Key result
Right VNS paired with motor training expands forelimb motor cortical representation ~3.5-fold vs sham.
Why the study?
Because right vagus nerve stimulation uniquely drives midbrain dopaminergic signaling, it remained unknown whether it enhances motor cortical plasticity or behavioral performance compared to traditional left vagus nerve stimulation.
Does right vagus nerve stimulation improve motor cortical plasticity or behavioral performance compared to left vagus nerve stimulation in healthy rats?
Does right vagus nerve stimulation improve motor cortical plasticity or behavioral performance compared to left vagus nerve stimulation in healthy rats?
Effect estimate: Hedge's g -2.65
Absolute Event Rate: 3.5% vs 1%
p-value: p=0.0034
Right vagus nerve stimulation is as effective as traditional left vagus nerve stimulation at inducing task-relevant motor cortical plasticity in healthy rats, suggesting it may be a viable alternative for stroke rehabilitation.
May support right VNS as alternative to left for motor plasticity; leaves open translation to stroke patients.
Stimulation of the left cervical vagus nerve (l-VNS) paired with motor training is FDA-approved to improve upper limb function after stroke. However, recent preclinical studies have revealed a striking asymmetry in engagement of the midbrain dopaminergic reward system by right versus left VNS. Unlike l-VNS, right VNS (r-VNS) reinforces behavior and drives activation of midbrain dopaminergic neurons. These findings raise the possibility that r-VNS may provide therapeutic advantages by engaging plasticity- or motivation-enhancing dopaminergic signaling. In the current study, we tested whether r-VNS enhances VNS-driven motor cortical plasticity or behavioral performance compared to traditional l-VNS. Healthy rats were trained on a stimulation-paired lever-pressing task previously shown to predict the efficacy of l-VNS treatment post-stroke. Both l-VNS and r-VNS significantly expanded the representation of task-relevant musculature in the motor cortex, with no differences observed between stimulation groups. Like l-VNS, r-VNS was not accompanied by increases in task engagement or percent correct performance in healthy subjects. Combined, our findings do not support the hypothesis that r-VNS provides significant benefit over l-VNS through differential engagement of motor learning or motivational circuits. However, our results suggest that r-VNS, like l-VNS, is highly effective at inducing cortical neuroplasticity, which is associated with enhanced stroke recovery.
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Welch et al. (2026) studied Healthy (preclinical stroke recovery model) (n=23). Right vagus nerve stimulation (r-VNS) vs. Sham stimulation and left vagus nerve stimulation (l-VNS) was evaluated on Proximal forelimb motor map representation (mm2) (Hedge's g -2.65, p=0.0034). Right vagus nerve stimulation paired with motor training significantly expanded the motor cortical representation of task-relevant proximal forelimb musculature compared to sham (3.5 vs 1.0 mm2).
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