The brief

Analyst view

• Vivistim Paired VNS is the only FDA-approved implant for chronic post-stroke arm weakness, approved in 2021.
• Paired stimulation during therapy increases arm function 2-3x compared to rehabilitation alone.
• American Heart Association partnership to expand VNS-based recovery therapies to multiple motor indications.

Technical approach

As reported

Vagal stimulation

Release neuromodulators during movement practice

Vivistim delivers brief stimulation to the vagus nerve during therapy, triggering norepinephrine and acetylcholine to enhance neuroplasticity.

Chronic implant

Safe long-term use in stroke patients

Designed for chronic use; therapy sessions in the 6-12 month post-stroke window when brain is most plastic.

Rehabilitation pairing

Timing stimulation with movement practice

VNS works best paired with goal-directed physical therapy; stimulation amplifies the brain's learning signals during motor training.