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StrokeNCT06388954

Plasticity Biomarkers,Interleukin-6 and Motor Performance in Response to Vagus Nerve Stimulation After Stroke

A study testing True Transcutaneous auricular Vagus Nerve Stimulation (TaVNS) in people with Stroke and Motor Disorders, run by Cairo University at 1 site in Egypt.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Seventy-eight clinically verified Egyptian patients from both sexes with ischemic stroke that occurred at least 6 months to 2 years before inclusion will be randomly assigned into 2 groups, control group (GA) and the experimental group (GB). Read more about this study

Who is it for?
Ages 55 to 65 years
Conditions the study is for
Stroke, Motor Disorders
What is being tested?
True Transcutaneous auricular Vagus Nerve Stimulation (TaVNS)
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
80 participants
Where
1 siteEgypt
Study dates
28 May 2024to 18 May 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 55 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Hemiparetic patients with ischemic middle cerebral artery stroke
  • The duration of illness ranged from at least 6 months to 2 years after stroke.
  • Patient's age ranged from 55 to 65 years, patients with unilateral upper limb motor function impairment.
  • Patients able to transfer at least one block in Box and Blocks Test.
  • Patients with sufficient cognitive abilities that enables them to understand and follow instructions.
  • Spasticity of upper limb muscles ranged from (grade 1:2) according to Modified Ashworth scale.

Who cannot join

  • Other neurological diseases that affect upper limb function other than stroke (e.g.: Multiple sclerosis, peripheral neuropathy, Parkinsonism….etc.).
  • Hemorrhagic stroke
  • Visual or auditory impairment affecting their ability to complete the testing.
  • Cognitive impairment.
  • Cardiovascular problems and pulmonary or kidney disorders
  • Musculoskeletal disorders (e.g. scoliosis, kyphosis, severe arthritis…etc.)
Show all 13Show fewer
  • Severe spasticity (a Modified Ashworth Scale score ≥3).
  • Patients with any taVNS contraindications such as previous surgical intervention on Vagus nerve.
  • Low blood pressure (<100/60mmHg) or low heart rate (<60bpm) and or high blood pressure (>220/130 mmHg).
  • Pacemaker or other implanted electrical device.
  • Any current or past history of cardiovascular disorders
  • Facial or ear pain
  • Recent ear trauma .

Trial locations and contacts

1 site in 1 country.

Engy B Saleh, PhD contact

00201099445112

engybm.saleh@yahoo.com

Moshera H. Darwish, PhD contact

00201015163617

dr.moshera11@yahoo.com

Egypt1 site, 1 recruiting
  • Faculty of Physical Therapy, Cairo University

    Giza, Dokki, 11432

    Engy BadrEldin S Moustafa, PhD, 00201099445112, engybm.saleh@cu.edu.eg

    Moshera H. Darwish, PhD, 00201015163617, dr.moshera11@yahoo.com

    Recruiting

Other trials in Egypt

About this study

Official title: Effect of Trans-auricular Vagus Nerve Stimulation on Plasticity Biomarkers,Interleukin-6 and Motor Performance Post Stroke : A Randomized Controlled Clinical Trial

Seventy-eight clinically verified Egyptian patients from both sexes with ischemic stroke that occurred at least 6 months to 2 years before inclusion will be randomly assigned into 2 groups, control group (GA) and the experimental group (GB). Patients will be randomly assigned into two equal groups: the control group (GA) and the experimental group (GB). Patients in the control group (GA) will be treated with sham Vagus nerve stimulation (taVNS) immediately before a selected physical therapy program, while in the experimental group (GB), patients will receive real transcutaneous auricular Vagus nerve stimulation (taVNS) followed by the same selected physical therapy program as (GA). Plasma level of Brain-Derived Neurotrophic Factors (BDNF) and Interleukin-6 (IL-6), Box and Blocks Test (BBT), and modified Ashworth scale (MAS) will be assessed at baseline and immediately post-treatment.

