Vagus Nerve Stimulation [2024]: VNS Guide |How It Works|Side Effects|Recovery|Results

May 9, 20248 min
Vagus Nerve Stimulation

Have you ever felt an overwhelming sense of being on high alert?

Your heart races, palms turn clammy with sweat—and it's not because you’re running late or there is a threat of a grizzly bear. It's just your nerves shifting into overdrive. 

Now, what if you were told that nestled within us is a superhero nerve—a power player capable of soothing our internal chaos and pacifying the turmoil with no external instructions? 

It is the vagus nerve, our body's unsung chill master and a pivotal player in the parasympathetic nervous system, and the method of stimulating it is explored in this article. 

Vagus Nerve Stimulation, or VNS for short, is an interesting way to treat mental health issues like depression. People are paying more attention to it because it can improve conditions such as depression when other treatments do not work, epilepsy, and also help people get better after having a stroke. 

Nonetheless, it is essential to understand how VNS functions, its benefits, potential side effects, and the recovery process involved in order to be well informed about whether or not it is the method you should look to adapt. 

What is Vagus Nerve Stimulation? 

The vagus nerve is among the twelve pairs of cranial nerves, sending electrical signals from the brain to different parts of the neck, head, and body trunk. It has a critical function in managing many activities of the body such as digestion, heart rate, and respiratory rate. 

Vagus Nerve Stimulation (VNS) is a special type of technique that changes nerve activity. It works by giving steady, gentle electric shocks to the vagus nerve in the neck.

These electric messages go to the brainstem and then move to different areas of the brain, changing how brain cells work. VNS is commonly called a "brain pacemaker" because it works in a way that's much like how a heart pacemaker does. 

What are the symptoms of an overstimulated vagus nerve? 

An overstimulated vagus nerve can exhibit a range of symptoms. These can include: 

  1. Difficulty in swallowing or speaking 
  2. Rapid or irregular heart rate
  3. Abdominal pain 
  4. Nausea and vomiting 
  5. Unintentional weight loss 
  6. Acid reflux 
  7. Dizziness or fainting 

If you experience any of these symptoms, you should consult with a doctor, as these are common symptoms of an overstimulated vagus nerve. 

How Vagus Nerve Stimulation Works? 

To understand how VNS works, it's important to know the anatomy of the vagus nerve and how electrical impulses are delivered to it. 

The anatomy of the vagus nerve 

The vagus nerve, also known as cranial nerve X, is the longest cranial nerve. It starts at the brainstem and passes through the neck to the chest and abdomen. This nerve is part of a circuit that links the neck, heart, lungs, and abdomen to the brain. 

How electrical impulses are delivered to the vagus nerve? 

VNS involves implanting a device that sends regular, mild pulses of electrical energy to the brainstem through the vagus nerve in the neck. After reaching the brainstem, the electrical charge is discharged to different areas of the brain to change the way brain cells work. 

How the brain is affected by vagus nerve stimulation?

VNS changes the amount of certain neurotransmitters in the  your brain which  , this has an impact on mood, and seizure formation, how seizures form and also helps stimulatione of the motor cortex during stroke recovery. 

For epilepsy, VNS may help with better blood flow to important parts of the brain, change the disorderly electrical pattern happening during a seizure, and raise levels of neurotransmitters like norepinephrine and serotonin that could control how seizures develop.

To manage depression, VNS is thought to change the amount of certain neurotransmitters in the brain that affect mood control. 

In the context of stroke recovery, VNS is thought to spark activity in the area of the brain known as the motor cortex. This controls arm and hand movement. 

What are the benefits and uses of Vagus Nerve Stimulation surgery? 

VNS surgery offers many advantages that vary with the particular illness being treated. For people who have epilepsy, VNS can reduce the number and strength of seizures. It is especially good for those who do not get better with seizure medicines. 

VNS is a helpful tool for rehabilitation in people recovering from an ischemic stroke who have experienced moderate to severe loss of function in their arms and hands. Vagus Nerve Stimulation changes the amount of certain brain chemicals that manage mood, prevent seizures, and help with muscle control recovery after a stroke. 

The VNS surgery can offer relief from depressive symptoms in instances where psychotherapy and medicines are not working effectively. 

The U.S. Food and Drug Administration (FDA) has approved the use of VNS for three primary purposes: 

1.Epilepsy:

 VNS is approved as an adjunctive therapy for focal (partial) seizures in adults and children aged four and older when medications have been ineffective in managing seizures.

2.Stroke Rehabilitation: 

VNS is approved as an add-on to rehabilitation therapy for people who have moderate to severe loss of arm and hand function due to ischemic (blocked blood flow) stroke. 

3.Depression:

VNS is approved for adults aged 18 and above who have chronic or recurrent major depression and haven't responded to four or more antidepressant treatments. 

Who is a Good Candidate for Vagus Nerve Stimulation? 

VNS is only for certain people who do not get better with usual treatments. Those who have epilepsy, need help after a stroke or whose depression does not improve with standard therapies are the main ones who might use VNS. 

1.Epilepsy 

VNS is especially helpful for people who have focal seizures that do not improve with anticonvulsant drugs. 

