{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T09:08:27Z","timestamp":1779700107663,"version":"3.53.1"},"reference-count":109,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background\/Objectives: Vagus nerve stimulation (VNS) has evolved from a laboratory experiment to a standard of care in several neurological disorders like epilepsy, depression and stroke rehabilitation at present. Methods: We reviewed the published literature relevant to its origins in animal models leading to various clinical applications. Results: Bailey and Bremer published their observations following VNS in animals while further studies established its utility in some forms of epilepsy. Subsequent observations in epilepsy patients treated with VNS revealed the unequivocal improvement in psychological and behavioral disorders. Consequently, VNS received approval for its application in resistant depression disorders. Multiple studies revealed changes due to neuronal plasticity following VNS that could result in the significant clinical recovery of motor function in chronic ischemic stroke patients. Chronic incomplete cervical spinal cord injury, head injury and peripheral nerve injury deficits are also being studied for recovery patterns. Transcutaneous approaches and closed-loop stimulation are showing encouraging results that may facilitate the extension of the application of neuromodulation using VNS. Conclusions: For the recovery of motor function following paralysis in stroke patients or cervical spinal cord injuries, the timing of the stimulation after physical activity during rehabilitation has been identified as a key factor. In addition to the timing of the stimulation, the titration of the parameters is also being studied to obtain optimized recovery in cases of motor, sensory, or sphincter deficits.<\/jats:p>","DOI":"10.3390\/neurolint18050094","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:06:26Z","timestamp":1779696386000},"page":"94","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vagus Nerve Stimulation for Neuromodulation: Evolution from Bench to Bedside"],"prefix":"10.3390","volume":"18","author":[{"given":"Prasad","family":"Vannemreddy","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7946-8639","authenticated-orcid":false,"given":"Konstantin V.","family":"Slavin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA"},{"name":"Section of Neurology, Jesse Brown Veterans Administration Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1002\/cne.900670104","article-title":"Quantitative studies of the vagus nerve in the cat: I. The ratio of sensory to motor fibers","volume":"67","author":"Foley","year":"1937","journal-title":"J. Comp. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1152\/jn.1938.1.5.405","article-title":"A sensory cortical representation of the vagus nerve: With a note on the effects of low blood pressure on the cortical electrogram","volume":"1","author":"Bailey","year":"1938","journal-title":"J. Neurophysiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/cne.901840303","article-title":"An autoradiographic examination of the central distribution of the trigeminal, facial, glossopharyngeal, and vagal nerves in the monkey","volume":"184","author":"Beckstead","year":"1979","journal-title":"J. Comp. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/BF01182232","article-title":"The afferent pathway to the locus coeruleus from the nucleus of the solitary tract","volume":"10","author":"Zhukova","year":"1980","journal-title":"Neurosci. Behav. Physiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/BF00381889","article-title":"Evidence for projections from medullary nuclei onto serotonergic and dopaminergic neurons in the midbrain dorsal raphe nucleus of the rat","volume":"270","author":"Herbert","year":"1992","journal-title":"Cell Tissue Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"6816","DOI":"10.1073\/pnas.1320827111","article-title":"Heterogeneous organization of the locus coeruleus projections to prefrontal and motor cortices","volume":"111","author":"Chandler","year":"2014","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/0306-4522(91)90076-Z","article-title":"The organization of serotonergic projections to cerebral cortex in primates: Regional distribution of axon terminals","volume":"44","author":"Wilson","year":"1991","journal-title":"Neuroscience"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1002\/cne.902750205","article-title":"Nucleus basalis (Ch4) and cortical cholinergic innervation in the human brain: Observations based on the distribution of acetyl cholinesterase and choline acetyltransferase","volume":"275","author":"Mesulam","year":"1988","journal-title":"J. Comp. