Doctors and scientists at the University of Glasgow's Institute of Cardiovascular and Medical Sciences are all set to undertake the world's first in-human trial of vagus nerve stimulation in stroke patients. The vagus is the most important nerve in the human body - the one responsible for the "mind-body connection".
Stroke can result in the loss of brain tissue and adversely affect various functions from speech to movement.
The study will recruit 20 patients who suffered a stroke six months ago and have been left with poor arm function as a result.
Each participant will receive three one-hour sessions of intensive physiotherapy each week for six weeks to help improve their arm function.
Half of the group will also receive an implanted a vagus nerve stimulator (VNS), which connects to the vagus nerve in the neck.
When they are receiving physiotherapy to help improve their arm, the device will stimulate the nerve. Doctors hope that this will stimulate release of chemicals from the brain called neurotransmitters that will help the brain form new neural connections which might improve the participants ability to use their arm.
If successful, such "rewiring of the brain" can come as a real boon for India which is expected to report 1.6 million cases of stroke annually by 2015.
The Indian Council of Medical Research says in 2004, there were 9.3 lakh cases of stroke and 6.4 lakh deaths due to stroke in India, mostly among people less than 45 years old.
Similar to a pacemaker, a VNS is a small device implanted under the skin near the collarbone. A wire under the skin connects the device to the vagus nerve.
The doctor programs the device to produce weak electrical signals that travel along the vagus nerve to the brain at regular intervals. These signals help prevent the electrical bursts in the brain that cause seizures.
Lead researcher Dr Jesse Dawson said: "When the brain is damaged by stroke, important neural connections that control different parts of the body can be damaged which impairs function. Evidence from animal studies suggests that vagus nerve stimulation could cause the release of neurotransmitters which help facilitate neural plasticity and help people re-learn how to use their arms after stroke, particularly if stimulation is paired with specific tasks."
A slightly different type of vagus nerve stimulation is already successfully used to manage conditions such as depression and epilepsy.
Dr Dawson added "This study is designed to provide evidence to support whether this is the case after stroke but our primary aim is to assess feasibility of vagus nerve stimulation after stroke. It remains to be seen how much we can improve function, but if we can help people perform even small actions again, like being able to hold a cup of tea, it would greatly improve their quality of life."
Stroke is a major cause for loss of life, limbs and speech in India. Experts say that if deaths as well as disability are counted together, then India lost 63 lakh of disability-adjusted life years in 2004 due to stroke.
The World Health Organization suggests that by 2050, 80% stroke cases in the world would occur in low and middle income countries mainly India and China.
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