Vagus Nerve Stimulation- Methods, Conditions, Side Effects, and Precautions

Creator: Dr. Lakshmi Aravind
Published: 2023-07-04T16:58:48

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Vagus nerve stimulation is a process of stimulating the nerve manually or electrically to treat some diseases. Read below to know more about it.

Written by

Dr. Lakshmi Aravind

Medically reviewed by

Dr. Abhishek Juneja

July 4, 2023

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Contents

What Is Vagus Nerve Stimulation?
What Are the Different Methods of Vagus Nerve Stimulation?
Which Conditions Are Treated by Vagus Nerve Stimulation?
What Are the Potential Side Effects of Vagus Nerve Stimulation?
Who Cannot Receive Vagus Nerve Stimulation?
What Are the Precautions to Be Taken After Vagus Nerve Stimulation?

Introduction:

The vagus nerve is the largest cranial nerve (12 pairs of nerves in the back of the brain) in humans. It is the main parasympathetic nerve and regulates functions like digestion, respiratory rate, heart rate, coughing, sneezing, vomiting, and swallowing. It also carries information from the gut to the brain and vice versa; hence, playing an important role in gut-brain communication. The vagus nerve helps the brain to monitor different functions in the body. Stimulation of the vagus nerve is done mainly to treat diseases like epilepsy, depression, and stroke.

What Is Vagus Nerve Stimulation?

Vagus nerve stimulation (VNS) is a medical procedure that involves the stimulation of the vagus nerve manually or electrically. The vagus nerve can be stimulated manually by natural methods. In electrical vagus nerve stimulation, a device is implanted that sends mild electrical pulses to the brainstem through the vagus nerve. This electrical device is similar to a pacemaker.

What Are the Different Methods of Vagus Nerve Stimulation?

Vagus nerve stimulation is of two types:

Manual Vagus Nerve Stimulation: Vagus nerve can be stimulated naturally with yoga, meditation, and breathing exercises. Other methods of stimulation are:
- Gargling loudly with water.
- Singing.
- Coughing.
- Laughing.
- Consumption of fiber-rich foods.
- Immersing face in cold water.
- Foot massage.
Electrical Vagus Nerve Stimulation: In electrical vagus nerve stimulation, a pulse generator device is inserted into the patient's chest by surgery under general anesthesia. A small thin lead wire from the device is connected to the vagus nerve. This device produces electrical impulses that are transmitted to the brain at regular intervals throughout the day. Epilepsy, caused due to abnormal electrical activity in the brain, can be controlled using this method. Methods of electrical vagus nerve stimulation are:
- Left Cervical Vagus Nerve Stimulation: In this method, the electrical device is implanted in the left upper chest. The lead wire from the device is connected to the part of the left vagus nerve in the mid-cervical region through an incision in the left neck. The four parameters, such as current charge, pulse width, pulse frequency, and duty cycle, are adjusted by the operator with a handheld computer. The operator can adjust it during operation. Later, the patient can temporarily turn it off by bringing a magnet close to the device. The life of the device depends on parameters. It can be replaced or permanently removed surgically.
- Right Cervical Vagus Nerve Stimulation: This method can treat seizures effectively. Besides, preclinical studies were conducted with right cervical vagus nerve stimulation with some modifications in heart patients. An electrical device implanted in the right chest wall is connected with the right cervical vagus nerve using a cuff to activate vagal efferent fibers, which in turn can affect cardiac function. It was found to be effective in preclinical studies.
- Transcutaneous Vagus Nerve Stimulation (t-VNS): In t-VNS, electrical impulses are targeted at the cutaneous area of the auricular (ear) branch of the vagus nerve. Stimulation is applied to the cymba conchae (part of the external ear) by locating electrodes. Patients can administer t-VNS by themselves by placing electrodes in cymba conchae either on one or both sides. Some clinical studies suggest that besides epilepsy, t-VNS can treat cluster headaches, migraine, and other types of headaches.

Which Conditions Are Treated by Vagus Nerve Stimulation?

Vagus nerve stimulation mainly treats epilepsy, stroke, and depression.

