Effects of Trans-Auricular Vagal Stimulation on Neuromotor Recovery in Subacute Stroke During Technological and Traditional Training

NCT ID: NCT07254390

Last Updated: 2025-11-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-08

Study Completion Date

2027-04-03

Brief Summary

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This randomized pilot clinical study aims to investigate the effects of trans-auricular vagus nerve stimulation (tVNS) on neuromotor recovery in patients in the subacute phase after stroke. Participants admitted for intensive rehabilitation at ICS Maugeri Centers (Montescano, Pavia, Nervi) will be randomized into four groups receiving either traditional or technological rehabilitation (Khymeia device), combined with active or sham tVNS.

The Parasym® device (CE 0197) delivers non-invasive stimulation of the auricular branch of the vagus nerve at the left ear for 60 minutes daily.

The primary outcome is the improvement in upper limb motor function, assessed by the Fugl-Meyer scale. Secondary outcomes include other clinical, cognitive, and psychological measures, as well as neurophysiological and cardiovascular autonomic parameters.

The study hypothesizes that coupling tVNS with rehabilitation enhances cortical plasticity and accelerates motor recovery. Adverse effects are expected to be minimal, with previous studies reporting only mild transient skin irritation. The results may provide new insights into the neurophysiological mechanisms of recovery and support the integration of non-invasive neuromodulation in post-stroke rehabilitation.

Detailed Description

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Conditions

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Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Khymeia + Active tVNS

Group Type EXPERIMENTAL

Active trans-auricular vagus nerve stimulation (tVNS) + Khymeia training

Intervention Type DEVICE

Active trans-auricular vagus nerve stimulation (tVNS) with the Parasym® device (CE 0197). Electrode placed on the left tragus, 25 Hz, 250 µs, intensity to tolerance, 60 min/day, 5 days/week for 4 weeks, combined with Khymeia robotic upper limb rehabilitation.

Khymeia + Sham tVNS

Group Type SHAM_COMPARATOR

Sham trans-auricular vagus nerve stimulation + Khymeia training

Intervention Type DEVICE

Sham tVNS using the Parasym® device with electrodes on the left earlobe (non-vagal area). Same schedule as active tVNS, combined with Khymeia rehabilitation.

Traditional Rehabilitation + Active tVNS

Group Type EXPERIMENTAL

Traditional Rehabilitation + Active tVNS

Intervention Type DEVICE

Active tVNS with Parasym® (left tragus, 25 Hz, 250 µs, 60 min/day, 5 days/week for 4 weeks) combined with traditional rehabilitation.

Traditional Rehabilitation + Sham tVNS

Group Type SHAM_COMPARATOR

Traditional Rehabilitation + Sham tVNS

Intervention Type DEVICE

Sham tVNS with Parasym® device, electrodes on left earlobe, 60 minutes/day, 5 days/week for 4 week. Same duration and schedule, combined with traditional rehabilitation.

Interventions

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Active trans-auricular vagus nerve stimulation (tVNS) + Khymeia training

Active trans-auricular vagus nerve stimulation (tVNS) with the Parasym® device (CE 0197). Electrode placed on the left tragus, 25 Hz, 250 µs, intensity to tolerance, 60 min/day, 5 days/week for 4 weeks, combined with Khymeia robotic upper limb rehabilitation.

Intervention Type DEVICE

Sham trans-auricular vagus nerve stimulation + Khymeia training

Sham tVNS using the Parasym® device with electrodes on the left earlobe (non-vagal area). Same schedule as active tVNS, combined with Khymeia rehabilitation.

Intervention Type DEVICE

Traditional Rehabilitation + Active tVNS

Active tVNS with Parasym® (left tragus, 25 Hz, 250 µs, 60 min/day, 5 days/week for 4 weeks) combined with traditional rehabilitation.

Intervention Type DEVICE

Traditional Rehabilitation + Sham tVNS

Sham tVNS with Parasym® device, electrodes on left earlobe, 60 minutes/day, 5 days/week for 4 week. Same duration and schedule, combined with traditional rehabilitation.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients with hemiplegia following ischemic or hemorrhagic stroke occurred within the previous 6 months, clinically stable
* Age ≥ 18 years
* Single cortical or subcortical lesion documented on neuroimaging, corresponding to the motor deficit
* Cognitively able to understand and follow therapeutic instructions
* Upper limb weakness confirmed by a Motricity Index score below maximum
* Spasticity, if present, compatible with limb function (Modified Ashworth Scale ≤ 2)
* Written informed consent provided

Exclusion Criteria

* Multiple brain lesions on neuroimaging
* Severe spasticity (Modified Ashworth Scale 3-4)
* Aphasia preventing comprehension of verbal instructions
* Cognitive decline or behavioral disorders interfering with collaboration during training
* Orthopedic conditions or surgical outcomes preventing the execution of the rehabilitation training
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istituti Clinici Scientifici Maugeri SpA

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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ICS Maugeri - Montescano

Montescano, Pavia, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Cira Fundaro'

Role: CONTACT

0385247268

Facility Contacts

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Cira Fundarò, MD

Role: primary

0385247268

Other Identifiers

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2665

Identifier Type: -

Identifier Source: org_study_id

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