Rewiring Recovery: UIC Leads New Era in Stroke Rehabilitation

The University of Illinois Chicago (UIC) is implementing a new stroke rehabilitation procedure that uses vagus nerve stimulation to support motor recovery. This first-of-its-kind intervention is used in ischemic stroke survivors with upper extremity impairments during the chronic phase of recovery.

“UIC has been surgically implanting devices in the vagus nerve for various treatments and conditions for almost 30 years,” said Dr. Konstantin Slavin, a neurosurgeon and professor at UIC. “But not for stroke treatment. There are a lot of stroke survivors who have motor deficits. So, we’re very excited to accept it as a part of our multidisciplinary effort to provide them with a sense of hope.”

Every year, over 795,000 people in the United States experience a stroke, according to the American Heart Association (AHA), making it the leading cause of severe long-term disability. Up to 60% of stroke survivors experience persistent hand and arm dysfunction weeks to months after the initial event.

Understanding Stroke

The vast majority of strokes—about 87%— are ischemic strokes, caused by blockage in the blood vessel that reduces blood flow. This blockage damages brain cells, resulting in varying degrees of impaired movement, speech, and cognition.

This evidence underscores the critical need for rehabilitation tools that can help restore function and improve outcomes for stroke survivors.

Improving Neuroplasticity After Stroke

Neuroplasticity refers to the brain’s natural ability to recover by reorganizing or rewiring itself by forming new neural connections. This process is especially critical after a stroke when neurons become damaged or lose function. Neurons act as traveling vehicles, carrying signals from one part of the brain to another. When a stroke occurs, it’s as if the road is obstructed or closed.

Neuroplasticity allows the brain to adapt by forming new pathways, like rerouting traffic through side roads, to restore function. However, this rewiring doesn’t happen instantly. It takes consistent, repetitive, and targeted therapy over time. These changes can lead to small but meaningful improvements in patients, such as the gradual return of hand and arm movements. Recovery varies from person to person, but this emphasizes the brain’s remarkable capacity for repair.

“That is why we wait at least six months after the stroke to assess a patient for this procedure,” said Dr. Slavin. “It takes some time for a stroke patient’s deficits to be finalized. The symptoms or damages caused by a stroke may be different in a couple of months due to natural neuroplasticity.”

Vagus Nerve’s Role in Stroke Recovery

The vagus nerves are the longest cranial nerves, extending from the brainstem through the neck, chest, and abdomen. The nerve plays a central role in the body’s communication network, acting as a vital link between the brain and several internal organs. So if neurons are the traveling vehicles carrying messages, the vagus nerve is the superhighway that guides them between the brain and the body to help regulate critical involuntary functions such as heart rhythm and immune response.

Devices for vagus nerve stimulation traditionally have been used to treat epilepsy and depression by sending impulses to areas of the brain that cause seizures and affect mood. MicroTransponder’s development of the Vivistim system has been FDA-approved for use after a stroke. The device helps make new pathways in the brain during exercise and can help people regain use of their hand or arm following a stroke

Vagus nerve stimulation has been shown in research to support neuroplasticity. This stimulation encourages the brain to rewire itself more effectively, improving motor function and supporting patient recovery. Its accessibility and deep integration with the central nervous system make it uniquely suited for this intervention.

How Vagus Nerve Stimulation Works

“We facilitate as surgeons,” said Dr. Slavin. In a same-day procedure, he implants a wire around the vagus nerve and the implantable pulse generator beneath the skin of the chest. But it’s the rehabilitation or physical therapy that activates the benefits of vagus nerve stimulation.

The implant marks the beginning of a new therapeutic pathway. During rehabilitation, a therapist uses a wireless transmitter to deliver stimulation to the vagus nerve while the stroke survivor performs goal-oriented tasks, such as lifting, grasping, or reaching. These actions are repeated hundreds of times per session, with a target of 300-500 stimulations, to help promote neuroplasticity. Over time, this supports the brain in building new communication pathways, which can lead to meaningful improvements in arm and hand function.

Roughly two weeks after surgery and, after clearance by their surgeon, stroke survivors begin the standard therapy protocol: three 90-minute sessions per week for six weeks.

Sessions are individualized to identify each stroke survivor’s goals for improved hand and arm function. While some stroke survivors want improved function for daily activities, such as buttoning clothes, cooking, eating, or opening doors, others are looking to regain hand and arm function to return to leisure activities such as golfing or fishing.

Potential risks of implantation include infection from the surgery and device connectivity, but the minimally invasive procedure and compact device design help reduce potential complications.

“We take the FDA approval of this as a sign of safety, which is why we feel it is essential to offer it to our patients,” said Dr. Slavin.

What the Future Holds

This procedure marks a critical step forward, reinforcing a shared commitment to improving outcomes for stroke survivors.

With ongoing advancements in neuromodulation procedures, UIC is uniquely positioned to expand access to breakthrough therapies. “We feel our center is one of the most appropriate places to use this procedure.”

Connect for consultation at the UI Health Stroke Center or call 312.996.3700.