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Post Operative DeliriumtVNSNCT07610655

Effects of Transcutaneous Vagal Nerve Stimulation on Post-Surgical Return to Consciousness, Delirium, and Depression

A study testing Transcutaneous vagal nerve stimulation in people with Post Operative Delirium and Cognitive Impairment, run by Northwestern University 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

This study will examine whether noninvasive, transcutaneous vagal nerve stimulation (tcVNS) can help restore consciousness in patients in the operating room and the Post Anesthesia Care Unit (PACU). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Transcutaneous vagal nerve stimulation
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
40 participants
Where
1 siteUnited States
Study dates
23 Apr 2026to 31 May 2029
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

  • Aged > 18 years of age
  • Patients undergoing lumbar surgery for degenerative disc disease or spinal stenosis involving two or more levels
  • Montreal Cognitive Assessment (MoCA) score ≥ 18 - accept mild
  • Ability to use a keyboard
  • Able to understand and communicate in English
  • Be able to consent independently
  • Women of child-bearing age must be comfortable confirming a negative pregnancy prior to participating in the study.
  • Must not be involved in any other research intervention study testing neurobehavioral functioning

Who cannot join

  • Age < 18 years of age
  • History of vagotomy (cutting the vagus nerve)
  • History of bradycardia, heart block, prolonged QT syndrome, brugada syndrome, heart failure with ejection fraction less than 35% and/or New York Heart Association symptoms
  • MoCA < 18
  • History of seizure disorder or intracranial hemorrhage
  • Patients with carotid stenosis
Show all 13Show fewer
  • Patients with aneurysms
  • Other neurological diagnoses or a diagnosis of severe psychiatric disorder (e.g., psychosis) or a reported childhood learning disability
  • Pregnancy, breastfeeding
  • Active addiction history
  • ECG adhesive allergy
  • Severe aphasia, preventing subject from understanding the protocol and giving written consent
  • Patients will be excluded postoperatively if there is neck swelling at the proposed site of left tcVNS.

Trial locations and contacts

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

United States1 site, 1 recruiting
  • Northwestern University Feinberg School of Medicine

    Chicago, Illinois, 60611

    Jordan Wood, BS, 312-695-0915, jordan.wood1@northwestern.edu

    Bin Zhang, MS, 312-695-7771, bin.zhang1@northwestern.edu

    Recruiting

Other trials in United States

About this study

This study will examine whether noninvasive, transcutaneous vagal nerve stimulation (tcVNS) can help restore consciousness in patients in the operating room and the Post Anesthesia Care Unit (PACU). The study will also investigate if tcVNS can expedite discharge from the PACU and examine whether tcVNS administerd in the PACU helps reduce delirium and depression after surgery. The study will also evaluate whether tcVNS speeds cognitive recovery from emergence of anesthesia and surgery.

Being tested
Transcutaneous vagal nerve stimulation, Sham (No Treatment)
Keywords
Anesthesia Care, Post Anesthesia Care, Post Surgical Care, Vagus Nerve Stimulation, Delirium, Cognitive Imparment, Depression, Hospital Length of Stay
Medical subject headings
Emergence Delirium, Cognitive Dysfunction, Depression, Delirium

What participants receive

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

  • Transcutaneous vagal nerve stimulationDevice

    The tcVNS device utilized in this study is not an implanted device, but rather is solely operated outside of the body by affixing it around the patient's ear. The device delivers stimulation of the vagus nerve at designated intensity, interval, and frequency.

  • Sham (No Treatment)Device

    The stimulator is flipped upside down so that the participant does not receive stimulation of the vagal nerve.

