Vagus Nerve Stimulation And Inflammation

Non-Invasive Vagus Nerve Stimulation Conceptual Representation
Non-Invasive Vagus Nerve Stimulation Conceptual Representation

Vagus Nerve Stimulation

Vagus nerve stimulation (VNS) is a medical treatment that is routinely used in the treatment of epilepsy and other neurological conditions. VNS studies are not just clinically, but also scientifically informative regarding the role of the vagus nerve in health and disease.

Vagus Nerve Stimulation Device and Method

Non-Invasive Vagus Nerve Stimulator Attached to the Auricular Concha via Ear Clip
Non-Invasive Vagus Nerve Stimulator Attached to the Auricular Concha via Ear Clip

Vagus nerve stimulation works by applying electrical impulses to the vagus nerve. The stimulation of the vagus nerve can be performed in two different ways: a direct invasive stimulation, which is currently the most frequent application and an indirect transcutaneous non-invasive stimulation. Invasive VNS (iVNS) requires the surgical implantation of a small pulse generator subcutaneously in the left thoracic region. In contrast to iVNS, transcutaneous VNS (tVNS) allows for a non-invasive stimulation of the vagus nerve without any surgical procedure. Here, the stimulator is usually attached to the auricular concha via ear clips and delivers electrical impulses at the subcutaneous course of the afferent auricular branch of the vagus nerve (2).

A pilot study that examined the application of VNS in 60 patients with treatment-resistant depressive disorder showed a significant clinical improvement in 30–37% of patients and a high tolerability (3). Five years later, the stimulation of the vagus nerve for the treatment of refractory depression was approved by the U.S. Food and Drug Administration (FDA) (4). Since then, the safety and efficacy of VNS in depression has been demonstrated in numerous observational studies as can be seen below. In contrast, there is no randomized, placebo-control clinical trial that reliably demonstrates antidepressant effects of VNS.

The vagus nerve represents the main component of the parasympathetic nervous system, which oversees a vast array of crucial bodily functions, including control of mood, immune response, digestion, and heart rate. It establishes one of the connections between the brain and the gastrointestinal tract and sends information about the state of the inner organs to the brain via afferent fibers. In this review article, we discuss various functions of the vagus nerve which make it an attractive target in treating psychiatric and gastrointestinal disorders. There is preliminary evidence that vagus nerve stimulation is a promising add-on treatment for treatment-refractory depression, posttraumatic stress disorder, and inflammatory bowel disease. Treatments that target the vagus nerve increase the vagal tone and inhibit cytokine production. Both are important mechanism of resiliency. The stimulation of vagal afferent fibers in the gut influences monoaminergic brain systems in the brain stem that play crucial roles in major psychiatric conditions, such as mood and anxiety disorders. In line, there is preliminary evidence for gut bacteria to have beneficial effect on mood and anxiety, partly by affecting the activity of the vagus nerve. Since, the vagal tone is correlated with capacity to regulate stress responses and can be influenced by breathing, its increase through meditation and yoga likely contribute to resilience and the mitigation of mood and anxiety symptoms.

VNS In Inflammatory Bowel Disease (IBD)

Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin (5) and intestinal inflammation (6). The VNs also indirectly modulates immune activity of the spleen through connections with the splenic sympathetic nerve (7). In rats with colonic inflammation, the 3-hour long daily VNS for a period of 5 days led to a reduction in inflammatory markers and an improvement in symptoms of colitis (8).

Vagus nerve stimulation should be of interest in other inflammatory diseases, such as rheumatoid arthritis, another TNF-α-mediated disease. In patients with rheumatoid arthritis, a study that demonstrated an improvement of symptoms in the early and late stages of the disease through 1–4 minutes of VNS daily (9). This study was also the first to show that VNS inhibits the production of TNF-α (also known as TNF-alpha) and other cytokines in humans by stimulating the inflammatory reflex, leading to an improvement of symptom severity. These data argue for an anti-inflammatory role of the vagus nerve and provide potential therapeutic applications for patients with IBDs (10, 8, 11).

