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Vagus nerve stimulation to improve post-stroke motor function and activity
Gauthier Everard1,2,3, Ita Daryanti Saragih4, Jesse Dawson5
1Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab (NMSK), Université Catholique de Louvain, Brussels, Belgium.
The Cochrane Database of Systematic Reviews
|March 13, 2026
Summary
Vagus nerve stimulation (VNS) combined with rehabilitation shows very uncertain short-term benefits for upper extremity (UE) motor function after stroke. VNS appears to have little to no increased risk of serious adverse events, but evidence quality is limited.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Clinical Trials
Background:
- Stroke frequently causes persistent upper extremity (UE) motor impairments, limiting daily activities.
- Conventional rehabilitation often yields limited recovery of UE function post-stroke.
- Vagus nerve stimulation (VNS) is explored as an adjunct therapy to enhance neuroplasticity and motor recovery.
Purpose of the Study:
- To evaluate the benefits and harms of vagus nerve stimulation (VNS) as an add-on therapy for post-stroke UE motor impairments.
- To assess VNS's impact on UE motor function, activity limitations, and quality of life in stroke survivors.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched multiple databases up to May 2025, including Cochrane Library, MEDLINE, Embase, and others.
- Included 10 RCTs (547 participants) comparing VNS plus rehabilitation versus rehabilitation alone.
Main Results:
- Evidence for VNS plus rehabilitation on short-term UE motor function is very uncertain (SMD 1.22).
- VNS combined with rehabilitation showed a low-certainty risk of serious adverse events (SAEs) (RR 2.38).
- Evidence for effects on UE activity and quality of life is very uncertain (SMD 0.88 and 0.04, respectively).
Conclusions:
- The current evidence for VNS as an adjunct to rehabilitation for post-stroke UE motor impairments is very uncertain.
- Limitations include high risk of bias in studies, small sample sizes, and limited long-term follow-up.
- Further high-quality research is needed to establish the efficacy and safety of VNS in stroke rehabilitation.
