The author suggests that pathological neural activity could be treated by directing specific plasticity to renormalize circuits and restore function. Rehabilitative therapies aimed to promote adaptive circuit changes after neurological disease or injury, are often prevented in supporting full recovery owing to insufficient or maladaptive plasticity. Adjunctive strategies that broadly support plasticity to facilitate rehabilitative interventions have the potential to improve treatment in a wide range of neurological disorders.
Vagus Nerve Stimulation (VNS) in conjunction with rehabilitation has emerged as one such potential targeted plasticity therapy. Vagus nerve stimulation (VNS) drives activation of neuromodulatory nuclei that are associated with plasticity, including the cholinergic basal forebrain and the noradrenergic locus coeruleus. Repeatedly pairing brief bursts of VNS sensory or motor events drives robust, event-specific plasticity in neural circuits.
The author points to mounting evidence from pilot clinical trials for the promise of VNS-based targeted plasticity therapies, discusses current uses and potential future applications of VNS-based targeted plasticity therapies, and outlines challenges for clinical implementation.