Conclusion

The interaction between the gut and the brain is based on a complex system that includes not only neural but also endocrine, immune, and humoral links.

The vagus nerve is an essential part of the brain–gut axis and plays an important role in the modulation of inflammation, the maintenance of intestinal homeostasis, and the regulation of food intake, satiety, and energy homeostasis. An interaction between nutrition and the vagus nerve is well known, and vagal tone can influence food intake and weight gain.

Moreover, the vagus nerve plays an important role in the pathogenesis of psychiatric disorders, obesity as well as other stress-induced and inflammatory diseases.

Vagus nerve stimulation and several meditation techniques demonstrate that modulating the vagus nerve has a therapeutic effect, mainly due to its relaxing and anti-inflammatory properties.

Extinction paired with VNS is more rapid than extinction paired with sham stimulation. As it is currently approved by the Federal FDA for depression and seizure prevention, VNS is a readily available and promising adjunct to exposure therapy for the treatment of severe anxiety disorders.

Vagus nerve stimulation is an effective anticonvulsant device and has shown in observational studies antidepressant effects in chronic treatment-resistant depression. Because the vagus nerve sends information to brain regions is important in the stress response (LC, orbitofrontal cortex, insula, hippocampus, and amygdala), this pathway might be involved in perceiving or manifesting various somatic and cognitive symptoms that characterize stress-related disorders.

Psychotropic drugs, such as serotonin reuptake inhibitors, have effects on both the brain and the gastrointestinal tract and consequently should be understood as modulators of the brain–gut axis.

Research investigating the interaction between nutritive factors, somatic factors, such as heart rate, psychological and pharmacological treatments, and vagal activity has the potential to lead to integrative treatment options that incorporate VNS, nutritional approaches, drugs, and psychological interventions, such as mindfulness-based approaches, which can be tailored to the needs of the individual patient.

A Final Thought About Vagus Nerve Stimulation And CES

Cranial Electrotherapy Stimulation (CES) has been engaging Vagus nerve stimulation for decades, through the use of ear clips to stimulate the nerve endings in the ears. Recent data from clinical studies and practical application reflect the positive results that may be gained by applying low amplitude, extremely low frequency (ELF) electric currents, through the Vagus nerve system. The CES Ultra cranial electrotherapy stimulator device incorporates both ELF and ear clip attachments, as part of its standard application to treat anxiety, depression, and insomnia without medication.

Get Your Own CES Ultra for only $299

Citations

  1. Frontiers in Psychiatry – Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders (original publication)
  2. National Center for Biotechnology Information, U.S. National Library of Medicine – Effect of transcutaneous auricular vagus nerve stimulation on major depressive disorder: A nonrandomized controlled pilot study
  3. Springer Nature – Vagus Nerve Stimulation (VNS™) for Treatment-Resistant Depression: Efficacy, Side Effects, and Predictors of Outcome
  4. ScienceDirect® – Safety and efficacy of Vagus Nerve Stimulation in treatment-resistant depression. A systematic review
  5. Springer Nature – Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin
  6. Springer Nature – Stimulation of the vagus nerve attenuates macrophage activation by activating the Jak2-STAT3 signaling pathway
  7. American Association for the Advancement of Science – Acetylcholine-Synthesizing T Cells Relay Neural Signals in a Vagus Nerve Circuit
  8. ScienceDirect – Anti-inflammatory effect of vagus nerve stimulation in a rat model of inflammatory bowel disease
  9. PNAS – Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis
  10. The Physiological Society – Anti‐inflammatory properties of the vagus nerve: potential therapeutic implications of vagus nerve stimulation
  11. Clinical Medicine Insights: Gastroenterology – Bioelectrical Stimulation for the Reduction of Inflammation in Inflammatory Bowel Disease
  12. CES Ultra – The Role of CES in Fighting Inflammation
  13. CES Ultra – Non-Drug Relief From Anxiety.

