Vagus Nerve Stimulation
- 1st Edition - November 16, 2024
- Imprint: Academic Press
- Editors: Peter Staats, Cenk Ayata, Imanuel Lerman, Alaa Abd-Elsayed
- Language: English
- Hardback ISBN:9 7 8 - 0 - 1 2 - 8 1 6 9 9 6 - 4
- eBook ISBN:9 7 8 - 0 - 1 2 - 8 1 6 9 9 7 - 1
In the complex realm of our physiology, the vagus nerve stands as a silent orchestrator, influencing health and disease in ways that have long been underestimated. Vagus Nerve… Read more
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Request a sales quoteIn the complex realm of our physiology, the vagus nerve stands as a silent orchestrator, influencing health and disease in ways that have long been underestimated. Vagus Nerve Stimulation delves into the profound significance of this 10th cranial nerve, tracing its course through the body and illuminating its role as a vital component of the parasympathetic nervous system.
This comprehensive reference, contributed by leading experts at the forefront of medical science, unveils the groundbreaking field of vagus nerve stimulation—a non-invasive approach to harness the body's innate potential for health optimization, inflammation control, and disease modification. Contributed by leading experts in the field, this comprehensive volume serves as a compendium of current knowledge about stimulating the vagus nerve in many different disease states. This book starts with the foundational insights in Basic Science and Technical Considerations. From there, it continues to Neurologic Conditions, where chapters explore applications for epilepsy, cluster headaches, and concussions. Evolving Therapy for Neurologic Conditions introduces cutting-edge treatments for acute ischemic stroke, synaptic plasticity, and neurodegenerative disorders. The book extends into Psychiatric and Somatic Conditions, providing insights into anxiety, depression, addiction disorders, and more. Conventional Inflammatory Conditions shed light on vagus nerve stimulation's role in combatting sepsis, immune-mediated inflammatory diseases, and metabolic syndrome, among others. Concluding with a foray into Oncology, the book highlights the potential of vagus nerve stimulation in addressing the lingering effects of long covid and migraine. With an authoritative blend of scientific rigor and practical application, this reference serves as an indispensable guide to the vast landscape of vagus nerve stimulation, transforming our understanding of health and wellness.
- Translates the basic science of vagus nerve stimulation into real-world clinical applications
- Explains VNS anatomy and signaling through central and autonomic nervous system
- Reviews VNS treatment of neurological, psychiatric, and inflammatory disorders
- Extends clinical utility to cardiac, renal, and metabolic disorders.
- Provides new insights to the disorder of vagus insufficiency syndrome
- Explores VNS treatment for headaches, TBI, stroke, seizures, and pain.
researchers, physicians and advanced graduate students in neuroscience and neurology
- Vagus Nerve Stimulation
- Cover image
- Title page
- Table of Contents
- Copyright
- Dedication
- Contributors
- Preface
- Introduction
- Section I: Why is the vagus getting so much attention
- Chapter 1 Vagus insufficiency syndrome
- Abstract
- Keywords
- Introduction
- Anatomy of the vagus nerve
- Explaining medically unexplained symptoms
- Traditional treatment of MUSs
- Vagus insufficiency syndrome
- History of vagus nerve stimulation
- Noninvasive VNS
- Cervical nVNS
- Headache disorders
- Episodic cluster headache
- Chronic cluster
- Acute treatment of migraine
- Prevention of migraine
