tVNS Responsiveness Testing With Pupil Size

Georgia Institute of Technology

Status: Completed

Conditions: Stroke

Treatments: Procedure: Unilateral Right tVNS stimulation; Procedure: Bilateral tVNS stimulation; Procedure: Unilateral Left Sham stimulation; Procedure: Unilateral Left tVNS stimulation; Procedure: Unilateral Right Sham stimulation; Procedure: Bilateral Sham stimulation

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT06335199

H24109

5P2CHD086844-09 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The goal of this study is to learn about the acute pupil response to transcutaneous vagus nerve stimulation (tVNS) in stroke survivors and healthy adults. The main question it aims to answer is whether pupil size response is greater with bilateral tVNS compared to unilateral tVNS. Participants will receive tVNS and sham at the outer ear unilaterally and bilaterally in resting condition. The pupil size of the participants will be recorded during tVNS.

Full description

Participants will wear surface electrodes on the outer ear on both sides and a finger device that monitors heart rate. The attachment sites are the tragus or the cymba concha (depending on the shape and size of the ear) for tVNS and the ear lobe for sham. The electrical current will have a pulse duration of 0.1 ms at 30 Hz with an intensity below the pain threshold or 5 milliamp, whichever is lower, for a duration of 0.5 s. The experimental stimulation intensity will be determined as just below the pain threshold. Participants will receive multiple blocks of unilateral and bilateral stimulations to the sham or tVNS electrodes at rest, during which their pupil size will be recorded. The order of unilateral/bilateral and sham/tVNS stimulation will be randomized.

Enrollment: 21 patients

Sex: All

Ages: 18 to 89 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 18-89 years old across all races, genders, and ethnicities.
• Post-stroke subjects will have persistent hemiparesis on the upper extremity (UE) with some residual UE voluntary movement.

Exclusion criteria

Able-bodied subjects:

• Younger than 18 years old or older than 89 years old
• Current or history of cardiac disease
• Have a vision problem not corrected by glasses or contact lenses
• Have an implanted device such as a neurostimulator or cochlear implant
• Current or history of tympanic membrane perforation
• Had a stroke or lesion (including tumor) in your brain
• Had a head injury or brain surgery
• Suffer from frequent or severe headaches
• Had a fainting spell or syncope
• Have any metal in the head such as shrapnel, surgical clips, or fragments from welding or metal work
• Have any implanted device such as cardiac pacemakers, medical pumps, or intra-cardiac lines
• Had any brain-related conditions (i.e. multiple sclerosis, Parkinson, Alzheimer)
• Had any illness that caused brain injury (i.e. meningitis, aneurysm, brain tumor)
• Had any head trauma that was associated with a loss of consciousness or diagnosed as a concussion
• Being treated for any psychiatric condition (i.e. depression, anxiety, PTSD, schizophrenia)
• Suspected of pregnancy

Post-stroke subjects:

• Younger than 18 years old or older than 89 years old
• Current or history of cardiac disease
• Have a vision problem not corrected by glasses or contact lenses
• Have any implanted devices such as a neurostimulator or cochlear implant
• Current or history of tympanic membrane perforation
• No persistent hemiparesis on the upper extremity (UE)
• No residual UE voluntary movement
• A first stroke less than 4 months prior to the participation
• Serious uncontrolled medical conditions
• Excessive pain in any joint of the more affected extremity
• Unable to stand independently for 2 min., transfer independently to and from the toilet or perform sit-to-stand
• Suffer from frequent or severe headaches
• Had a fainting spell or syncope
• Have any metal in the head such as shrapnel, surgical clips, or fragments from welding or metal work
• Have any implanted device such as cardiac pacemakers, medical pumps, or intra-cardiac lines
• Had any illness that caused brain injury (i.e. meningitis, aneurysm, brain tumor)
• Had any head trauma that was associated with a loss of consciousness or diagnosed as a concussion
• Being treated for any psychiatric condition (i.e. depression, anxiety, PTSD, schizophrenia)
• Suspected of pregnancy
• A score of less than 24 on the Folstein Mini-Mental State Examination
• Excessive frailty or lack of stamina (e.g., cannot attend to instructions, stay awake, engage in functional activities, etc.)
• Excessive pain in any joint of the more affected extremity that could limit ability to cooperate with the intervention

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Double Blind

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21 participants in 6 patient groups

Unilateral Left tVNS

Experimental group

Description:

Electrical stimulation to the vagus nerve area of the outer ear on the left side.

Treatment:

Procedure: Unilateral Left tVNS stimulation

Bilateral tVNS

Experimental group

Description:

Electrical stimulation to the vagus nerve area of the outer ear on both sides.

Treatment:

Procedure: Bilateral tVNS stimulation

Unilateral Left Sham

Sham Comparator group

Description:

Electrical stimulation to the non-vagus nerve area of the outer ear on the left side.

Treatment:

Procedure: Unilateral Left Sham stimulation

Bilateral Sham

Sham Comparator group

Description:

Electrical stimulation to the non-vagus nerve area of the outer ear on both sides.

Treatment:

Procedure: Bilateral Sham stimulation

Unilateral Right tVNS

Experimental group

Description:

Electrical stimulation to the vagus nerve area of the outer ear on the right side.

Treatment:

Procedure: Unilateral Right tVNS stimulation

Unilateral Right Sham

Sham Comparator group

Description:

Electrical stimulation to the non-vagus nerve area of the outer ear on the right side.

Treatment:

Procedure: Unilateral Right Sham stimulation