Study groups in NCT07610655
Study groupRoleWhat they receive
tcVNS Stimulation (Intervention)Active comparatorTranscutaneous vagal nerve stimulation (tcVNS)
Receives: Device: Transcutaneous vagal nerve stimulation
Sham tcVNS stimulation (Control)Sham comparatorSham transcutaneous vagal nerve stimulation (Sham tcVNS)
Receives: Device: Sham (No Treatment)

What is being measured

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

  1. Aim 1: Primary Endpoint 1: Determine if administering auricular tcVNS enhances the speed of recovery of anesthesia.

    Time in minutes to a Patient State Index (PSI) (Sedline Sedation Monitor) score of 85. The PSI is a quantitative score derived from 4 channel EEG monitoring of the frontal and prefrontal cortex for assessing level of consciousnes during sedation and general anesthesia. The score ranges from 0 (EEG supression) -100 (fully awake). A PSI range of 25-50 indicates optimal hypnotic state for general anesthesia

    Measured: 24 Hours

  2. Aim1:Primary Endpoint 2 : Richmond Agitation Sedation Scale (RASS Score)

    The Richmond Agitation-Sedation Scale (RASS) is a 10-point validated scale used to measure patient sedation levels in post-anesthesia care unit, ranging from +4 (combative) to -5 (unarousable). A score of 0 is "alert and calm".Measured on arrival to PACU then at 10,15,30,45,60 minutes after admission to PACU.

    Measured: 1 Hour

  3. Aim 2: Primary Endpoint 1: Post Anesthesia Care Unit Discharge (PACU)

    Admission time to the PACU to discharge from PACU in minutes elapsed.

    Measured: 3 Hours

  4. Aim 2: Primary Endpoint 2: Discharge from Hospital

    Time from Post Anesthesia Care Unit discharge to discharge from the hospital in days/minutes

    Measured: From PACU discharge (average of two hours post-surgical end time) to study completion (average of two days)

  5. Aim 3: Primary Endpoint 1: Post Anesthesia Care Unit delirium

    Comparison between active and sham tcVNS on delirium scores in the PACU at 30, 45 and 60 minutes after admission to the PACU. The 3D Confusion Assessment Method (3D CAM) will be administered at 30, 45 and 60 minutes after admission to PACU. The 3D CAM diagnostic tool scores delirium based on four core features, where Feature 1 (Acute Change) AND Feature 2 (Inattention) MUST be present, plus either Feature 3 (Disorganized Thinking) or Feature 4 (Altered Consciousness). It offers a severity score (3D-CAM-S) ranging from 0-20, with higher scores indicating more severe symptoms (0/20 low 20/20 high

    Measured: From PACU arrival to one hour post-PACU arrival

  6. Aim 3: Primary Endpoint 1a: Post Anesthesia Care Delirium

    Delirium scores 30 days after discharge from the hospital. The 3D Confusion Assessment Method (3D CAM) will be administered 30 days after discharge from the hospital. The 3D CAM diagnostic tool scores delirium based on four core features, where Feature 1 (Acute Change) AND Feature 2 (Inattention) MUST be present, plus either Feature 3 (Disorganized Thinking) or Feature 4 (Altered Consciousness). It offers a severity score (3D-CAM-S) ranging from 0-20, with higher scores indicating more severe symptoms (0/20 low 20/20 high

    Measured: 30 Days after discharge

  7. Aim3:Primary Endpoint 1b: PHQ-9

    The Patient Health Questionnaire Nine (PHQ-9) is a 9-question survey used to measure patient depression potential, ranging 1-27 (1 low possibility of depression to 27 highest potential for depression. Tested at baseline, post operative day 1 and 30 days post discharge from hospital.

    Measured: 30 days

Secondary outcomes (7)
  1. Aim 3: Secondary Endpoint 1:EEG Monitoring Data

    Continuous EEG monitoring data to be evaluated for patterns associated with delirium (polymorphiic delta waves, generalized slowing quantified as delta range vs alpha range power

    Measured: From pre-surgical EEG placement (i.e. approximately 30 minutes before surgery) through study completion (an average of 2 days)

  2. The Montreal Cognitive Assessment (MoCA) evaluations

    The MoCA includes measures of memory recll, visuospatial processing, executive functions, attention, language, abstract reasoning and orientation to time and place. Administered baseline and post operative day 2. 0-30 point scale, 26 and above is normal, 18-25 mild cognitive dysfunction, 10-17 is moderate dysfunction and 0-10 is severe dysfunction.