Read the detailed description

Background: Neuromodulation techniques play an integral role in restoring motor function in stroke patients by affecting the adaptive neuroplasticity and activation of neuromodulators that may reduce brain inflammation post stroke.

Objective: To assess the efficacy of transcutaneous auricular vagal nerve stimulation on plasma levels of Brain-Derived Neurotrophic Factors (BDNF), Interleukin-6 (IL-6), gross manual dexterity, and muscle tone in patients with ischemic stroke.

Materials and Methods: Seventy-eight clinically verified Egyptian patients from both sexes with ischemic stroke that occurred at least 6 months to 2 years before inclusion, aged 55 to 65 years, were recruited. Patients will be randomly assigned into two equal groups; control group (GA) and the experimental group (GB). Patients in the control group (GA) were treated with sham Vagus nerve stimulation (taVNS) immediately before a selected physical therapy program, while in the experimental group (GB), patients received real transcutaneous auricular Vagus nerve stimulation (taVNS) followed by the same selected physical therapy program as (GA). Plasma levels of Brain-Derived Neurotrophic Factors (BDNF), serum Interleukin-6 (IL-6) , Box and Blocks Test (BBT) and Modified Ashworth scale (MAS) were assessed at baseline and immediately post-treatment.

Results: There was a statistically significant improvement in BBT, plasma IL-18 level and BDNF in experimental group (GB) post-treatment (P< 0.05) with no change in MAS. There was no statistical significant difference in BBT, plasma Interleukin-6 (IL-6) and MAS in control group post treatment (P> 0.05). While, there is a statistically significant improvement in BDNF in the control group post treatment. A statistically significant improvement was observed of BBT and BDNF in the study group compared to the control group (P< 0.05). There was no statistical significant difference in MAS between study and control groups (P> 0.05).

Conclusions: Non-invasive VNS as an adjunct to conventional physical rehabilitation enhances neuroplasticity and improves upper limb motor ability after ischemic stroke, as well as reducing the stroke-induced inflammatory process, which may affect the disease prognosis.

Being tested
True Transcutaneous auricular Vagus Nerve Stimulation (TaVNS), Sham Trancutaneous auricular Vagus Nerve Stimulation
Keywords
Neurotrophic Factors, Ischemic Stroke, Neural Plasticity, Interleukin-6, Vagus Nerve Stimulation
Medical subject headings
Stroke, Motor Disorders, Ischemic Stroke

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • True Transcutaneous auricular Vagus Nerve Stimulation (TaVNS)Device

    Also called Transcutaneous Vagus Nerve Stimulation (TVNS)

    Vagus Nerve Stimulation (VNS) consists in the activation of the Vagus nerve using electrical current, Transcutaneous auricular VNS works through the placement of noninvasive electrodes on the neck or auricle for stimulation of the auricular branch of the vagus nerve.

    Transcutaneous electrical nerve stimulation (TENS) electrodes will be used to stimulate the auricular branch of the Vagus nerve, The active electrode will be placed on the cymba concha of the left ear. This reduced the risk of taVNS side effect on the heart. The reference electrode will be placed outside the left ear attached to the tragus. TENS parameters used were: 30 minutes treatment time, a pulse width of 300 microseconds, pulse frequency 20 hertz and a duty cycle of 25%. The stimulation intensity was set at super-threshold levels, such as 200% of patient perceptual threshold.

  • Sham Trancutaneous auricular Vagus Nerve StimulationDevice

    Sham transcutaneous vagal nerve stimulation will be performed by the same procedures of the study group but without electrical stimulation. The active electrodes will be attached to the left cymba conchae. The taVNS stimulator will be turned on and the stimulation intensity will be increased until the patient perceived the electrical stimulation and then the stimulator will be turned off.