Last Modified: December 4, 2019

Global Market place recognizes Cranial Electrotherapy devices

ces-global-market

With the increasingly stressful lifestyle there is also rise in other types of disorders such as anxiety and sleep disorders. With the lack of sufficient treatments that address these disorders, cranial electrotherapy stimulation comes as an innovative and required treatment.

Cranial Electrotherapy Stimulation (CES) device is a small device that stimulates the cranium and brain with a current less than 4 mA, which cannot be sensed by the patient. The cranial electrotherapy stimulation is approved by the FDA for the treatment of insomnia, depression and anxiety. Besides, it has potential application in the treatment of a number of disorders such as attention deficit hyperactivity disorder (ADHA), obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), cognitive dysfunction, traumatic brain injury, pain, enhancing attention and concentration, and for reducing assaultive behavior.

A relatively large number of the population across the globe is diagnosed with such disorders. A significant portion of the U.S. population is affected by poor mental health, which leads to development of various kinds of mental health disorders. The treatment method is complementary and an alternative of medicine. There are large number of clinical trials currently active, which have proved the CES device as an effective treatment method. For an instance, as of 2017 the Sham Cranial Electrotherapy Stimulation by Electromedical Products International Inc. is under clinical trial and is currently recruiting candidates for the same.

The increasing number of cases of poor mental health with the development of disorders such as depression, anxiety and other sleep disorders is driving the growth of the market. Although animal studies have proved this device to be effective, the adoption of these devices is affected due to lack of strong evidence in humans proving the efficacy of the devices in all or most of the cases. However, there are a number of new clinical trials in the recruiting stage, which may help fill the gap in the market.

Use of Cranial Electrotherapy Stimulation in Hospitals and the Growing Demand of Wearable Type of Devices
There are various types of cranial electrotherapy stimulator devices and they can be broadly classified based on the type of electrode placement, such as invasive or transcranial and non-invasive or wearable. The wearable type is the dominant segment in the market. The wearable type device is user-friendly and does not requires surgical insertion of the electrode. Most of the FDA-approved devices are suitable for the treatment of insomnia, depression and anxiety, as the prevalence of these disorders is increasing, in which depression is the most common and growing disorder in the young population. Since most of these devices are available only in prescribed hospitals and mental health clinics, they have a large scope as end-use segments in the market.

Regional Market Outlook

North America has a large number of mental health cases, which has increased the use of the device in the region. Also, growing awareness regarding the treatment of mental health along with technological advancements make North America a potential market for electrotherapy stimulation devices. Likewise, growing awareness in other regions such as Asia Pacific, there is a scope for rapid development in the region.


There are three major cranial electrotherapy stimulation devices, namely the CES Ultra by Neuro-fitnesss LLC, Alpha-Stim M and the Alpha-Stim AID by Electromedical Products International (EPI), and the Fisher-Wallace Simulator. Other FDA-approved products include BR-2 Biorest (Biorest Inc), Biotron 18 (Biotronics Corp), Elexoma Medic (Redplane AG), FM 10/C (Johari Digital Healthcare Ltd.), and HP-1 Heathpax or Nurtipax (Health Directions Inc), among others.

REF:> digitaldaynews.com | by Div Kolher

The history of the medical use of electricity

electric sleep machine

The history of the medical use of electricity goes back more than 2000 years.  In AD 46, the Roman physician, Scribonius Largus wrote his Compositiones Medicae,  recommending patients stand on a live black torpedo fish to relieve gout and other pain.  To do this they waded out into shallow water in the ocean and stood on the fish (presumably against its will).

Much later, Claudius Galen (131-201 AD) was still recommending the use of shock from electrical fish for various medical therapies.  Galen’s word was “law” in medical circles for several thousand years, as was his recommended use of electric fish.

Electricity was not generally known and used separately (from fish) in medicine until the 1700s, when various medical devices were developed and used.  An earlier researcher developed an electrical device that could be used to shock a heart that had stopped beating into beating again.  The church stopped that treatment very quickly by saying that bringing dead people back to life was the work of the devil.