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/0165-0173(80)90009-0","article-title":"Descending projections of the locus coeruleus and subcoeruleus\/medial parabrachial nuclei in monkey: Axonal transport studies and dopamine-beta-hydroxylase immunocytochemistry","volume":"2","author":"Westlund","year":"1980","journal-title":"Brain Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.expneurol.2016.12.005","article-title":"Parametric characterization of neural activity in the locus coeruleus in response to vagus nerve stimulation","volume":"289","author":"Hulsey","year":"2017","journal-title":"Exp. Neurol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/0013-4694(52)90064-3","article-title":"The effect of vagal afferent stimulation on the EEG pattern of the cat","volume":"4","author":"Zanchetti","year":"1952","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/0031-9384(68)90121-2","article-title":"Cortical and subcortical EEG patterns of response to afferent abdominal vagal stimulation: Neurographic correlates","volume":"3","author":"Chase","year":"1968","journal-title":"Physiol. Behav."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1111\/j.1528-1157.1992.tb01751.x","article-title":"Inhibition of experimental seizures in canines by repetitive vagal stimulation","volume":"33","author":"Zabara","year":"1992","journal-title":"Epilepsia"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1046\/j.1528-1157.2001.09700.x","article-title":"Destruction of peripheral C-fibers does not alter subsequent vagus nerve stimulation-induced seizure suppression in rats","volume":"42","author":"Krahl","year":"2001","journal-title":"Epilepsia"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1111\/j.1528-1157.1990.tb05852.x","article-title":"Effects of vagal stimulation on experimentally induced seizures in rats","volume":"31","author":"Woodbury","year":"1990","journal-title":"Epilepsia"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/0920-1211(95)00035-9","article-title":"Regional induction of fos immunoreactivity in the brain by anticonvulsant stimulation of the vagus nerve","volume":"22","author":"Naritoku","year":"1995","journal-title":"Epilepsy Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1111\/j.1528-1157.1998.tb01155.x","article-title":"Locus coeruleus lesions suppress the seizure-attenuating effects of vagus nerve stimulation","volume":"39","author":"Krahl","year":"1998","journal-title":"Epilepsia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1139\/jpn.0936","article-title":"Enhancement of the function of rat serotonin and norepinephrine neurons by sustained vagus nerve stimulation","volume":"34","author":"Manta","year":"2009","journal-title":"J. Psychiatry Neurosci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jpsychires.2015.05.002","article-title":"The antidepressant-like effect of vagus nerve stimulation is mediated through the locus coeruleus","volume":"68","author":"Grimonprez","year":"2015","journal-title":"J. Psychiatr. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"112975","DOI":"10.1016\/j.expneurol.2019.112975","article-title":"Norepinephrine and serotonin are required for vagus nerve stimulation directed cortical plasticity","volume":"320","author":"Hulsey","year":"2019","journal-title":"Exp. Neurol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"5782","DOI":"10.1038\/s41467-019-13695-0","article-title":"Enhancing plasticity in central networks improves motor and sensory recovery after nerve damage","volume":"10","author":"Meyers","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.brainres.2006.08.048","article-title":"Increased extracellular concentrations of norepinephrine in cortex and hippocampus following vagus nerve stimulation in the rat","volume":"1119","author":"Roosevelt","year":"2006","journal-title":"Brain Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.brs.2015.08.018","article-title":"Cortical map plasticity as a function of vagus nerve stimulation intensity","volume":"9","author":"Borland","year":"2016","journal-title":"Brain Stimul."