Study groups in NCT06388954
Study groupRoleWhat they receive
Control group (GA)Placebo comparatorPatients in the control group (GA) will be treated by 12 sessions of sham transcutaneous auricular Vagus nerve stimulation for 30 minutes immediately, will be followed by 30 minutes of a selected physical therapy program, three sessions per week for four consecutive weeks. Sham transcutaneous vagal nerve stimulation was performed using the same procedures as the study group but without electrical stimulation.
Receives: Device: Sham Trancutaneous auricular Vagus Nerve Stimulation
Study group (GB)ExperimentalPatients in the study group (GB) will be treated by 12 sessions of true transcutaneous auricular Vagus nerve stimulation for 30 minutes , then immediately followed by 30 minutes of a selected physical therapy program (GA), three sessions per week for four consecutive weeks. The stimulation of the auricular branch of the Vagus nerve will be performed by conventional TENS device with one channel and two electrodes.
Receives: Device: True Transcutaneous auricular Vagus Nerve Stimulation (TaVNS)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Muscle tone of the upper limb

    The Modified Ashworth Scale (MAS) will be used; it is a six-point ordinal scale. It ranges from 0 (no increase in muscle tone) to 4 (affected part rigid in flexion or extension). The muscle tone was measured by observing the response of the muscle group to the resistance of passive movement in the affected hand. The degree of muscle tone in the affected hand was classified as (0 = normal, 1 or 1+ = mild, 2 or 3 = moderate, or 4 = severe).

    Measured: Baseline Assessment and Immediately Post Treatment.

  2. Gross hand dexterity

    The Box and Blocks Test (BBT) will be used; it is a quick, simple, and inexpensive test for measuring unilateral gross manual dexterity in stroke. The patients were asked to transfer as many blocks as they could from one compartment to the other for 60 seconds. The patient was allowed to choose any block of any color and to carry only one block each time with his hand, which must cross over the partition.

    Measured: Baseline Assessment and Immediately Post Treatment.

  3. Level of Plasma brain-derived Derived factor (BDNF)

    Sandwich-ELISA kits will be used according to the manufacturer's instructions. Venous blood samples were collected in a disposable plastic vacuum tube with an anticoagulant. Samples were centrifuged for 15 min at 1000×g at 2-8 °C within 30 min of collection.

    Measured: Baseline Assessment and Immediately Post Treatment.

  4. Level of Serum Interleukin IL-6

    Interleukin-6 (IL-6) is a crucial inflammatory factor in that its significant increase was observed in stroke patients shortly following the ischemic event and serves a vital role as a messenger molecule between leucocytes, the vascular endothelium, and parenchyma. A single referral lab will test the samples using ELISA and U/CyTech kits. From each participant, 10 milliliters of non-fasting blood sample will be obtained 6 to 24 hours after the onset of symptoms and kept in citrate tubes. Blood samples will thereafter centrifuged within 1 hour at 3000 × g for 15 minutes at 4°C and resultant plasma will be kept in -80°C.

    Measured: Baseline Assessment, Immediately Post Treatment, 3 Month Posttreatment Assessment (Follow-up)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Apr 2024
  2. Study start28 May 2024
  3. Primary completion25 Jan 2025
  4. Study completion18 May 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Single-blind, randomized controlled study.
Masking
Single blind
Who is masked
Participant
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06388954
Sponsor's protocol ID
P.T.REC/012/005107
Status last verified
May 2024
First submitted
19 Apr 2024
Last updated
13 May 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • S Moustafa EB, Darwish MH, El-Tamawy MS, Mostafa M, Abu Elkasem ST, Khalifa HA. Plasticity Biomarkers, Interleukin 6, and Motor Performance Responses to Trans-auricular Vagus Nerve Stimulation Post-Stroke: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2026 Jun 1;105(6):479-485. doi: 10.1097/PHM.0000000000002878. Epub 2025 Oct 4.

    PubMed 41224215

Questions about this trial

What is this clinical trial studying?

A study testing True Transcutaneous auricular Vagus Nerve Stimulation (TaVNS) in people with Stroke and Motor Disorders, run by Cairo University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 13 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Engy B Saleh, PhD (00201099445112, engybm.saleh@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Muscle tone of the upper limb (time frame: Baseline Assessment and Immediately Post Treatment.). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06388954, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 May 2025.

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