New Insights into the Brain’s Motor Cortex

How Vagus Nerve Stimulation Can Help Some Patients Improve Their Recovery After Stroke

By Michael Clayton, Mayo Clinic

A vagus nerve stimulation device, approved by the Food and Drug Administration, is being used in rehabilitation to help patients recovering from an ischemic stroke. If a patient is having trouble using their hand or arm after a stroke, this stimulation device helps create new pathways in the brain as the person performs exercises. This can help the person regain function faster than rehabilitation alone.

Dr. Jonathon Parker, a Mayo Clinic neurosurgeon, discusses how the vagus nerve stimulation device is helping some stroke patients recover their mobility in this Mayo Clinic Minute.

An ischemic stroke can be life-changing for those who survive. Many people may need speech, physical or occupational therapy to regain their abilities. The vagus nerve stimulator device also used to treat epilepsy, can help some patients recover strength in their arms, even many months or years after their stroke.

"We can stimulate the nervous system in a way that we can then augment the body's ability to recover from something like a stroke," says Dr. Parker.

This advanced device can be used to deliver stimulation at the moment the patient is performing a rehabilitation exercise. Pairing this action can help patients recover lost strength from stroke and, in many cases, regain function in their hands and arms.

"We study this therapy in patients who are already in that chronic phase of recovery from their stroke. Nearly half of those patients were able to have a very significant improvement in their motor strength," he says.

Researchers also are studying vagus nerve stimulation as a potential treatment for a variety of other conditions. Research is looking at the potential benefits of the therapy for rheumatoid arthritis, inflammatory bowel disease, bipolar disorder, obesity, and Alzheimer's disease.

It’s Mental Health Awareness Month

National Center for Complementary and Integrative Health

May is Mental Health Awareness Month, a good time to think about ways in which you can protect your mental health, including taking steps to manage stress.

Long-term stress can contribute to or worsen many mental and physical health problems. But fortunately, there are ways to counteract its effects. We have access to a built-in “stress reset button” that acts as an antidote to stress. It’s called the relaxation response. It’s the opposite of your body’s response to stress. The relaxation response slows your heart rate, lowers your blood pressure, and decreases oxygen consumption and levels of stress hormones.

By learning simple techniques that produce the relaxation response—such as progressive muscle relaxation, simple mindfulness exercises, and slow, deep breathing—you can help prevent stress from building up. That’s good for both your mind and your body.

Learn More About Stress

Surgeon General Outlines Framework to Address Loneliness

The Hill | By Lauren Sforza

Surgeon General Vivek Murthy, M.D., plans to introduce a three-part framework to address loneliness in the US, as about half of Americans are experiencing loneliness at any given time, and social disconnection can lead to an increased risk of mental health and physical issues in addition to premature death. Social connection must be a priority and "will require reorienting ourselves, our communities, and our institutions to prioritize human connection and healthy relationships," Dr. Murthy writes.

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Guidance for the Expiration of the COVID-19 Public Health Emergency (PHE)

Staff Vaccination Requirements

On November 5, 2021, the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) issued an interim final rule (CMS-3415-IFC) requiring Medicare and Medicaid-certified providers and suppliers to ensure that their staff were fully vaccinated for COVID-19 (i.e., obtain the primary vaccination series), which was a critical step to protect patients. On April 10, 2023, the President signed legislation that ended the COVID-19 national emergency. On May 11, 2023, the COVID-19 public health emergency is expected to expire. In light of these developments and comments received on the interim final rule, CMS will soon end the requirement that covered providers and suppliers establish policies and procedures for staff vaccination. CMS will share more details regarding ending this requirement at the anticipated end of the public health emergency. We continue to remind everyone that the strongest protection from COVID-19 is the vaccine. Therefore, CMS urges everyone to stay up to date with your COVID-19 vaccine.

Emergency Preparedness: Training and Testing Program Exemption

The following information supersedes the previously issued QSO-20-41-ALL-REVISED memo for all certified providers/suppliers. CMS regulations for Emergency Preparedness (EP) require the provider/supplier to conduct exercises to test their EP plan to ensure that it works and that staff are trained appropriately about their roles and the provider/supplier’s processes. During or after an actual emergency, the EP regulations allow for a one-year exemption from the requirement that the provider/supplier perform testing exercises. The exemption only applies to the next required full-scale exercise (not the exercise of choice), based on the 12-month exercise cycle. The cycle is determined by the provider/supplier (e.g., calendar, fiscal or another 12- month timeframe). The exemption only applies when a provider/supplier activates its emergency preparedness program for an emergency event.

See pages 10-12 of the attached document for updates on other home health and hospice-specific waivers.