Epilepsy: Epilepsy is a neurological disorder characterized by seizures that occurs due to abnormal electrical activities in the brain. An epileptic patient is advised to undergo vagus nerve stimulation when they don't show any progress with medications. Vagus nerve stimulation, in conjunction with antiepileptic medication, helps in the successful treatment of epilepsy. It is indicated in children above 4 years and adults. The duration of treatment may last for 2 years.
Depression: Depression is a mental illness that goes undiagnosed most of the time. It can be treated with antidepressant medications. Vagus nerve stimulation is advised in patients where antidepressants won't work. It is indicated only in depression patients above 18 years of age. Other mental illnesses like post-traumatic stress disorder (PTSD) can also be treated with vagus nerve stimulation.
Stroke: Vagus nerve stimulation in conjunction with physical therapy helps in stroke rehabilitation by improving upper limb function that has been impaired due to ischemia (reduced blood flow).

Beside these disorders, vagus nerve stimulation has also been found to be effective in treating other disorders, which include Crohn’s disease, rheumatoid arthritis, ulcerative colitis, obesity, diabetes, and migraine.

What Are the Potential Side Effects of Vagus Nerve Stimulation?

Vagus nerve stimulation is considered safe and effective for many people. But, in some patients, it may produce mild complications which are mostly short lasting. Some of them are:

Difficulty in swallowing.
Difficulty in breathing.
Hoarseness in voice.
Nausea or vomiting.
Insomnia.
Neck, ear, and chest pain.
Muscle twitching.
Wound infection.

Who Cannot Receive Vagus Nerve Stimulation?

Vagus nerve stimulation is indicated in untreatable epilepsy, depression, and many more disorders. However, if a patient is having any of the following conditions, then vagus nerve stimulation cannot be performed on them.

History of vagotomy (a surgical procedure that dissects one or more parts of the vagus nerve).
History of schizophrenia, bipolar or delusional disorders.
Suicidal behavior.
Insulin-dependent diabetes mellitus.
Chronic obstructive pulmonary disorders (COPD) and asthma.
Patients with one vagus nerve.

However, vagus nerve stimulation is safe in pregnant and pediatric patients.

What Are the Precautions to Be Taken After Vagus Nerve Stimulation?

A whole-body MRI (magnetic resource imaging) scan cannot be done with a vagus nerve-stimulating device. However, an MRI of the head can be conducted with a transient/receive head coil.
Therapeutic ultrasound is not considered safe, but diagnostic ultrasound is safe.
Cell phones, metal detectors, and other electronic devices should not interrupt the function of the vagal nerve stimulation device.

Conclusion:

Vagus nerve stimulation is a procedure that has been practiced for many decades. The Vagus nerve can be stimulated manually as well as electrically. Stimulating the vagus nerve electrically has been proven to treat many disorders, such as epilepsy, stroke, depression, heart failure, autoimmune disorders, gastrointestinal disorders, and so on. This is because the vagus nerve mediates a lot of functions in our body, such as digestion, respiration, reflex actions, etc. Different methods of vagus nerve stimulation have been developed with advancements in technology, and these methods target treating a specific number of diseases.

Frequently Asked Questions

1. How Is Manual Stimulation of the Vagus Nerve Achieved?

Manual stimulation is applying pressure to certain body spots or gently rubbing the carotid sinus (a small part of the carotid artery in the neck senses variations in blood flow and communicates with the brain to modify blood vessel diameter and heart rate) in the neck. This tactile method encourages relaxation and a parasympathetic reaction by stimulating the vagus nerve. This method must be used carefully because applying too much pressure can have negative effects. It is also a good idea to speak with a healthcare provider.

2. How Is Self-Massage on the Vagus Nerve Performed?

Techniques such as neck and throat muscle relaxation, light neck massage, and auricular branch stimulation are examples of self-massage. By raising the vagal tone, these techniques promote calmness. Including self-massage in everyday life can be a proactive approach to managing stress and improving general health.

3. In What Ways Can Vagus Nerve Be Naturally Repaired?

Deep breathing techniques, meditation, regular exercise, and an omega-3-rich diet are all part of natural restoration. These exercises promote vagal nerve activity and the general health of the nervous system. Developing a regular regimen of these exercises promotes long-term mental and physical resilience in addition to vagus nerve healing.