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1227\/NEU.0b013e3182351699","article-title":"Frederic Gibbs and his contributions to Epilepsy surgery and electroencephalography","volume":"70","author":"Vannemreddy","year":"2012","journal-title":"Neurosurgery"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S162","DOI":"10.1016\/0013-4694(85)90626-1","article-title":"Peripheral control of hypersynchronous discharge in epilepsy","volume":"61","author":"Zabara","year":"1985","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1111\/j.1528-1157.1990.tb05844.x","article-title":"Feasibility and safety of vagal stimulation in monkey model","volume":"31","author":"Lockard","year":"1990","journal-title":"Epilepsia"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3171\/2016.1.PEDS15534","article-title":"Complications and safety of vagus nerve stimulation: 25 years of experience at a single center","volume":"18","author":"Revesz","year":"2016","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"S40","DOI":"10.1111\/j.1528-1157.1990.tb05848.x","article-title":"Prevention of intractable partial seizures by intermittent vagal stimulation in humans: Preliminary results","volume":"31","author":"Penry","year":"1990","journal-title":"Epilepsia"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1212\/WNL.43.7.1338","article-title":"Treatment of epilepsy by stimulation of the vagus nerve","volume":"43","author":"Uthman","year":"1993","journal-title":"Neurology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/j.1540-8159.1991.tb04054.x","article-title":"Vagal stimulation for control of complex partial seizures in medically refractory epileptic patients","volume":"14","author":"Wilder","year":"1991","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1111\/j.1528-1157.1994.tb02482.x","article-title":"First International Vagus Nerve Stimulation Study Group. Vagus nerve stimulation for treatment of partial seizures: A controlled study of effect on seizures","volume":"35","author":"Ristanovic","year":"1994","journal-title":"Epilepsia"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1212\/WNL.52.6.1265","article-title":"Evaluation of refractory epilepsy treated with vagus nerve stimulation for up to 5 years","volume":"52","author":"Hellstrom","year":"1999","journal-title":"Neurology"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"(1995). The Vagus Nerve Stimulation Study Group. A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. Neurology, 45, 224\u2013230.","DOI":"10.1212\/WNL.45.2.224"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1212\/WNL.51.1.48","article-title":"Vagus nerve stimulation therapy for partial-onset seizures: A randomized active-control trial","volume":"51","author":"Handforth","year":"1998","journal-title":"Neurology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.1007\/s00381-015-2921-1","article-title":"Meta analysis of vagus nerve stimulation treatment for epilepsy: Correlation between device setting parameters and acute response","volume":"31","author":"Ghani","year":"2015","journal-title":"Childs Nerv. Syst."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1212\/01.wnl.0000168899.11598.00","article-title":"Vagus nerve stimulation for epilepsy: Randomized comparison of three stimulation paradigms","volume":"65","author":"DeGiorgio","year":"2005","journal-title":"Neurology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1046\/j.1528-1157.2001.0420081017.x","article-title":"Vagus nerve stimulation: Analysis of device parameters in 154 patients during the long-term XE5 study","volume":"42","author":"DeGiorgio","year":"2001","journal-title":"Epilepsia"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0920-1211(00)00181-9","article-title":"Vagus nerve stimulation is associated with mood improvements in epilepsy patients","volume":"42","author":"Elger","year":"2000","journal-title":"Epilepsy Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/S0006-3223(99)00304-2","article-title":"Vagus nerve stimulation (VNS) for treatment-resistant depressions: A multicenter study","volume":"47","author":"Rush","year":"2000","journal-title":"Biol. Psychiatry"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1097\/00004424-200108000-00006","article-title":"Feasibility of vagus nerve stimulation-synchronized blood oxygenation level-dependent functional MRI","volume":"36","author":"Bohning","year":"2001","journal-title":"Investig. Radiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.biopsych.2003.12.004","article-title":"Acute vagus nerve stimulation using different pulse widths produces varying brain effects","volume":"55","author":"Mu","year":"2004","journal-title":"Biol. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/YCT.0000000000000424","article-title":"Hippocampal gray volumes increase in treatment-resistant depression responding to vagus nerve stimulation","volume":"33","author":"Perini","year":"2017","journal-title":"J. ECT"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.brs.2018.01.006","article-title":"A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder","volume":"11","author":"Tu","year":"2018","journal-title":"Brain Stimul."