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StrokeNOVUSNCT06761404

Non-invasive VNS in Stroke Recovery

A study testing taVNS in people with Stroke, run by The Methodist Hospital Research Institute at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

To evaluate feasibility and effectiveness of non-invasive VNS to enhance stroke recovery Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Stroke
What is being tested?
taVNS
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
1 siteUnited States
Study dates
15 Apr 2025to 1 Jun 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Symptomatic ischemic or hemorrhagic stroke verified by computerized axial tomography or magnetic resonance imaging resulting in hemiparesis (MRC 1-4).
  • Age more than 18, Male or Female, All racial and ethnic groups
  • Entry into the study >6 months post onset
  • Patients who can safely undergo taVNS
  • Able to follow 2 step commands
  • Modified Ashworth Scale Score =<3 in the involved upper extremity
  • Passive range of motion within functional ranges at the shoulder, elbow, wrist and hand
  • UFM =< 60 (scale 0-66)

Who cannot join

  • Patients with history of severe alcohol or drug abuse, psychiatric illnesses like severe depression, poor motivational capacity, or severe language disturbances, particularly of receptive nature or with serious cognitive deficits (defined as unable to follow study instructions).
  • Patients with bilateral paresis, or weakness or sensory damage due to peripheral causes (e.g. peripheral nerve injury, muscle or orthopedic injury etc.)
  • Subjects with contraindication to MRI of the brain
  • Patients with severe uncontrolled medical problems (e.g. cardiovascular disease, severe rheumatoid arthritis, active joint deformity of arthritic origin, active cancer or renal disease, any kind of end-stage pulmonary or cardiovascular disease, or a deteriorated condition due to age, epilepsy or others).
  • Patients with unstable cardiac arrhythmia, reentry tachycardia.
  • Pregnancy
  • Patients with pacemakers or stimulators that interfere with the stimulation, or other investigational devices or drugs
  • Non-English speaking individuals will only be eligible if they can provide the appropriate translator for all the sessions of the study as no funding is available to pay for such services. However we plan to include them once funding has been secured in the subsequent larger trial.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Darrel W Cleere, MPH contact

7134413770

dwcleere@houstonmethodist.org

United States1 site, 1 recruiting
  • Houston Methodist Research Institute

    Houston, Texas, 77030

    Darrel Cleere, 713-441-3770, dwcleere@houstonmethodist.org

    Recruiting

Other trials in United States

About this study

To evaluate feasibility and effectiveness of non-invasive VNS to enhance stroke recovery

Read the detailed description

In this study, (Aim 1) we will test whether our non-invasive trans-auricular vagus nerve stimulation (taVNS) during occupational therapy task performance has the potential for large scale application through superior clinical benefit compared to sham in a broad group of stroke survivors including hemorrhagic strokes.

To determine the predictors of effective brain rewiring in the individual stroke patient, we will use an EEG and/or functional MRI (fMRI) connectivity biomarker independently of the success of the stimulation paradigm (Aim 2). We will test the hypothesis that better motor function will be associated with increased motor network connectivity pattern.

The central objective of this application is to determine whether taVNS significantly improves motor recovery for both ischemic and hemorrhagic strokes through increased connectivity as measured by a biomarker of plasticity. We address our objective through the following aims:

Aim 1: To determine the extent to which taVNS with concurrent occupational therapy (OT), causes significant, lasting motor gains in chronic stroke population

Hypothesis A: More chronic stroke patients treated with taVNS+OT will show clinically meaningful improved hand motor function over Sham+OT immediately after treatment as measured by upper extremity Fugl-Meyer (uFM) test response rate. 60 patients at least 6 months after ischemic or hemorrhagic stroke with persistent arm weakness will be enrolled in a 6-week double masked, sham-controlled, balanced parallel group design phase 2 clinical trial.

Hypothesis B: The sham group will achieve the same degree of motor function improvement in the open label cross-over phase as the original active taVNS group sustained clinical improvement after OT+VNS.

Hypothesis C: The open label home extension taVNS+OT phase will produce additional motor function improvement and will be associated with improved patient and caregiver satisfaction.

Aim 2: To determine the induced connectivity pattern of the brain resulting in the improved motor performance

Hypothesis A: Chronic stroke patients with improved motor performance will demonstrate increased connectivity between motor cortical areas as measured by high-definition EEG and/or fMRI functional connectivity compared to the non-responders immediately after treatment.

Hypothesis B: Network activation with taVNS is dependent on timing compared to movement and stimulation intensity. We will perform fMRI and /or high-definition EEG to evaluate network activity during taVNS at different intensity and phase of the movement.

This study evaluates the feasibility, efficacy and underlying plasticity changes of adjuvant noninvasive VNS to enhance motor recovery following ischemic and hemorrhagic strokes.

Conditions
Stroke
Being tested
taVNS
Keywords
taVNS, trans-auricular, non-invasive vagus nerve stimulation, stroke recovery, neuromodulation, rehabilitation, chronic stroke
Medical subject headings
Stroke

What participants receive

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

  • taVNSDevice

    Experimental. The current will be increased gradually for both sham and real stimulation at the beginning of the 90-minute stimulation to lessen the itchy/numb skin sensation and to create the same skin sensation for subject blinding.

