Neuroscience has not to date produced significant treatments for people with neurological and psychiatric conditions. This talk will review the processes through which scientific discovery leads to new clinical therapies related to behavior, summarize the primary reasons why initial excitement often fails to translate to clinical utility, and explore the lessons learned about how to improve the robustness of scientific study and improve clinical application.

This talk will review the science behind a promising new therapy to restore function after neurotrauma. The technique uses brief bursts of closed-loop vagus nerve stimulation (VNS) to engage pro-plasticity neuromodulatory circuits during therapy. VNS during therapy was first developed in rats ten years ago by researchers at the Texas Biomedical Device Center (www.txbdc.com) and has now been tested in over two hundred implanted patients.

In August of 2021, the therapy was approved by the U.S. FDA to treat arm impairments in people with chronic ischemic stroke. Our ongoing animal studies demonstrate that VNS paired with rehabilitative training enhances recovery in multiple models of neurological injury, including spinal cord injury, stroke, TBI, and PTSD. Recovery is produced by synaptic plasticity in spared neural networks activated during therapy.

Now that the synaptic mechanisms responsible for targeted plasticity therapy are well understood, the TxBDC has shifted its focus to developing the hardware and software tools necessary to deliver VNS-enhanced therapy for the most debilitating neurological and psychiatric conditions. Results from our clinical trials in people with chronic PTSD, stroke and spinal cord injury are encouraging.

The talk will conclude by discussing lessons for improving the plasticity by other forms of therapy.