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.biopsych.2005.07.028","article-title":"A one-year comparison of vagus nerve stimulation with treatment as usual for treatment-resistant depression","volume":"58","author":"George","year":"2005","journal-title":"Biol. Psychiatry"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/0306-4522(92)90163-V","article-title":"Serotonin and L-norepinephrine as mediators of altered excitability in neonatal rat motoneurons studied in vitro","volume":"47","author":"Elliott","year":"1992","journal-title":"Neuroscience"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/S0306-4522(02)00026-X","article-title":"Neuromodulatory transmitter systems in the cortex and their role in cortical plasticity","volume":"111","author":"Gu","year":"2002","journal-title":"Neuroscience"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1038\/nature09656","article-title":"Reversing pathological neural activity using targeted plasticity","volume":"470","author":"Engineer","year":"2011","journal-title":"Nature"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.expneurol.2011.10.026","article-title":"Pairing tone trains with vagus nerve stimulation induces temporal plasticity in auditory cortex","volume":"233","author":"Shetake","year":"2012","journal-title":"Exp. Neurol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.brs.2015.01.408","article-title":"Pairing speech sounds with vagus nerve stimulation drives stimulus-specific cortical plasticity","volume":"8","author":"Engineer","year":"2015","journal-title":"Brain Stimul."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.brs.2017.11.007","article-title":"The interaction of pulse width and current intensity on the extent of cortical plasticity evoked by vagus nerve stimulation","volume":"11","author":"Loerwald","year":"2018","journal-title":"Brain Stimul."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2867","DOI":"10.1016\/j.neuron.2022.06.017","article-title":"Vagus nerve stimulation drives selective circuit modulation through cholinergic reinforcement","volume":"110","author":"Bowles","year":"2022","journal-title":"Neuron"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"21645","DOI":"10.1038\/s41598-021-00976-2","article-title":"Local activation of \u03b12 adrenergic receptors is required for vagus nerve stimulation induced motor cortical plasticity","volume":"11","author":"Tseng","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1089\/neu.2005.22.1485","article-title":"Electrical stimulation of the vagus nerve enhances cognitive and motor recovery following moderate fluid percussion injury in the rat","volume":"22","author":"Smith","year":"2005","journal-title":"J. Neurotrauma"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2365","DOI":"10.1093\/cercor\/bhr316","article-title":"Repeatedly pairing vagus nerve stimulation with a movement reorganizes primary motor cortex","volume":"22","author":"Porter","year":"2012","journal-title":"Cereb. Cortex"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1161\/STROKEAHA.117.019202","article-title":"Vagus nerve stimulation enhances stable plasticity and generalization of stroke recovery","volume":"49","author":"Meyers","year":"2018","journal-title":"Stroke"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1002\/ana.25664","article-title":"Restoration of somatosensory function by pairing vagus nerve stimulation with tactile rehabilitation","volume":"87","author":"Darrow","year":"2020","journal-title":"Ann. Neurol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1161\/STROKEAHA.115.010477","article-title":"Safety, feasibility, and efficacy of vagus nerve stimulation paired with upper-limb rehabilitation after ischemic stroke","volume":"47","author":"Dawson","year":"2016","journal-title":"Stroke"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"159","DOI":"10.3233\/NRE-172273","article-title":"Vagus nerve stimulation paired with tactile training improved sensory function in a chronic stroke patient","volume":"42","author":"Kilgard","year":"2018","journal-title":"NeuroRehabilitation"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2789","DOI":"10.1161\/STROKEAHA.118.022279","article-title":"Vagus nerve stimulation paired with upper limb rehabilitation after chronic stroke","volume":"49","author":"Kimberley","year":"2018","journal-title":"Stroke"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(21)00475-X","article-title":"Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): A randomized, blinded, pivotal, device