- Novel diseases being studied for treatment with VNS
- Fibromyalgia
- Rheumatoid arthritis
- Sjögren’s Syndrome
- Asthma
- Posttraumatic stress disorder
- Gastrointestinal dysfunction
- Anxiety and depression
- Building the rationale for vagal control of MUS
- Exploring the economic impact of MUS
- Vagus nerve stimulation in vagus insufficiency
- Conclusion
- References
- Chapter 2 Randomized controlled studies do not reflect the complexity of chronic disease, including the vagal response
- Abstract
- Keywords
- Conflict of interest statements
- Acknowledgments
- Common links to chronic illnesses
- Threat physiology
- Allostatic load
- Overall resilience of the nervous system
- Root causes
- Obstacles to treatment
- Prospective randomized studies are insufficient in defining “standard of care”
- An example treatment paradigm
- Overview of solutions
- Conclusion
- References
- Chapter 3 Vagus nerve stimulator (VNS)—What the surgeon needs to know
- Abstract
- Keywords
- Introduction
- Indications
- Contraindications
- VNS hardware
- Leads
- Implantable pulse generators
- Surgical noninplantable accessories
- Nonsurgical accessories
- De novo VNS system implantation
- Preoperative work-up
- Surgical technique
- Programming
- Postoperative regimen
- Complications
- Side effects of VNS
- MRI compatibility
- Electrosurgery
- IPG replacement
- Lead revision
- Explantation of entire VNS system
- References
- Chapter 4 Noninvasive vagus nerve stimulation: History, mechanisms, indications, and obstacles
- Abstract
- Keywords
- Introduction
- History of vagus nerve stimulation
- Relevant anatomy of the vagus nerve
- Mechanism
- Indications
- Measurement of vagus nerve function
- Part one: Cognitive approaches
- Mindfulness and biofeedback
- Deep breathing and muscle relaxation techniques
- External approaches to vagus nerve stimulation
- Cold water immersion
- Safe and sound protocol
- Vagal maneuvers
- Noninvasive vagus nerve stimulation
- Electromagnetic field therapy
- Obstacles to the use of noninvasive vagus nerve stimulation
- Technical challenges
- Variable response rates
- Device limitations
- Patient education and acceptance
- Regulatory and reimbursement issues
- Lack of long-term data
- Future directions
- Conclusions
- References
- Chapter 5 Exploring vagus nerve stimulation through the lens of the polyvagal theory☆
- Abstract
- Keywords
- Evolution and the emergence of a ventral vagal circuit
- A functional social engagement system
- Sensory pathways of the social engagement system: Potential portals to stimulate vagal function
- Vagal pathways
- Vagus nerve stimulation: Assumed mode of action
- Ventral vagal complex: A portal for vagus nerve stimulation
- Role of afferents in vagus nerve stimulation
- Recruiting the acoustic efferent limb of the social engagement system: A portal to stimulate vagal efferent activity
- Vagal brake
- Summary
- References
- Section II: Neurologic conditions
- Chapter 6 Vagus nerve stimulation for the management of epilepsy
- Abstract
- Keywords
- Introduction
- Mechanism of action
- Local effects
- Central effects
- Effects over neurochemistry, neurotransmitters, and neuroinflammatory pathways
- Clinical use and efficacy
- Closed-loop stimulation
- Quality-of-life improvement
- SUDEP and VNS
- Side effects of VNS
- Practical aspects of programming and maintenance of the VNS device
- Predicting treatment outcomes
- Patient selection
- Conclusions and future directions
- References
- Chapter 7 Noninvasive vagus nerve stimulation in migraine treatment
- Abstract
- Keywords
- Introduction
- Migraine clinical presentation
- Migraine pathophysiology