    Measured: 48 hours

  3. SF-36 Survey

    The 36-Item Short Form Survey (SF-36) is a self-reported patient outcome measure that assesses physical and mental health across eight domains, including functioning, pain, and vitality. Score ranges from 0 low to 100 high. The higher the score the better the overall health. Administered at baseline and 30 days after discharge.

    Measured: 30 days

  4. Neuro Qol Cognition Function Short Form

    This is a brief self-report tool used to measure perceived difficulties in everyday cognitive tasks. It is a portion of of the Quality of Life in Neurological Disorders (Neuro-QoL). he short form uses T-scores, which standardize results against a reference population (typically the U.S. general population).There are 8 questions. A T-score of 50 represents the average for the reference population. A high score indicates better perceived cognitive function. Completed at baseline and 30 days.

    Measured: 30 Days

  5. Neuro- QOL

    Neuro-QoL(Quality of Life in Neurological Disorders) is a measurement system that evaluates and monitors the physical, mental, and social effects experienced by adults who may have neurological conditions. Tested at baseline and 30 days.

    Measured: 30 Days

  6. DRS-R-98

    The Delirium Rating Scale (DRS-R-98) is a tool for assessing symptom severity and diagnosing delirium in clinical settings. This sixteen-item scale in a thirteen-item severity section and three diagnostic items, tracking changes over a twenty-four-hour period. The 16-item, clinician-rated tool used to diagnose and measure the severity of delirium. It consists of 13 severity items (scored 0-3) and 3 diagnostic items (scored 0-2 or 0-3), with a maximum total score of 46. Higher scores indicate more severe delirium, with scores of15 or greater than or greater than 17.5 often indicating delirium. Assessed at Day 1 and day 2 post operative.

    Measured: 48 hours

  7. DigitSpan Test

    Digit Span test measures auditory short-term memory and working memory capacity by asking participants to repeat sequences of digits in forward, reversed, or ordered sequences. It is used to measure cognitive processing, attention, and executive function, usually contains 5-9 digits. scoring typically awards one point for each correctly repeated sequence. Performed post operative day 1and 2.

    Measured: 48 Hours

Timeline

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

  1. First posted28 May 2026
  2. Study start23 Apr 2026
  3. Primary completion31 Dec 2028 (estimated)
  4. Study completion31 May 2029 (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 pilot trial.
Masking
Single blind
Who is masked
Participant
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07610655
Sponsor's protocol ID
STU00223307
Acronym
tVNS
Status last verified
May 2026
First submitted
13 May 2026
Last updated
28 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Assenza G, Tombini M, Lanzone J, Ricci L, Di Lazzaro V, Casciato S, Morano A, Giallonardo AT, Di Bonaventura C, Beghi E, Ferlazzo E, Gasparini S, Giuliano L, Pisani F, Benna P, Bisulli F, De Falco FA, Franceschetti S, La Neve A, Meletti S, Mostacci B, Sartucci F, Striano P, Villani F, Aguglia U, Avanzini G, Belcastro V, Bianchi A, Cianci V, Labate A, Magaudda A, Michelucci R, Verri A, Zaccara G, Pizza V, Tinuper P, Di Gennaro G; Epilepsy Study Group of the Italian Neurological Society. Antidepressant effect of vagal nerve stimulation in epilepsy patients: a systematic review. Neurol Sci. 2020 Nov;41(11):3075-3084. doi: 10.1007/s10072-020-04479-2. Epub 2020 Jun 10.

    PubMed 32524324
  • Ben-Menachem E, Revesz D, Simon BJ, Silberstein S. Surgically implanted and non-invasive vagus nerve stimulation: a review of efficacy, safety and tolerability. Eur J Neurol. 2015 Sep;22(9):1260-8. doi: 10.1111/ene.12629. Epub 2015 Jan 23.

    PubMed 25614179
  • Han S, Kim M, Kim H, Shin H, Youn I. Ketamine Inhibits Ultrasound Stimulation-Induced Neuromodulation by Blocking Cortical Neuron Activity. Ultrasound Med Biol. 2018 Mar;44(3):635-646. doi: 10.1016/j.ultrasmedbio.2017.11.008. Epub 2017 Dec 21.