trial","volume":"397","author":"Dawson","year":"2021","journal-title":"Lancet"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e32058","DOI":"10.7554\/eLife.32058","article-title":"Closed-loop neuromodulation restores network connectivity and motor control after spinal cord injury","volume":"7","author":"Ganzer","year":"2018","journal-title":"eLife"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Morrison, R.A., Hays, S.A., and Kilgard, M.P. (2021). Vagus nerve stimulation as a potential adjuvant to rehabilitation for post-stroke motor speech disorders. Front. Neurosci., 15.","DOI":"10.3389\/fnins.2021.715928"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Vannemreddy, P.S., Cummings, M., Bahrii, R.V., and Slavin, K.V. (2025). Vagus Nerve Stimulation in Stroke Management: Brief Review of Evolution and Present Applications Paired with Rehabilitation. Brain Sci., 15.","DOI":"10.3390\/brainsci15040346"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e13571","DOI":"10.1111\/psyp.13571","article-title":"Moving beyond belief: A narrative review of potential biomarkers for transcutaneous vagus nerve stimulation","volume":"57","author":"Burger","year":"2020","journal-title":"Psychophysiology"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"113220","DOI":"10.1016\/j.expneurol.2020.113220","article-title":"Parametric characterization of the rat Hering-Breuer reflex evoked with implanted and non-invasive vagus nerve stimulation","volume":"327","author":"Bucksot","year":"2020","journal-title":"Exp. Neurol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1016\/j.brs.2023.08.009","article-title":"How to fail with paired VNS therapy","volume":"16","author":"Hays","year":"2023","journal-title":"Brain Stimul."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/j.brs.2018.03.018","article-title":"Transcutaneous nerve stimulation via the tragus: Are we really stimulating the vagus nerve?","volume":"11","author":"Burger","year":"2018","journal-title":"Brain Stimul."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"7997","DOI":"10.1038\/s41598-018-26135-8","article-title":"Cervical vagus nerve morphometry and vascularity in the context of nerve stimulation\u2013 A cadaveric study","volume":"8","author":"Hammer","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Chang, J.L., Coggins, A.N., Saul, M., Paget-Blanc, A., Straka, M., Wright, J., Datta-Chaudhuri, T., Zanos, S., and Volpe, B.T. (2021). Transcutaneous auricular vagus nerve stimulation (tAVNS) delivered during upper limb interactive robotic training demonstrates novel antagonist control for reaching movements following stroke. Front. Neurosci., 15.","DOI":"10.3389\/fnins.2021.767302"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.4103\/1673-5374.332155","article-title":"Efficacy and safety of transcutaneous auricular vagus nerve stimulation combined with conventional rehabilitation training in acute stroke patients: A randomized controlled trial conducted for 1 year involving 60 patients","volume":"17","author":"Li","year":"2022","journal-title":"Neural Regen. Res."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1001\/jama.1951.02920240001001","article-title":"The surgical treatment of psychomotor epilepsy","volume":"10","author":"Bailey","year":"1951","journal-title":"J. Am. Med. Assoc."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1212\/WNL.58.3.452","article-title":"J.L. Corning and vagal nerve stimulation for seizures in the 1880s","volume":"58","author":"Lanska","year":"2022","journal-title":"Neurology"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Afra, P., Adamolekun, B., Aydemir, S., and Watson, G. (2021). Evolution of the vagus nerve stimulation (VNS) therapy system technology for drug-resistant epilepsy. Front. Med. Technol., 3.","DOI":"10.3389\/fmedt.2021.696543"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1111\/ane.13375","article-title":"Vagus nerve stimulation in patients with Lennox-Gastaut syndrome: A meta-analysis","volume":"143","author":"Greco","year":"2021","journal-title":"Acta Neurol. Scand."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/j.brs.2014.07.031","article-title":"Non-invasive vagus nerve stimulation in healthy humans reduces sympathetic nerve activity","volume":"7","author":"Clancy","year":"2014","journal-title":"Brain Stimul."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"221","DOI":"10.2147\/NDT.S198774","article-title":"Management of treatment-resistant depression: Challenges and strategies","volume":"16","author":"Voineskos","year":"2020","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1017\/S109285290002191X","article-title":"Vagus nerve stimulation: A new form of therapeutic brain stimulation","volume":"5","author":"George","year":"2000","journal-title":"CNS Spectr."