- Migraine pharmacotherapy and limitations
- Mechanism of action of noninvasive vagus nerve stimulation
- Noninvasive vagus nerve stimulation efficacy in migraine treatment
- Noninvasive vagus nerve stimulation safety
- Migraine treatment with noninvasive vagus nerve stimulation
- References
- Chapter 8 Vagal nerve stimulation in rare headache disorders
- Abstract
- Keywords
- Introduction
- History of VNS
- Epilepsy studies
- Depression studies
- Physiology of VNS in headache disorders
- Modalities of VNS
- VNS in cluster headache
- VNS in indomethacin-sensitive headaches
- VNS in SUNA/SUNCT
- References
- Chapter 9 Vagus nerve stimulation for the management of traumatic brain injury
- Abstract
- Keywords
- Introduction
- The history of electrical neuromodulation
- Electroconvulsive therapy
- Deep brain stimulation
- Vagus nerve stimulation
- Cranial nerve X: Vagus nerve
- Anatomy
- Mechanisms of action
- Vagus nerve stimulation approaches
- Implanted devices
- Transcutaneous
- Off-label uses and future applications
- tVNS for TBI: A pilot study
- Rationale for the study
- Study design
- Preliminary results
- Limitations
- Conclusion
- References
- Section III: Evolving therapy for neurologic conditions
- Chapter 10 Vagus nerve stimulation in acute stroke: Review based on current modalities and emerging trends
- Abstract
- Keywords
- Introduction
- Overview of acute strokes
- Pathophysiology of acute strokes
- Clinical manifestations and consequences
- Introduction to vagus nerve stimulation
- Historical background of VNS
- Application of VNS in neurological disorders
- VNS in acute stroke: Mechanisms and rationale
- Mechanisms underlying VNS in stroke recovery
- Rationale for using VNS in acute stroke management
- Preclinical studies supporting the use of VNS in stroke
- Overview of clinical trials investigating VNS in acute stroke patients
- Ongoing trials
- Current modalities of VNS in acute stroke
- Noninvasive vagus nerve stimulation
- Electrical parameters of VNS
- Clinical efficacy of VNS in acute stroke
- Summary of clinical studies evaluating the efficacy of VNS in acute stroke patients
- Analysis of outcomes such as functional recovery, neurological deficits, and quality of life
- Emerging modalities and future directions
- Noninvasive VNS techniques
- Potential advantages and limitations compared to invasive VNS
- Investigation of VNS combined with other therapeutic modalities
- Synergistic effects and rationale for combination therapies
- Novel targets and mechanisms
- Advances in understanding the neurobiological mechanisms underlying VNS efficacy
- Predictive biomarkers
- Personalized medicine approaches for optimizing VNS treatment in acute stroke patients
- Conclusion
- References
- Chapter 11 Using vagus nerve stimulation to direct synaptic plasticity and treat neurological disease
- Abstract
- Keywords
- Introduction
- Summary of findings from nonclinical studies
- Rationale for the use of VNS paired with rehabilitation
- VNS paired with rehabilitative training improves recovery of motor function in multiple rat models of brain injury
- VNS paired with rehabilitative training improves recovery in rat models of SCI
- Summary of findings from clinical research
- VNS is widely used and safe
- VNS paired with rehabilitation improves recovery after neurological injury
- Conclusions
- References
- Chapter 12 Vagus nerve stimulation for the management of tinnitus
- Abstract
- Keywords
- Introduction
- Pathophysiology
- Treatments for tinnitus
- Sound paired vagus nerve stimulation for tinnitus
- How does sound paired VNS exert its clinical benefit?
