Stony Brook Medicine has introduced a new procedure aimed at improving upper limb function in ischemic stroke survivors. This initiative marks the first time this FDA-approved technology has been used on Long Island, targeting patients who have not regained mobility after rehabilitation therapy.
Ischemic strokes account for nearly 90% of all stroke cases and result from blocked blood flow to the brain. Vagus nerve stimulation (VNS), a neurotechnology previously used for epilepsy and depression, is now being applied to aid stroke recovery. Charles Mikell, MD, associate professor and vice chair of the Department of Neurosurgery at Stony Brook University, explained that "VNS provides small pulses of electricity to a nerve in the neck that helps your brain make changes that are beneficial."
Earlier this year, Mikell's team conducted a 90-minute surgery on Gerald Doroski, a 68-year-old Long Island resident who suffered a stroke three years ago. The Vivistim® Paired VNS™ System was implanted in his chest. Doroski reported positive results post-surgery: “My mind was in a brain fog since my stroke and now my thoughts are more defined.”
Stony Brook is currently the only center on Long Island performing VNS for stroke rehabilitation and one of two centers in the tri-state area offering this procedure due to its technical demands. Mikell emphasized collaboration with St. Charles Rehabilitation Center as crucial for their program's success: “We do the surgery, they do the rehabilitation.”
Mikell noted that while VNS is FDA-approved only for ischemic strokes at present, it holds potential benefits for other hand deficits. He stated: “Stroke is one of the leading causes of death and disability in the United States,” adding that many could benefit from this technology.
Candidates for vagus nerve stimulation undergo evaluation at St. Charles Rehabilitation Center before referral to Stony Brook if deemed suitable. According to Mikell, patients with partial hand function recovery post-stroke may be eligible.
Although the exact mechanism behind VNS remains unclear, it appears to enhance "plasticity," helping recruit other brain areas to regain hand function. Benefits seem long-lasting; however, data collection continues as Mikell remarked: “Once you benefit from vagus nerve stimulation, you can pretty much count on those benefits being durable for the rest of your life.”
Mikell also highlighted potential future applications of VNS beyond strokes: “I think in the next few years we’re going to see an expansion of applications.” He expressed pride in offering this option locally: “We’re very proud to be the first on Long Island... At Stony Brook Medicine we’re leading way providing access best care most effective medical technology all stages stroke care recovery.”
Gerald Doroski shared his progress four months post-surgery: “I have more movement in my right arm and hand... I have more confidence moving forward.” His experience underscores potential impacts on quality-of-life improvements following such interventions.