Vagus Nerve Stimulation
Vagus Nerve Stimulation:
Helping Your Body Find the Brake Pedal
Vagus Nerve Stimulation
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Helping Your Body Find the Brake Pedal
Your nervous system has two big jobs.
It needs to help you respond when something demands your attention.
And it needs to help you settle back down when the challenge is over.
Sometimes the second part doesn't happen as smoothly as we'd like.
That's where the vagus nerve gets interesting.
Meet the Vagus Nerve
The vagus nerve is one of the largest communication pathways between your brain and your body.
It helps your brain communicate with many important areas, including your:
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Heart
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Lungs
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Throat
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Digestive system
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Other internal organs
It also plays an important role in the part of your nervous system that helps your body rest, recover, digest, and regulate itself.
Think of it a little like the brake pedal in your car.
The gas pedal is important.
But you probably don't want to drive everywhere with your foot stuck on it.
Why Would We Look at the Vagus Nerve?
Your body is constantly adjusting.
Stand up—adjust.
Eat a meal—adjust.
Exercise—adjust.
Get startled—adjust.
Relax afterward—adjust again.
A healthy nervous system needs to be able to move between these different states.
When we evaluate vagal and autonomic function, we aren't simply asking:
“Are you relaxed?”
We're asking:
“How well can your nervous system change gears when it needs to?”
How Do We Work With It?
There are several ways healthcare providers and researchers can interact with pathways associated with the vagus nerve.
Some use electrical stimulation.
In our office, depending on the patient and what we find during the examination, we may also use carefully selected sensory input such as:
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Light or photobiomodulation
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Sound and vibration
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Tuning forks
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Mechanical vibration
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Breathing and movement exercises
Not every tool does the same thing.
And not every patient needs the same tool.
That's why we test first.
What Does Treatment Feel Like?
Usually, pretty easy.
Depending on the technique, you may feel gentle vibration, hear a tone, experience light stimulation, perform a breathing exercise, or receive another form of sensory input.
Then we reassess.
Because our goal isn't simply to stimulate something.
Our goal is to find out:
Did your nervous system respond?
For Those Who Need to Know the “Why”
Your Brain and Body Have a Very Busy Group Chat
The word vagus comes from a Latin word meaning “wandering.”
That's actually a pretty good description.
The vagus nerve begins in the brainstem and travels through the neck into the chest and abdomen, communicating with structures along the way.
It's cranial nerve number ten—CN X if you want to impress someone at dinner.
More importantly, it is a major component of the parasympathetic nervous system.
The Vagus Is a Two-Way Street
People often think of the vagus nerve as the brain sending instructions down into the body.
That's only part of the story.
A large proportion of vagal fibers are afferent.
That means information travels from the body toward the brain.
Your brain is constantly receiving information about what is happening inside you and adjusting its output accordingly.
Heart rate.
Breathing.
Digestion.
Blood pressure regulation.
Swallowing.
Internal organ function.
Inflammatory signaling.
The conversation never really stops.
Thankfully, you don't have to consciously manage it.
Imagine having to remember to adjust your heart rate after lunch.
You already have enough passwords to remember.
Sympathetic vs. Parasympathetic
You've probably heard of fight or flight.
That's associated with sympathetic nervous system activity.
But sympathetic activity isn't bad.
You need it.
If a bear walks into the room, this is not the ideal moment for your nervous system to concentrate on digestion.
The problem isn't having a gas pedal.
The problem is losing access to the brake.
The parasympathetic system—including important vagal pathways—helps regulate functions associated with recovery, digestion, cardiovascular control, and returning toward baseline after a challenge.
The goal isn't to keep someone permanently “parasympathetic.”
The goal is adaptability.
Gas when you need gas.
Brake when you need brake.
And the ability to smoothly move between them.
What Is Vagus Nerve Stimulation?
True vagus nerve stimulation, or VNS, means applying a stimulus intended to influence activity in vagal pathways.
There are several very different ways this can be done.
Implanted VNS
Traditional medical VNS uses a surgically implanted electrical device connected to the vagus nerve in the neck.
This is established medical technology used for specific neurological conditions.
That's not what we're doing during a typical neurologic treatment session in our office.
Noninvasive Cervical VNS
Specialized medical devices can deliver electrical stimulation through the skin over the vagus nerve in the neck.
These devices have been studied for several neurological applications.
Transcutaneous Auricular VNS
Here's where things become especially interesting.
Parts of the outer ear receive sensory innervation from the auricular branch of the vagus nerve.
Researchers can apply controlled electrical stimulation to specific areas of the ear—particularly areas such as the cymba conchae—to investigate whether vagal pathways can be influenced without surgery.
This is called transcutaneous auricular vagus nerve stimulation, or taVNS.
Research into taVNS is growing rapidly, although the best stimulation locations, frequencies, intensities, treatment durations, and clinical applications are still being worked out.