- Vagus nerve stimulation and tinnitus
- Conclusion
- References
- Chapter 13 Vagus nerve stimulation for the management of neurodegenerative disorders
- Abstract
- Keywords
- Introduction
- Mechanism of action
- Contraindications
- Indications
- Parkinson’s disease
- Alzheimer’s disease
- Traumatic brain injury
- Stroke
- Mild cognitive impairment
- Complications
- References
- Chapter 14 Vagal nerve stimulation for cognitive and performance enhancement
- Abstract
- Keywords
- Introduction
- The historical context of VNS in medical applications
- The concept of enhancing cognition through VNS
- Anatomy and function of the vagus nerve
- Role of the vagus nerve in the autonomic nervous system
- The connection between the vagus nerve and cognitive processes
- Types of devices
- Mechanisms of VNS in performance enhancement
- Norepinephrine pathways
- Acetylcholine pathway
- GABA
- Dopamine
- Cognitive functions and VNS
- Human conditions
- Anxiety
- Posttraumatic stress disorder
- Sleep disorder
- VNS and Alzheimer’s
- Challenges and considerations
- Future directions and research opportunities
- Conclusion
- References
- Chapter 15 Vagus nerve stimulation for the management of chronic pain
- Abstract
- Keywords
- Introduction
- Anatomy and physiology of the vagus nerve with regards to nociceptive pathways
- Influence of vagal activity on pain levels
- Rationale for treatment
- Animal studies
- Human studies
- Areas for future research
- Conclusion
- References
- Section IV: Psychiatric and somatic conditions
- Chapter 16 Vagus nerve stimulation for the management of depression and anxiety
- Abstract
- Keywords
- Major depressive disorder
- Anxiety disorders
- Pathophysiology of depression and anxiety
- Vagus nerve anatomy and VNS
- Mechanism of action of vagus nerve stimulation in depression and anxiety
- The history of VNS
- The beginning of VNS for depression
- VNS randomized control studies for depression
- Further VNS studies for depression
- Meta-analysis of VNS for depression
- VNS for anxiety-related disorders
- Noninvasive VNS
- Clinical indications
- Adverse effects
- Conclusions
- References
- Chapter 17 Application of vagal nerve stimulation to post-traumatic stress disorder
- Abstract
- Keywords
- Introduction
- Neurobiology of PTSD and stress-related psychiatric disorders
- Neural changes
- Hypothalamic–pituitary–adrenal Axis and PTSD
- Inflammatory responses in PTSD and related disorders
- Cognitive decline in PTSD
- Neuromodulation in stress-related psychiatric disorders
- Vagus as a treatment target for PTSD
- Vagal nerve stimulation as a PTSD treatment modality
- Acute effects of tVNS in trauma-exposed individuals without PTSD
- Acute physiological effects of tVNS in individuals with PTSD
- Future directions and conclusions for PTSD and vagal nerve stimulation
- Avenues for future research
- Conclusions
- References
- Chapter 18 Vagus nerve stimulation for the management of fibromyalgia
- Abstract
- Keywords
- Part 1: Introduction to and pathophysiology of fibromyalgia
- Part 2: Mechanisms of vagus nerve stimulation
- Autonomic modulation and neuroplasticity
- Cholinergic antiinflammatory pathway
- Clinical trials of VNS for fibromyalgia and chronic overlapping pain conditions
- Part 5: Safety considerations
- Conclusions/key points/recommendations
- References
- Chapter 19 Vagus nerve stimulation for the management of visceral pain
- Abstract
- Keywords
- Vagus nerve stimulation in chronic visceral pain
- Visceral pain
- Anatomy of the vagus nerve
- Mechanism of action of VNS in chronic visceral pain
- Mechanism of vagus nerve stimulation in antinociception
- Vagus nerve stimulation techniques and devices
- Evidence for vagus nerve stimulation for chronic visceral pain
- Conclusion
- References
- Chapter 20 Vagus nerve stimulation for the management of addiction disorders
- Abstract
- Keywords
- Introduction and background
- Vagus nerve and its multifaceted roles
- The neurobiology of addiction: Reward pathway, vagus nerve, and potential therapies
- The emergence of neuromodulation therapies for addiction treatment
- Challenges and limitations of VNS for addiction treatment
- Future directions for VNS and addiction
- Summary and conclusion
- References
- Section V: Vagus nerve stimulation and inflammation
- Chapter 21 Vagal nerve stimulation for the management of sepsis
- Abstract
- Keywords
- Sepsis
- Bidirectional communication between the immune and nervous systems
- VNS in preclinical models of sepsis and systemic inflammation
- Characterization of the CAP
- Antiinflammatory mechanisms of vagus nerve stimulation
- Vagus nerve stimulation inhibits inflammation in clinical studies
- Implantable VNS systems
- Transcutaneous VNS systems
- Concluding remarks
- References
- Chapter 22 Vagus nerve stimulation for the management of immune-mediated inflammatory diseases
- Abstract
- Keywords
- Introduction to vagus nerve and the immune reflex
- The cholinergic antiinflammatory pathway
- Hypothalamic–pituitary-adrenal axis
- Brain-gut axis
- Vagus nerve stimulation
- VNS in immune-inflammatory diseases: from mouse models to humans
- Rheumatoid arthritis
- Inflammatory bowel disease
- VNS studies in other immune-inflammatory diseases
- Primary Sjögren’s syndrome
- Scleroderma
- Systemic lupus erythematosus
- Knowledge gap/future research needs
- References
- Chapter 23 Vagus nerve stimulation for the management of inflammatory bowel disease and the cholinergic antiinflammatory pathway
- Abstract
- Keywords
- Introduction
- Ulcerative colitis
- Crohn’s disease
- Diagnosis
- Treatment
- Complications of IBD
- Cholinergic antiinflammatory pathway and the effect of the vagus on intestinal barrier function
- Where might vagus nerve stimulation fit into the IBD treatment paradigm in the future?
