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. 2019 Mar 29;13:280. doi: 10.3389/fnins.2019.00280

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Copyright © 2019 Engineer, Kimberley, Prudente, Dawson, Tarver and Hays.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Vagus Nerve Stimulation paired with rehabilitation in the clinic and at home, (A) In-clinic rehabilitation with VNS: VNS is delivered by a therapist using a push button timed with a task-specific movement. Pressing the button delivers a brief burst of VNS (0.5 s) during an active goal-directed movement. The VNS system includes an implantable pulse generator (implanted device) that is implanted under the individual’s chest wall, an implantable lead, wireless transmitter (for communication between the device and computer) and custom programming software. (B) Home-based VNS therapy: Participants are provided a magnet (inset) to swipe over the device once before the start of each rehabilitation session to self-initiate 30 min of VNS (0.5 s burst of VNS every 10 s for 30 min). During the 30 min, participants performed at-home exercises prescribed by the therapist and adapted to their functional level and goals.