By the time John Wesley and his brother and their friends left the Anglican Church and began Methodism which took the Word directly to the people in the streets of London, they also set up medical clinics for the treatment of the indigent.  In each of those clinics they installed electrical treatment devices.

By the turn of the 20th century, the vast majority – some say more than 90% – of physician’s offices in large U.S. cities, such as New York City, had electrical treatment devices on hand.

CES from the early 1900s to 1953 and beyond

While electricity had been used in medicine for some time, in the early 1900s researchers in Europe began trying to find a way to use electricity to put people to sleep.  They tried different pulse rates, various intensities of stimulation, direct and alternating (biphasic) current and so forth.  They found that if they used a strong enough current, they could put patients into unconsciousness, but the patient tended to regain consciousness the minute the current was turned off.

electrosleep

In 1953 Russian scientists began using 100 pulses per second, limited to from 1 to 4 milliamperes of current, which tended to relax patients and allow them to proceed to a restful sleep.  Current was passed through the head with an electrode over each closed eyelid and one over each mastoid process behind the ears.  The device was the Somniatron, and the treatment was called “electrosleep.”

Chionophobia and how to cope with it

ces-snow-phobia

Chionophobia, or intense fear of snow, is a type of phobia categorized as a natural environment phobia.

The word originates from Greek chion meaning snow and phobos meaning fear, aversion or dread. People with Chionophobia often understand that their fear is unfounded and weird. However, they are unable to control it.

Overview

Chionophobia is not just a dislike of snow or a rational fear of severe weather forecasts, it is an irrational fear of snow that is typically linked to a fear of bodily harm or death. Though phobias can and do manifest themselves differently in different people’s experiences, there are typically two primary fears behind chionophobia: the fear of becoming snowbound and the fear of being stranded in snow.

Symptoms

Like all phobias, the fear of snow may cause a variety of symptoms. Paying undue attention to weather reports, refusing to leave home during snowy weather, and experiencing panic attacks are extremely common in people with chionophobia. For people with true chionophobia, the mere forecast of a winter storm or snowfall can induce physiological symptoms of fear and anxiety-like cold sweats, panic attacks, and even an unrealistic feeling of doom and dread.

Coping

The best methods for coping with the fear of snow depend on the severity and the level of impact that your fear has on your life. Some people find that becoming educated about different types of snow and their effects on local conditions can calm their fears. Others find that gradual exposure to winter activities is calming. If your fear is severe or life-limiting, however, seek the guidance of a trained mental health professional. Winter weather is a fact of life, but with proper assistance and hard work, there is no reason for it to seriously curtail your life when faced with snowy winter weather.

Living with chionophobia is not easy, especially during the winter or in places where snow is the way of life. Friends and family may ignore the phobia, thinking the sufferer is attention seeking. However, for the phobic, this is a real and serious phobia that interferes with your everyday life.

According to a study carried out by the American Meteorological Society, chionophobia is the second most prevalent natural environment phobia subtype.

If you are anxious about a snow storm coming, and your anxiety is becoming greater and greater – do not wait until it reaches the level of a phobia. You can use Cranial Electrotherapy neuro stimulation to reduce anxiety. CES balances your brain’s chemistry, allowing you to be at peace with yourself again. Many experience this immediately in the course of treatment; others, hours, or several days after. CES leaves you feeling both relaxed and alert. The effect differs from pharmaceutical treatments in that people report their body as feeling lighter and more relaxed and their mind, more alert and clearer. Results are cumulative and lasting. And unlike drugs, CES has no negative side effects. It is non-addictive and you can use it safely as often as you like.

ref:> verywellmind.com, cesultra.com

Snowed in with CES Ultra

ces-snowing

It’s snowing again. CES Ultra’s employees are fighting the snow in their cars trying to reach the office. Good luck everyone. Drive safe. Or simply stay at home, grab your CES Ultra and relax on a sofa.