Targeted Neuroplasticity Training to Accelerate Complex Skill Learning

Military personnel are required to utilize a wide variety of complex perceptual, motor, and cognitive skills under challenging conditions. Mastery of these difficult skills, including fluency in foreign languages, requires thousands of hours of practice. Intensive training is time consuming, financially burdensome, and fails to effectively improve performance in some individuals. The development of an optimized strategy to accelerate learning of complex skills would significantly reduce required resources and simultaneously enhance operational capabilities. Neuroplasticity (i.e., changes in neural networks) underlies learning of complex skills. Recent developments in neuroscience indicate that neuromodulation strategies that engage brain regions that regulate learning and could greatly accelerate learning rates. We have developed a revolutionary strategy that leverages peripheral nerve stimulation to enhance neuroplasticity and support learning. This technique uses vagus nerve stimulation (VNS) to release known pro-plasticity neuromodulators following a correct trial to specifically reinforce those neural networks that were involved in performing the particular task. This targeted neuroplasticity training (TNT) paradigm provides specificity to direct plasticity in relevant circuits, while allowing flexibility to accelerate learning in a variety of motor, sensory, and cognitive training paradigms. To date, we have directed this powerful technology to enhance rehabilitative training to boost recovery of skills lost as a result of neurological injury or disease. In the past five years, we have demonstrated success in preclinical development of VNS-based neuroplasticity therapies for tinnitus, traumatic brain injury, peripheral nerve injury, spinal cord injury, stroke, intracerebral hemorrhage, and PTSD1-9. Based on our promising preclinical results and a long-track record of safety, we have successfully translated VNS-based targeted plasticity into clinical trials in human patients of stroke and tinnitus10-16. The incredible promise of this technology has been highlighted in preeminent scientific and clinical journals, including Nature and the New England Journal of Medicine1,17. This proposal outlines an aggressive plan to leverage vagus nerve stimulation technology to accelerate language learning. Language learning provides an ideal testbed for evaluation, development, and optimization of this TNT paradigm because it requires improvement across multiple cognitive domains, including perception, skilled motor function, comprehension, and decision-making. We will assess the ability of TNT to accelerate learning and enhance performance in these domains and test generalizability of improvement to similar functions, a core component of learning. Although the primary emphasis is on language learning, neural plasticity is a universal substrate of learning and the ability of TNT to accelerate learning will likely generalize to other complex skills.