    PubMed 29276137
  • Redgrave J, Day D, Leung H, Laud PJ, Ali A, Lindert R, Majid A. Safety and tolerability of Transcutaneous Vagus Nerve stimulation in humans; a systematic review. Brain Stimul. 2018 Nov-Dec;11(6):1225-1238. doi: 10.1016/j.brs.2018.08.010. Epub 2018 Aug 23.

    PubMed 30217648
  • Hachem LD, Wong SM, Ibrahim GM. The vagus afferent network: emerging role in translational connectomics. Neurosurg Focus. 2018 Sep;45(3):E2. doi: 10.3171/2018.6.FOCUS18216.

    PubMed 30173606
  • Rufener KS, Geyer U, Janitzky K, Heinze HJ, Zaehle T. Modulating auditory selective attention by non-invasive brain stimulation: Differential effects of transcutaneous vagal nerve stimulation and transcranial random noise stimulation. Eur J Neurosci. 2018 Sep;48(6):2301-2309. doi: 10.1111/ejn.14128. Epub 2018 Sep 9.

    PubMed 30144194
  • Ruffoli R, Giorgi FS, Pizzanelli C, Murri L, Paparelli A, Fornai F. The chemical neuroanatomy of vagus nerve stimulation. J Chem Neuroanat. 2011 Dec;42(4):288-96. doi: 10.1016/j.jchemneu.2010.12.002. Epub 2010 Dec 16.

    PubMed 21167932
  • George MS, Aston-Jones G. Noninvasive techniques for probing neurocircuitry and treating illness: vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). Neuropsychopharmacology. 2010 Jan;35(1):301-16. doi: 10.1038/npp.2009.87.

    PubMed 19693003
  • Weintraub S, Dikmen SS, Heaton RK, Tulsky DS, Zelazo PD, Bauer PJ, Carlozzi NE, Slotkin J, Blitz D, Wallner-Allen K, Fox NA, Beaumont JL, Mungas D, Nowinski CJ, Richler J, Deocampo JA, Anderson JE, Manly JJ, Borosh B, Havlik R, Conway K, Edwards E, Freund L, King JW, Moy C, Witt E, Gershon RC. Cognition assessment using the NIH Toolbox. Neurology. 2013 Mar 12;80(11 Suppl 3):S54-64. doi: 10.1212/WNL.0b013e3182872ded.

    PubMed 23479546
  • Gershon RC, Lai JS, Bode R, Choi S, Moy C, Bleck T, Miller D, Peterman A, Cella D. Neuro-QOL: quality of life item banks for adults with neurological disorders: item development and calibrations based upon clinical and general population testing. Qual Life Res. 2012 Apr;21(3):475-86. doi: 10.1007/s11136-011-9958-8. Epub 2011 Aug 27.

    PubMed 21874314
  • Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83.

    PubMed 1593914
  • Inouye SK. Delirium in older persons. N Engl J Med. 2006 Mar 16;354(11):1157-65. doi: 10.1056/NEJMra052321. No abstract available.

    PubMed 16540616
  • Simon SE, Bergmann MA, Jones RN, Murphy KM, Orav EJ, Marcantonio ER. Reliability of a structured assessment for nonclinicians to detect delirium among new admissions to postacute care. J Am Med Dir Assoc. 2006 Sep;7(7):412-5. doi: 10.1016/j.jamda.2006.02.006. Epub 2006 May 30.

    PubMed 16979083
  • Gusmao-Flores D, Salluh JI, Chalhub RA, Quarantini LC. The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies. Crit Care. 2012 Jul 3;16(4):R115. doi: 10.1186/cc11407.

    PubMed 22759376

Questions about this trial

What is this clinical trial studying?

A study testing Transcutaneous vagal nerve stimulation in people with Post Operative Delirium and Cognitive Impairment, run by Northwestern University 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 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: looking for participants now, as of the sponsor's last update on 28 May 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 Jordan Wood, BS (3126950915, jordan.wood1@northwestern.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Aim 1: Primary Endpoint 1: Determine if administering auricular tcVNS enhances the speed of recovery of anesthesia. (time frame: 24 Hours). The study lists 7 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 NCT07610655, which also lists 14 linked publications.

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 28 May 2026.

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