- References
- Chapter 24 Clinical applications of vagal nerve stimulation for gastrointestinal motility disorders and chronic abdominal pain
- Abstract
- Keywords
- Introduction
- Invasive vagal nerve stimulation
- Noninvasive vagal nerve stimulation
- Irritable bowel syndrome
- Gastroparesis
- Functional dyspepsia
- Postoperative ileus
- Visceral pain
- Summary and future perspectives
- References
- Chapter 25 Treatment of acute asthma exacerbations with vagus nerve stimulation
- Abstract
- Keywords
- Introduction
- Preclinical animal studies
- Clinical results
- Mechanism of action
- Conclusions
- References
- Chapter 26 Metabolic syndrome: Understanding its root cause, and the role of macrophages and why vagus nerve stimulation may be an effective treatment
- Abstract
- Keywords
- Introduction
- The role of macrophages in the maintenance of healthy organ and tissue function
- Obesity and the failure of normal efferocytotic mechanisms
- Mitochondria, calcium, ROS, and melatonin
- Inflammation and mitochondrial dysfunction
- The cholinergic antiinflammatory pathway
- Type 2 diabetes
- NADFLD-NASH
- Atherosclerosis
- Hypertension
- Alzheimer’s disease as type 3 diabetes
- Conclusions
- References
- Chapter 27 Vagus nerve stimulation for the management of obesity, type 2 diabetes mellitus, and metabolic syndrome
- Abstract
- Keywords
- Introduction
- Origin, branches, and pathway of vagus
- Vagotomy
- Vagotomy/vagus nerve blocking/vagus nerve stimulation
- Vagus nerve in obesity, type 2 DM, and metabolic syndrome
- VNS is beneficial, but how and why?