4. What Are the Triggers for Vagus Nerve?

The vagus nerve is activated by deep breathing, relaxation techniques, singing, laughing, and certain yoga poses. Vagal tone can be improved, and well-being can be enhanced by being aware of and utilizing these triggers. Frequent vagus nerve stimulation facilitates emotional equilibrium, adaptability, and a deeper level of relaxation.

5. What Causes Weakening of Vagus Nerve?

Vagus nerve weakening results from chronic stress, sedentary lifestyles, inflammation, and poor food. Changing one's lifestyle to promote vagal health is made possible by acknowledging these aspects. A nutrient-dense diet, regular exercise, and stress management can all play a major role in gradually strengthening the vagus nerve.

6. Which Organ Regulates the Vagus Nerve?

The medulla oblongata in the brainstem controls the vagus nerve. This nerve's central nervous system regulates heart rhythm, digestion, and general relaxation. The importance of the medulla oblongata in preserving autonomic balance and homeostasis (the body's ability to maintain stable internal conditions despite external changes) is highlighted by its connections to other brain regions.

7. What Occurs When Vagus Nerve Undergoes Stimulation?

A relaxation response is brought on by stimulation, lowering blood pressure, reducing heart rate, and lessening inflammation. This activation encourages the parasympathetic nervous system (aids in the body's ‘rest and digest’ by lowering heart rate and promoting healthy digestion) to take over, which calms the body. In addition to its physiological effects, vagus nerve stimulation has been linked to mood elevation, better sleep, and sharper cognitive performance.

8. How Is Relaxation Induced in the Vagus Nerve?

Progressive muscular relaxation, yoga, meditation, and deep breathing help promote relaxation. By improving vagal tone, these techniques help to maintain a more balanced autonomic nervous system. The vagus nerve benefits from the regular application of relaxation techniques into daily life, forming the basis for general mental and emotional health.

9. In What Manner Can Vagus Nerve Be Tested at Home?

At-home testing includes deep breathing exercises, heart rate variability monitoring, and self-evaluation of vagal tone symptoms. These easy measurements shed light on the function of the vagus nerve. A more accurate picture of vagal health can be achieved by consulting a healthcare expert for a thorough assessment, even though home testing might provide useful information.

10. Which Vitamin Aids in Healing the Vagus Nerve?

The myelin coating and general nerve function are supported by vitamin B12, which is essential for nerve health. Sufficient intake of B12 aids in the vagus nerve's mending process. A diet rich in foods like meat, fish, and dairy must contain vitamin B12 to keep nerve function at its best.

11. What Foods Contribute to Healing the Vagus Nerve?

Probiotics, leafy greens, and fatty salmon all have nerve-nourishing and anti-inflammatory qualities. Consuming these foods increases general well-being and the health of the vagus nerve. Reducing processed foods and carbohydrates can also help the healing process by lowering oxidative stress and inflammation.

12. How Can the Overactive Vagus Nerve Be Calmed?

Relaxation methods, trigger avoidance strategies, and stress reduction approaches are all part of calming. Taking a comprehensive approach is one way to calm and balance a hyperactive vagus nerve. Including exercises like Tai chi or biofeedback training can give patients more tools to control their overactive vagus nerve.

13. What Methods Are Effective in Soothing the Vagus Nerve?

Deep breathing techniques, mindfulness meditation, and light neck massages work well to calm the vagus nerve. These techniques improve vagal tone and encourage relaxation. Incorporating these techniques with consistent exercise and a well-rounded diet can result in a holistic strategy for vagal health.

14. How Is an Irritated Vagus Nerve Addressed?

Identifying and avoiding triggers, putting stress-reduction strategies into practice, and upholding a healthy lifestyle are all part of addressing irritation. The vagus nerve can return to equilibrium and improve general health by reducing irritants. Reducing irritation and promoting vagal health may also be aided by establishing regular sleep habits and using adaptogenic herbs.

Sources

Dr. Abhishek Juneja

Neurology

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