Dr. Gary Steinberg

So I think that's another area that we need to encourage.

Right.

Well, for stroke, and as I alluded to, vagal nerve stimulation coupled with physical therapy, physical activity, very intensive, was the very first FDA-approved treatment for chronic stroke patients.

That was approved in 2021, three years ago.

And it was shown in the study that compared with non-stimulation, in other words, putting the stimulator on but not stimulating and doing the therapy, that patients did better.

It was a modest improvement, but it felt to be meaningful.

And it was shown to be effective at 90 days, only three months.

Now, recently at the last international stroke meeting this past February, it was presented, and I don't know if it's been published yet, that those results hold up for up to a year.

So the way it works, presumably, is that you stimulate the entire vagus nerve in the neck.

And it's not the peripheral effects on the heart or the other autonomic organs where it's working.

It's stimulation that goes back to the brain.

Because when you stimulate a nerve, it doesn't go in one direction.

And that's probably how it works for depression also, not a systemic.

And the vagus has lots of connection with brain functions.

And so it's not completely clear which areas are being stimulated to recover from stroke or improve depression.

But it's brain stimulation that somehow, again, resurrects circuits or induces plasticity in circuits.

Again, it's something that we're learning about.

And I think not just vagal nerve stimulation, but stimulation of the brain is becoming a very important innovative treatment for many brain diseases and injuries.

You have to do an operation.

It's low risk, very few side effects.