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<p>Vagus nerve stimulation (VNS) paired with physical rehabilitation has shown promise for improving upper-limb function after neurological injury. In this study, we introduce SmartVNS, a wearable system that automatically delivers movement-paired transcutaneous auricular VNS using a wrist-worn intertial measurement unit (IMU) for accurate functional movement detection. We evaluated feasibility, usability and performance of the SmartVNS system in a four-week, 20-session clinical feasibility study involving nine individuals with stroke or spinal cord injury during conventional therapy. Despite a wide range of baseline upper-limb function in patients (ARAT scores 0-52), the system adapted to individual abilities and demonstrated a consistent stimulation rate between sessions and patients, averaging 14.7 stimulations/min with a low variability (SD = 3.4 stimulations/min; n = 9). The IMU-based movement detection algorithm achieved stimulation precision comparable to therapist manual triggering (precision as mean ± SEM: SmartVNS: 76.3 ± 3.1%, therapists: 82.4 ± 2.6%, video analysis used a ground truth), while delivering stimulation in double the number of movements (sensitivity as mean ± SEM: SmartVNS: 50.4 ± 5.0%, therapists: 23.4 ± 4.7%, video analysis used a ground truth). The system demonstrated high usability (patients and therapists rated UMUX: 85 ± 12%) and was well-tolerated by participants, with patients able to self-apply the device. Exploratory clinical outcomes showed consistent functional improvements across participants. These findings support the feasibility and usability of SmartVNS as a scalable neuromodulation platform to support neurorehabilitation.</p>

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Closed-loop movement-paired transcutaneous auricular vagus nerve stimulation for upper-limb rehabilitation: a feasibility study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月20日

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  • Clément Lhoste,
  • Max Quast,
  • Andrea Ronco,
  • Abigail Vogel,
  • Chris Easthope Awai,
  • Meret Branscheidt,
  • Olivier Lambercy,
  • Paulius Viskaitis,
  • Dane C Donegan

摘要

Vagus nerve stimulation (VNS) paired with physical rehabilitation has shown promise for improving upper-limb function after neurological injury. In this study, we introduce SmartVNS, a wearable system that automatically delivers movement-paired transcutaneous auricular VNS using a wrist-worn intertial measurement unit (IMU) for accurate functional movement detection. We evaluated feasibility, usability and performance of the SmartVNS system in a four-week, 20-session clinical feasibility study involving nine individuals with stroke or spinal cord injury during conventional therapy. Despite a wide range of baseline upper-limb function in patients (ARAT scores 0-52), the system adapted to individual abilities and demonstrated a consistent stimulation rate between sessions and patients, averaging 14.7 stimulations/min with a low variability (SD = 3.4 stimulations/min; n = 9). The IMU-based movement detection algorithm achieved stimulation precision comparable to therapist manual triggering (precision as mean ± SEM: SmartVNS: 76.3 ± 3.1%, therapists: 82.4 ± 2.6%, video analysis used a ground truth), while delivering stimulation in double the number of movements (sensitivity as mean ± SEM: SmartVNS: 50.4 ± 5.0%, therapists: 23.4 ± 4.7%, video analysis used a ground truth). The system demonstrated high usability (patients and therapists rated UMUX: 85 ± 12%) and was well-tolerated by participants, with patients able to self-apply the device. Exploratory clinical outcomes showed consistent functional improvements across participants. These findings support the feasibility and usability of SmartVNS as a scalable neuromodulation platform to support neurorehabilitation.