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/S0893-133X(01)00271-8","article-title":"Vagus nerve stimulation (VNS\u2122) for treatment-resistant depression: Efficacy, side effects, and predictors of outcome","volume":"25","author":"Sackeim","year":"2000","journal-title":"Neuropsychopharmacology"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.4088\/JCP.v66n0902","article-title":"Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes","volume":"66","author":"Nahas","year":"2005","journal-title":"J. Clin. Psychiatry"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.biopsych.2005.05.025","article-title":"Vagus nerve stimulation for treatment resistant depression: A randomized, controlled acute phase trial","volume":"58","author":"Rush","year":"2005","journal-title":"Biol. Psychiatry"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/00004691-200109000-00004","article-title":"Vagus nerve stimulation: Clinical experience in a large patient series","volume":"18","author":"Scherrmann","year":"2001","journal-title":"J. Clin. Neurophysiol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.yebeh.2016.10.005","article-title":"Quality-of-life metrics with vagus nerve stimulation for epilepsy from provider survey data","volume":"66","author":"Englot","year":"2017","journal-title":"Epilepsy Behav."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1177\/1545968315616494","article-title":"Vagus nerve stimulation during rehabilitative training improves forelimb recovery after chronic ischemic stroke in rats","volume":"30","author":"Khodaparast","year":"2016","journal-title":"Neurorehab Neural Repair."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Engineer, N.D., Kimberley, T.J., Prudente, C.N., Dawson, J., Tarver, W.B., and Hays, S.A. (2019). Targeted vagus nerve stimulation for rehabilitation after stroke. Front. Neurosci., 13.","DOI":"10.3389\/fnins.2019.00280"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1016\/j.apmr.2024.05.018","article-title":"Distal versus proximal arm improvement after paired vagus nerve stimulation therapy after chronic stroke","volume":"105","author":"Vora","year":"2024","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Gerstner, W., Lehmann, M., Liakoni, V., Corneil, D., and Brea, J. (2018). Eligibility traces and plasticity on behavioral time scales: Experimental support of neo Hebbian three-factor learning rules. Front. Neural Circuits, 12.","DOI":"10.3389\/fncir.2018.00053"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1126\/science.1255514","article-title":"A critical time window for dopamine actions on the structural plasticity of dendritic spines","volume":"345","author":"Yagishita","year":"2014","journal-title":"Science"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/j.neuron.2015.09.037","article-title":"Distinct eligibility traces for LTP and LTD in cortical synapses","volume":"88","author":"He","year":"2015","journal-title":"Neuron"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1097\/WNR.0000000000000154","article-title":"The timing and amount of vagus nerve stimulation during rehabilitative training affect poststroke recovery of forelimb strength","volume":"25","author":"Hays","year":"2014","journal-title":"Neuroreport"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.neuroscience.2023.09.015","article-title":"Vagus nerve stimulation must occur during tactile rehabilitation to enhance somatosensory recovery","volume":"532","author":"Ruiz","year":"2023","journal-title":"Neuroscience"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"114628","DOI":"10.1016\/j.expneurol.2023.114628","article-title":"Vagus nerve stimulation as immunomodulatory therapy for stroke: A comprehensive review","volume":"372","author":"Jelinek","year":"2024","journal-title":"Exp. Neurol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1101\/lm.048447.118","article-title":"Peripheral effects of vagus nerve stimulation on anxiety and extinction of conditioned fear in rats","volume":"26","author":"Noble","year":"2019","journal-title":"Learn. Mem."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Brougher, J., Sanchez, C.A., Aziz, U.S., Gove, K.F., and Thorn, C.A. (2021). Vagus nerve stimulation induced motor map plasticity does not require cortical dopamine. Front. Neurosci., 15.","DOI":"10.3389\/fnins.2021.693140"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1146\/annurev.neuro.31.060407.125547","article-title":"Descending pathways in motor control","volume":"31","author":"Lemon","year":"2008","journal-title":"Ann. Rev. Neurosci."