MicroTransponder
Rethinking Stroke Recovery with Vagus Nerve Stimulation

For millions of stroke survivors, recovery no longer means settling for physical limitations; it can mean breaking through them. Where progress once plateaued after traditional physical and occupational therapy, a new approach is helping patients move beyond that barrier.

MicroTransponder^®, Inc., a commercial-stage medical technology company, is changing the lives of stroke survivors with the Vivistim^® Paired VNS™ System—a medical device that pairs vagus nerve stimulation (VNS) with rehabilitative stroke therapy. By harnessing the brain’s natural ability to rewire, MicroTransponder offers patients a powerful path to healing, renewed confidence, lasting independence, and something often in short supply: real, measurable progress.

At the helm of the company driving this meaningful breakthrough is CEO Richard Foust, a leader who has transformed MicroTransponder from a research-based startup into a commercial-stage pioneer in stroke care.

“We are not tweaking an old system—we have created a new one. We spent years developing a patented mechanism that pairs vagus nerve stimulation with occupational and physical therapy to help stroke survivors regain upper limb function well beyond what they had been limited to with traditional therapy,” explains Foust.

A Scientific Breakthrough

The foundation of MicroTransponder’s innovation was laid over a decade ago, when a landmark paper in Nature outlined a new approach to rewiring the brain. The therapy is based on the principle of neuroplasticity—the brain’s ability to reorganize and form new connections. Stimulating the vagus nerve during functional activities that were lost as a result of stroke helps stroke survivors accelerate motor recovery by strengthening the appropriate neural pathways.

Traditional stroke therapies rely on repetition to help patients regain arm and hand function, but progress often stalls. MicroTransponder’s system offers an evidence-based therapy to help stroke survivors regain meaningful improvements in arm and hand function.

VNS is FDA-approved for the treatment of epilepsy and depression and has been implanted in more than 150,000 patients worldwide. Unlike VNS for epilepsy and depression, MicroTransponder’s technology is based around the concept of targeted or paired plasticity, i.e., delivering VNS in conjunction with movement to enhance neuroplasticity. But how does the vagus nerve do this? The vagus nerve is a communication superhighway that connects the brain to various organs in the body and transmits information about the state of the body to the brain. VNS activates areas of the brain that are important for learning, attention and motivation. When repeatedly paired with a specific movement or functional task, it strengthens the brain connections involved in that task, making long-lasting connections that make it easier to learn and remember how to do the task.

Paired VNS is a useful therapeutic intervention for stroke and potentially for a host of chronic neurological conditions.

This well-designed idea became a real-world, evidence-based option for millions of chronic stroke survivors in 2021 when the Vivistim System received FDA approval. The green light came after a rigorous, triple-blinded, sham-controlled crossover trial, published in The Lancet, which revealed compelling results that patients receiving Vivistim’s therapy improved two to three times more than those undergoing rigorous upper limb therapy that is well beyond the standard of care.

Validating the long-term effectiveness of Vivistim Therapy™, a one-year follow up analysis study published in Stroke demonstrated that stroke survivors treated with Paired VNS™ Therapy for upper extremity deficits post-stroke maintained improvements in function, activity, participation and quality of life for at least one year after completing the course of therapy and utilizing self-directed therapy outside of the clinic.

A Simple System, a Powerful Impact

Despite its cutting-edge approach, implementing the Vivistim System is surprisingly straightforward. An implantable pulse generator is surgically placed in the chest and a lead or wire is connected to the vagus nerve on the left side. Once the patient recovers from the short procedure, physical or occupational therapy begins. During each session, a therapist triggers stimulation by pressing a handheld remote, delivering electrical signals to the vagus nerve while the patient performs functional tasks. The effect is transformative.

Rather than reinforcing compensatory movements, Vivistim enhances task-specific plasticity, enabling the individual to relearn natural, functional movements that were lost as a result of the stroke and promoting long-lasting neurorestorative effects.

The impact of Vivistim therapy extends far beyond the clinical measures like improved test scores and functional assessments. For stroke survivors, it’s often about reclaiming deeply personal experiences—writing, drawing, cooking, or simply holding a loved one’s hand.

One powerful story comes from Kathy, a grandmother who, after a stroke, couldn’t write. Her dream was to send handwritten letters to her grandchildren. Just six weeks into therapy, she went from drawing illegible scribbles to writing complete sentences and sent a heartfelt thank-you note to her therapist. A year later, she continues to improve.

Then there’s the story of a 22-year-old art student who had her dominant side incapacitated after a stroke. Her father, a physician, learned about MicroTransponder by researching options for his daughter. After Vivistim Therapy, she regained the ability to draw. She now shares pictures of herself eating sushi with chopsticks—a symbol of regained dexterity and personal triumph.

These stories are not outliers. Across the country, patients and therapists are discovering and implementing a new standard of care that empowers profound change in stroke survivors rather than forcing them to accept limitations of their condition. Therapists, in particular, have been energized by the results. They are often the first to witness the frustrating limits of traditional therapy, and they now have a tool that helps push patients beyond the plateau.

Changing the System

Despite the success stories and FDA approval, MicroTransponder faces one of the toughest challenges in healthcare: changing the status quo. Stroke care has traditionally focused on the acute phase—life-saving emergency response, hospitalization, and early recovery. Once patients leave the hospital, support dwindles and is disconnected.

“Medical advancements have made it so that more people survive strokes. Now, we have to think about stroke recovery beyond the acute crisis,” says Foust. “We are transforming chronic stroke interventions with Vivistim so that recovery doesn’t end at discharge—it starts there.”

MicroTransponder isn’t just offering a new therapy. It’s advocating for a new model in which stroke is treated like a chronic condition, with long-term management, continuous support, and scalable therapies. Like cardiology, which has evolved to include lifelong patient monitoring and care, stroke therapy and recovery must extend beyond the hospital walls.

Raising Awareness, Expanding Access

The company’s biggest hurdle isn’t competition—it’s awareness. Vivistim is the only FDA-approved device of its kind, but many physicians, therapists, and insurers still don’t know this option exists. The FDA designated Vivistim as a Breakthrough Device, and Medicare granted traditional pass-through payment status, reinforcing its clinical significance and supporting hospital access. While most commercial insurers require prior authorization, many have not yet established formal coverage policies, resulting in inconsistent access. MicroTransponder is focused on fostering engagement, growing clinical evidence and demonstrating real-world adoption to generate widespread payer adoption.

“There are far more people who don’t know we exist than do,” says Foust. “Our main focus right now is building awareness and expanding access.”

MicroTransponder is expanding strategically across the U.S., ensuring more stroke survivors have access to Vivistim Therapy. As it grows, the company is also laying the groundwork for international expansion, though the initial focus remains domestic. Each new facility or clinic that adopts the system represents a new opportunity to shift the narrative around stroke care in the U.S.

The Beginning of Something Bigger

With strong clinical evidence, passionate healthcare partners, and inspiring patient outcomes, MicroTransponder is poised to redefine the future of stroke recovery.

It’s not just about function—it’s about freedom. By giving patients a tool that brings movement and momentum, MicroTransponder proves that real transformation is possible by harnessing the body’s healing potential.