JA, Anderson JE, Manly JJ, Borosh B, Havlik R, Conway K, Edwards E, Freund L, King JW, Moy C, Witt E, Gershon RC. Cognition assessment using the NIH Toolbox. Neurology. 2013 Mar 12;80(11 Suppl 3):S54-64. doi: 10.1212/WNL.0b013e3182872ded. PubMed 23479546 ↗
  • Gershon RC, Lai JS, Bode R, Choi S, Moy C, Bleck T, Miller D, Peterman A, Cella D. Neuro-QOL: quality of life item banks for adults with neurological disorders: item development and calibrations based upon clinical and general population testing. Qual Life Res. 2012 Apr;21(3):475-86. doi: 10.1007/s11136-011-9958-8. Epub 2011 Aug 27. PubMed 21874314 ↗
  • Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83. PubMed 1593914 ↗
  • Inouye SK. Delirium in older persons. N Engl J Med. 2006 Mar 16;354(11):1157-65. doi: 10.1056/NEJMra052321. No abstract available. PubMed 16540616 ↗
  • Simon SE, Bergmann MA, Jones RN, Murphy KM, Orav EJ, Marcantonio ER. Reliability of a structured assessment for nonclinicians to detect delirium among new admissions to postacute care. J Am Med Dir Assoc. 2006 Sep;7(7):412-5. doi: 10.1016/j.jamda.2006.02.006. Epub 2006 May 30. PubMed 16979083 ↗
  • Gusmao-Flores D, Salluh JI, Chalhub RA, Quarantini LC. The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies. Crit Care. 2012 Jul 3;16(4):R115. doi: 10.1186/cc11407. PubMed 22759376 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2026 (actual). Primary completion is estimated for Dec 2028, 32 months after the start.

Of 184 non-industry interventional studies with no phase under Emergence Delirium, half reached primary completion within 19 months of starting (the median), counting those still running; a quarter within 7 and three quarters within 36. This study's planned 32 months is above that.

Counting every sponsor, half of 184 studies reached it within 19 months; a quarter within 7 and three quarters within 36.

How these figures are worked out, and which studies are left out of them.

Registered
May 13, 2026
First posted
May 28, 2026
StartActual
Apr 23, 2026
Primary completionEst.
Dec 31, 2028
CompletionEst.
May 31, 2029
Last update
May 28, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 28, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07610655
Responsible party
Charles Hogue (James E. Eckenhoff Professor, Chair, Department of Anesthesiology, Northwestern University) — Principal investigator
First posted
May 28, 2026
Start date
Apr 23, 2026
Primary completion
Dec 31, 2028 (estimated)
Completion
May 31, 2029 (estimated)
Last update
May 28, 2026

Study contacts

Jordan Wood, BS
Contact
jordan.wood1@northwestern.edu
3126950915
Charles Hogue, MD
principal investigator · Northwestern University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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