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The Vivistim Paired VNS System is leading the charge as one of the most exciting neurorehabilitation technologies of this year. This system combines Vagus Nerve Stimulation (VNS) with intensive task-specific therapy to drive neuroplasticity and deliver sustained, clinically significant improvements in chronic stroke survivors with moderate-to-severe upper extremity deficits.

The system delivers brief pulses of stimulation to the vagus nerve during a therapist-guided rehabilitation session. This pairing enhances the brain’s natural ability to reorganize neural circuits, reinforcing the connections needed for regaining arm and hand function, acting as a powerful reinforcement signal to the brain. VNS causes a rapid, widespread release of key neuromodulators throughout the cortex, including acetylcholine (ACh) and norepinephrine (NE).

When VNS is precisely paired with a specific motor task performed during physical therapy, these neuromodulators reinforce the neural activity related to that movement. This process strengthens existing neural connections and promotes the formation of new, more efficient neural pathways. Over time, this targeted reinforcement leads to a reorganisation of the motor cortex. The area of the brain controlling the specific rehabilitated movement expands, effectively rerouting the motor command around the damaged stroke area.

Recent findings (the VNS-REHAB trial) published in the last 2025 issue of Stroke validated the long-term effectiveness of the therapy. One year after completing the protocol, survivors maintained significant and clinically meaningful improvements in motor function, activity, participation, and quality of life. The trial also demonstrated that stroke survivors receiving paired VNS therapy had improvements in hand and arm function that were two to three times greater than those who received conventional rehabilitation alone.

For chronic stroke survivors who are often told that recovery potential plateaus, the Vivistim system clearly could offer new hope for regaining independence in daily tasks. The tech is safe, well-tolerated, and is gaining significant adoption within comprehensive stroke centres. For clinicians, it represents an evidence-based tool for expanding the therapeutic options available for chronic stroke rehabilitation.


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