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1097\/j.pain.0000000000000930","article-title":"Modulation of brainstem activity and connectivity by respiratory-gated auricular vagal afferent nerve stimulation (RAVANS) in migraine patients","volume":"158","author":"Garcia","year":"2017","journal-title":"Pain"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/j.brs.2020.02.028","article-title":"Design and validation of a closed-loop, motor-activated auricular vagus nerve stimulation (MAAVNS) system for neurorehabilitation","volume":"13","author":"Cook","year":"2020","journal-title":"Brain Stimul."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Badran, B.W., Jenkins, D.D., Cook, D., Thompson, M., DeVres, W.H., Mappin, G., Summers, P., Bikson, M., and George, M.S. (2020). Transcutaneous auricular vagus nerve stimulation paired rehabilitation for oromotor feeding problems in newborns: An open label pilot study. Front. Hum. Neurosci., 14.","DOI":"10.3389\/fnhum.2020.00077"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1016\/j.jstrokecerebrovasdis.2018.02.056","article-title":"Transcutaneous auricular vagus nerve stimulation with concurrent upper limb repetitive task practice for poststroke motor recovery: A pilot study","volume":"27","author":"Redgrave","year":"2018","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"104348","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.104348","article-title":"Transcutaneous auricular vagus nerve stimulation with upper limb repetitive task practice may improve sensory recovery in chronic stroke","volume":"28","author":"Baig","year":"2019","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"7876507","DOI":"10.1155\/2017\/7876507","article-title":"Transcutaneous Vagus nerve stimulation combined with robotic rehabilitation improves upper limb function after stroke","volume":"2017","author":"Capone","year":"2017","journal-title":"Neural. Plast."},{"key":"ref_101","unstructured":"(2026, January 01). ClinicalTrials.gov, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04129242?term=NCT04129242&rank=1."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1177\/15459683231173357","article-title":"Motor Activated Auditory Vagus Nerve Stimulation as a potential neuromodulation approach for post-stroke motor rehabilitation: A pilot study","volume":"37","author":"Badran","year":"2023","journal-title":"Neurorehabilit. Neural Repair"},{"key":"ref_103","unstructured":"(2026, January 01). ClinicalTrials.gov, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04288245?term=NCT04288245&rank=1."},{"key":"ref_104","unstructured":"(2026, January 01). ClinicalTrials.gov, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05601661?term=NCT05601661&rank=1."},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Yozbatiran, N., Francisco, G.E., and Korupolu, R. (2024). Safety and feasibility of paired vagus nerve stimulation with rehabilitation for improving upper extremity function in people with cervical spinal cord injury: Study protocol. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1465764"},{"key":"ref_106","first-page":"112","article-title":"Complications of implanted vagus nerve stimulation: A systematic review and meta-analysis","volume":"54","author":"Kalagara","year":"2025","journal-title":"Cerebrovasc. Dis."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1001\/jama.296.17.2095","article-title":"Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: The EXCITE randomized clinical trial","volume":"296","author":"Wolf","year":"2006","journal-title":"J. Am. Med. Assoc."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1161\/01.STR.0000196940.20446.c9","article-title":"Task-specific training with trunk restraint on arm recovery in stroke: Randomized control trial","volume":"37","author":"Michaelsen","year":"2006","journal-title":"Stroke"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1179\/016164110X12767786356354","article-title":"Adaptively controlling deep brain stimulation in essential tremor patient via surface electromyography","volume":"32","author":"Graupe","year":"2010","journal-title":"Neurol. Res."}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/18\/5\/94\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:55:52Z","timestamp":1779699352000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/18\/5\/94"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,15]]},"references-count":109,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["neurolint18050094"],"URL":"https:\/\/doi.org\/10.3390\/neurolint18050094","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,15]]}}}