Study groups in NCT06761404
Study groupRoleWhat they receive
Sham StimulationSham comparatorSame procedure as with the active stimulation using the device's sham settings to elicit the same cutaneous sensation as the other stimulation conditions..
Receives: Device: taVNS
taVNSExperimentalWeak current (up to 0.8-4 mA) will be delivered using pulses according to standard protocol during each motor task for up to 90-minutes through surface electrodes which will be administered using the intensity identified as resulting in well tolerated skin sensation and best motor performance during our initial testing session.
Receives: Device: taVNS

What is being measured

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

  1. To evaluate feasibility and effectiveness of non-invasive VNS to enhance stroke recovery

    To determine the extent to which taVNS with concurrent occupational therapy (OT), causes significant, lasting motor gains in chronic stroke population

    Upper extremity Fugl-Meyer (uFM) The uFM test measures both proximal and distal upper extremity movements, ranges 0-66, higher score is better.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

Secondary outcomes (16)
  1. To evaluate the biomarkers of plasticity associated with VNS

    We will use an EEG and/or functional MRI (fMRI) connectivity biomarker.

    Measured: [Time Frame: Baseline 1(week 1), post-intervention (week 6), post intervention for sham crossover only (week 12)]

  2. Wolf Motor Function Test (WMFT)

    The WMFT is a time-based method to evaluate upper extremity performance while providing insight into joint-specific and total limb movements. This measurement includes video recording of the task performance where de-identifying will be attempted to the degree possible (face not in the frame, removing/blocking out identifying jewelry etc.). All patients will sign an informed consent explicitly authorizing such video-recording.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

  3. Functional upper extremity levels (FUEL)

    The FUEL is an upper extremity post-stroke motor function classification system that does not require significant extra time or evaluator training.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

  4. NIH STROKE SCALE (NIHSS)

    The NIHSS is a standardized clinical examination to evaluate clinical functional impairment after stroke.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]. Max score 42, minimum score 0. Score of 0 is best outcome

  5. MRC grading scale

    The MRC grading scale is a clinical scale to evaluate the motor impairment.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]. Minimum score 0, max score 5 per item. 5 is normal, 0 is no movement.

  6. Timed up and Go

    This test assesses gait speed, mobility, balance, walking ability and fall risk in older adults.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

  7. Barthel Index (BI)

    The Barthel Index is an index measuring the patients' activities of daily living and of patient's independence in mobility and personal care.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]. Minimum score 0, maximum score 100. Higher score is better

  8. Stroke Impact Scale (SIS)

    A self-report questionnaire that evaluates disability and health-related quality of life after stroke from the perspective of the patient.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]. Minimum score 0, maximum score 100. 0 means no recovery, 100 means fully recovered

  9. Zarit Burden Interview: Short (12-items)

    Caregiver perspective questionnaire to assess caregiver burden. Additional caregiver questionnaire for perception of user friendliness, time savings, helpfulness, ease of use, perceived improvement and free comments will be collected.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

  10. Modified Rankin Scale (mRS)

    Clinician-reported measure of global disability that has been widely applied for evaluating recovery from stroke and as a primary end point in randomized clinical trials (RCTs) of emerging acute stroke treatments.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

  11. Modified Ashworth Spasticity Scale

    The modified Ashworth spasticity scale provides a rating of the degree of spasticity of a limb evaluated by clinical neurologic examination.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

  12. Quick Inventory of Depressive Symptomatology, Self-report (QIDS-SR)

    A validated 16-item0-27 scale self-report questionnaire of depression.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]. Minimum score 0, maximum score greater than 21. 0-5 means normal, greater than 21 is not

  13. taVNS questionnaire

    Visual Analog Scale to prospectively evaluate taVNS effects such as skin sensation, tingling, skin redness etc. This will serve as a safety and tolerability measure.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

  14. Motor Activity log

    A structured interview to assess how stroke survivors use their affected arm outside of the laboratory.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

  15. Wrist flexion-extension measurement

    This measurement will be performed with our hand device to record maximum force of flexion and extension in standard arm position. taVNS test improvement will be calculated based on the speed and accuracy of the writs flexion measurement as described in our prior published work.

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

  16. To determine the taVNS induced connectivity pattern of the brain

    Primary outcome measure: Hypothesis A and Hypothesis B: Connectivity measure between motor cortical areas as measured by high definition EEG and fMRI functional connectivity in taVNS compared to Sham+OT immediately after treatment

    Measured: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]

Timeline

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

  1. First posted7 Jan 2025
  2. Study start15 Apr 2025
  3. Primary completion31 Dec 2027 (estimated)
  4. Study completion1 Jun 2028 (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
Sham stimulation vs taVNS
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06761404
Sponsor's protocol ID
PRO00038365
Acronym
NOVUS
Status last verified
Feb 2026
First submitted
13 Dec 2024
Last updated
2 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes

Questions about this trial

What is this clinical trial studying?

A study testing taVNS in people with Stroke, run by The Methodist Hospital Research Institute at 1 site in United States.

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 8 inclusion and 8 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: looking for participants now, as of the sponsor's last update on 2 Mar 2026. 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 United States. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Darrel W Cleere, MPH (7134413770, dwcleere@houstonmethodist.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

To evaluate feasibility and effectiveness of non-invasive VNS to enhance stroke recovery (time frame: [Time Frame: Baseline, post intervention (week 6), post intervention (week 12), and follow up for the sham crossover group (week 18)]). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 2 Mar 2026.

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