On April 24th, 2021, The Lancet published a paper that shared details of a clinical trial for people who suffered from an ischaemic stroke and lost arm function who then received an implant to stimulate the vagus nerve in helping to regain motor function. The results were promising which indicates that this treatment can be an option for helping stroke victims regain motor function. But, this trial and research open up new (and terrifying) applications.
The Vagus Nerve and the Vivistim System
First, what is the vagus nerve? The vagus nerve is named after the Latin “vagus” meaning “wandering”. This nerve wanders from the brain to organs all over the body. It acts as a data transfer pathway, informing the brain of organ functions so it can monitor them and take action. This nerve can cause the brain to release neuromodulators that help regulate the body’s various responses. Here are a few other key ways the vagus nerve helps us:
- communication between the gut and the brain
- communciation with diaphragm
- send anti-inflammatory signals
The vagus nerve serves unique purposes compared to other nerves but it also functions in a similar manner – sending electrical signals to parts of the body to generate a chemical or physical response. Vagus nerve stimulation treatment has helped with epilepsy, anxiety disorders, and Alzheimer’s disease. But, this recent treatment helped patients regain motor function, a different area of treatment altogether. Scientists used this nerve’s ability to generate neuromodulators which help in the process of motor functions.
On August 27th, 2021, the FDA approved the Microtransponder Vivistim Paired VNS system that can help patients who suffered an ischaemic stroke and also lost motor function. The device also includes software that allows doctors to modify many aspects of the device and gather data:
“Accompanying the implantable components are clinician software preloaded onto a laptop and a wireless transmitter to be used only by a health care provider. The software allows a health care provider managing a patient’s rehabilitation to input the appropriate settings on the IPG, including amplitude, frequency, and pulse width for the stimulation, and also records stimulation history, movements performed, and information about the IPG. The wireless transmitter communicates adjustments to the IPG settings made using the software.”
How do we learn a skill?
Practice, practice, practice. A popular “fact” thrown around is that it takes 10,000 hours to master a skill, but that has been refuted. Personally, I think it’s impossible to attach a number of hours to master a skill – there’s so much more that goes into it. But, one can argue that the more you practice a skill, the better you get at it. From a brain science perspective, learning a skill means creating neural pathways that help send signals from the brain to different parts of the body. The more the neural pathways are used, the stronger they get.
Now, let’s go back to the clinical trial of using an implant to stimulate the vagus nerve to help patients regain motor function of their arm. In addition to the implant, patients also underwent physical therapy. Scientists discovered that this procedure had compressed what would have been years of physical therapy into months. The implant along with practicing a very simple skill helped strengthen those neural pathways that allow someone to perform simple motor functions.
And now I’ll get to the exciting question – what if I had a similar device implanted that helped me improve my golf swing? Could I compress developing that motor function from years into months? Now, a golf swing is complex; there is so much coordination that goes into it and there are different golf swings for different shots. And yet, from a brain science perspective, a golf swing is a series of signals firing through neural pathways at the right cadence in order to generate multiple muscle movements. The more often you go to the range and practice, the stronger those neural pathways become.
Augmentation to Build Skills
There have been blogs/presentations about VR/AR for training employees and using machine learning and data to improve athletes’ performance. It’s clear these will be utilized in the future (and some are being used now), but there’s a chance that humans will pursue augmentation to reduce the time it takes to learn a task or skill. Can a baseball player with this device implanted train faster for properly swinging at a fastball? Could a worker be implanted with a device to stimulate the vagus nerve in order to gain better motor functions for their job? We have devices that monitor hearts, help reduce blood clots, and there are recent advancements in connecting human brains to robotic hands or speech devices – augmentation to improve learning could be next.
Obviously, there are concerns. This is an invasive procedure and you are stimulating a nerve that is critical to bodily functions. But, there is research into non-invasive techniques for stimulating the nerve using magnetic technology. If this procedure is proven to be safe, would you be ok watching an Olympic event where one athlete developed skills this way while competing against an athlete who did not? (More troubling – how would you know?) What about competing for a job where someone else built a sought-after skill and you didn’t? Could this further separate the wealthy from everyone else? (Move along private SAT tutors, here’s a device that could get my kid into college.)
I do not see this procedure being used outside of helping patients recover motor function in the next decade or two due to technology challenges, regulations, and the public’s perception of such an alteration to their body. In addition, its current use case is to regain simple motor function. There is a wide gap between regaining the motor function of your arm and hitting a 5 iron to within 10 feet of the hole. But, big innovations often start with small advancements. If this procedure becomes a part of our society, then it will impact all aspects of our lives. Maybe one day, like Neo, we can learn new skills like Kung-Fu very quickly…
Also, here are signs of a stroke so you can get help fast for yourself or others:
- sudden numbness or weakness in face, arm, or leg, especially on one side of the body
- sudden confusion, trouble speaking, or difficulty understanding speech
- sudden trouble seeing in one or both eyes
- sudden trouble walking, dizziness, loss of balance, or lack of coodination
- sudden severe headache with no known cause
If this new procedure does help stroke victims regain motor functions quickly, then I am all for it. But, it may open up new opportunities that will fundamentally reshape how people learn and develop skills.