2.Stroke Rehabilitation 

VNS might be suggested as an additional treatment to therapy for rehabilitation in people who have had a stroke caused by lack of blood flow and are now facing significant difficulties with arm and hand movements.

3.Treatment-Resistant Depression 

Adults who are 18 years old or oldermore and suffer from long-term or returning serious depression that has not improved after trying at least four different antidepressant medications might be eligible for VNS treatment. However, It is very important to talk with a medical professional to know if VNS therapy suits your condition., though. 

Who shouldn't get VNS? 

VNS may not be appropriate for everyone. You ideally should not consider getting VNS if you are:

  1. Pregnant 
  2. Have respiratory issues
  3. Active peptic ulcer disease 
  4. Insulin-dependent diabetes mellitus 
  5. Only one vagus nerve
  6. Dysautonomias
  7. Are receiving other forms of brain stimulation 
  8. Have heart arrhythmias or other heart abnormalities 
  9. A history of schizophrenia
  10. Schizoaffective disorder
  11. Delusional disorders
  12. Rapid cycling bipolar disorder 
  13. Previous surgery to the left neck involving removal of part of the vagus nerve

Implantation and Programming of the Device to Improve Mood 

The process of implanting and programming the VNS device involves several steps.

Preparing for VNS treatment 

Before surgery, your doctor will conduct a physical examination and may order blood tests to determine your health status. The procedure can typically be performed as an outpatient procedure, but some surgeons may recommend an overnight stay. 

During the VNS treatment 

The surgery involves making two incisions, one on the left side of the neck to expose the vagus nerve, and the other on the upper left chest. The electrodes at the end of the lead wire are gently wrapped around the left vagus nerve through the neck incision. The wire is then guided from the neck to the chest incision, where it's connected to a battery implanted in a pocket made over the muscle. The device is tested to ensure it's stimulating the vagus nerve properly. 

After VNS treatment 

Following the surgery, you'll need to visit your doctor after two to four weeks to turn on or adjust the stimulation if it's already been turned on. The device is programmed using a computer, software, and a programming wand.

How to stimulate your vagus nerve? 

There are ways to stimulate your vagus nerve at home and through specific exercises. However, these methods should be carried out under the guidance of a doctor. 

In-Home - VNS

Stimulation at home usually involves using a handheld magnet to swipe over the device to send extra stimulation to the brain if a seizure is about to occur or during home rehabilitation exercises following a stroke. 

By exercise - VNS

Certain exercises can also stimulate the vagus nerve. These exercises should be performed under the guidance of a trained professional. 

What happens when the vagus nerve is Stimulated/triggered? 

When the vagus nerve is stimulated, it influences various physiological processes. It can help control seizures in people with epilepsy, alleviate symptoms in people with depression, and aid in stroke rehabilitation by stimulating the motor cortex of the brain. 

What are the Side Effects and Risks of Vagus Nerve Stimulation?

While VNS offers several potential benefits, it's also associated with certain side effects and risks.

1.Will coughing affect implantation 

Coughing shouldn't affect the implantation of the VNS device. However, if you experience persistent coughing following the procedure, you should consult with your doctor. 

2.Common side effects of vagus nerve stimulation 

Common side effects include a tickling sensation in the throat or neck, hoarseness, mild cough, and voice changes when the stimulation is on. 

3.Serious side effects and risks of vagus nerve stimulation 

Some of the serious side effects and risks include vocal cord paralysis, infection, Horner’s syndrome, muscle weakness in the lower face, cardiac arrest, and mechanical complications like a break in the lead wire or device malfunction. 

How side effects and risks are managed 

If you experience any side effects from VNS, it's crucial to consult with your doctor. They can adjust the programming to lower the amount of stimulation or temporarily or permanently turn off the device. 

What are alternative treatments for epilepsy, depression, and stroke rehabilitation? 

Although VNS looks hopeful in dealing with various conditions, it's not the only choice. For epilepsy, depression, and stroke rehabilitation there are other possible treatments like drugs, psychotherapy, or diverse methods of stimulating the brain. We should consider these options under a healthcare expert's direction. 

Can stimulating the vagus nerve improve mental health?

Stimulating the vagus nerve has also been shown to have potential benefits for mental health. It's believed to alter the level of specific neurotransmitters in the brain that play a role in regulating mood, thereby potentially helping to alleviate symptoms of depression and anxiety

Conclusion 

Vagus Nerve Stimulation, with its possible side effects and dangers, is showing much promise as a treatment method for some neurological and mental conditions. Even though it has risks involved, the advantages it offers in handling hard-to-treat problems like epilepsy or depression as well as helping stroke recovery make this therapy beneficial. 

But, it's important to always remember that VNS is not a good fit for all people. Those who are thinking about using this treatment must talk with their doctor first to learn if it's the correct choice for them. 

In the future, as research goes on, the application of VNS might be extended to treat additional conditions and give more people relief. 

Knowing VNS's workings and possibilities can offer fresh approaches to treatment, as well as assist people in making wise choices about their healthcare. 

Given the fast progress in medical technology, there is a lot of potential for VNS and we can expect exciting advancements in this area. 

Author's Profile picture
Mave
Clinical Psychologist