- Vagus transmits messages between liver and brain
- Vagus communicates between liver and pancreatic β cells
- Vagus also regulates insulin secretion
- Role of vagus in obesity, type 2 DM, and metabolic syndrome
- Conclusions and future therapeutic implications
- References
- Chapter 28 Vagus nerve stimulation and kidney function
- Abstract
- Keywords
- Introduction
- Acute kidney injury
- Chronic kidney disease
- End-stage kidney disease
- Kidney transplant
- Chronic kidney inflammatory disorders
- Lupus
- Sympathetic overactivity in kidney disease
- Conclusions
- References
- Chapter 29 The neural tourniquet
- Abstract
- Keywords
- Introduction
- The inflammatory reflex
- Traumatic hemorrhage
- Hemorrhage management in clinical medicine
- Rationale for enhancing hemostasis
- The neural tourniquet
- Swine ear hemorrhage
- Rodent visceral hemorrhage
- Murine tail hemorrhage
- Murine hemophilia A
- Clinical applications
- Conclusions
- References
- Section VI: Future applications for vagus nerve stimulation
- Chapter 30 Vagus nerve stimulation for the treatment of heart failure
- Abstract
- Keywords
- Introduction
- Autonomic nervous system modulation in HF
- Structural and functional organization of cardiac nervous system
- Maladaptive cardiac neuronal hierarchy in HF
- Relevance of vagus nerve as a target for HF
- Preclinical studies of VNS for HF
- Stimulation parameters
- Experimental studies of VNS in animal models
- Neural fulcrum
- Clinical trials of VNS for HF
- Avenues for future research
- Conclusions
- References
- Chapter 31 Vagus nerve stimulation for long COVID
- Abstract
- Keywords
- Introduction
- The vagus nerve, a strong link to overcome Long COVID
- Noninvasive VNS clinical trials in LC are promising
- Noninvasive VNS could prevent LC
- Conclusion
- References
- Chapter 32 Vagal nerve stimulation applications in oncology
- Abstract
- Keywords
- Introduction
- The vagus nerve
- Vagus nerve stimulation
- Mechanism of action
- Literature review
- Other applications outside of tumorigenesis and disease modification
- Complications associated with VNS
- Conclusion
- References
- Index
- Edition: 1
- Published: November 16, 2024
- Imprint: Academic Press
- No. of pages: 500
- Language: English
- Hardback ISBN: 9780128169964
- eBook ISBN: 9780128169971
PS
Peter Staats
Peter S. Staats, MD, MBA is a board-certified physician specializing in pain medicine. Currently, Dr. Staats is seeing patients at Premier Pain Centers, a pain management practice with seven locations throughout New Jersey. He has been consistently recognized as one of the country’s foremost pain management doctors. This includes being named one of America’s Top Doctors by U.S. News and World Report for the last decade, noted as being among the top 1% of pain management physicians in the country. He has been acknowledged as one of New Jersey’s Top Doctors from New Jersey Monthly magazine for the past seven years. Dr. Staats was also the recipient of the Outstanding Pain Physician award, a national recognition as selected by his peers in the interventional pain medicine community.Dr. Staats is certified by the National Board of Medical Examiners, the American Board of Pain Medicine, and the American Board of Anesthesiology. He is also a fellow of the World Institute of Pain and the North American Neuromodulation Society. He is the author of over 200 articles, abstracts and chapters regarding pain management, and has written several books on the science of pain medicine.
Affiliations and expertise
Premier Pain Center, Chief Medical Officer, electroCore, Chief Medical Officer, National Spine and Pain Center, New Jersey, USACA
Cenk Ayata
Dr. Ayata is a Neurologist and a clinician-scientist dedicated to translational research on neurovascular function and dysfunction. He explores therapies to augment perfusion and oxygenation in acute stroke (e.g., hyperoxia, induced hypertension, Rho-kinase inhibition), the pathophysiological roles of injury depolarizations in stroke, and targeting spreading depression in migraine. Dr. Ayata is expert in non-invasive in vivo investigations of cerebrovascular physiology and pathophysiology in mice under full systemic physiological control. In collaboration with Dr. Joutel, Dr. Ayata defined a novel enhanced CSD-susceptibility phenotype in Notch3R90C mutant mice, providing an explanation for the increased incidence and severity of migraine with aura in CADASIL patients.
Affiliations and expertise
Assistant Professor,Harvard Medical School; Assistant in Neurology and Neuroscience, Massachusetts General Hospital, Boston, MA, USAIL
Imanuel Lerman
Dr. Lerman is a board-certified neurologist who specializes in pain management. He has extensive experience in ultrasound guidance for interventional pain procedures and interventional headache treatment, teaching and speaking nationally on these subjects. As an assistant professor in the Department of Anesthesiology at UC San Diego School of Medicine, Dr. Lerman carries out numerous clinical trials at UC San Diego Medical Center, the Altman Clinical Trial Research Institute, and the VA San Diego Healthcare System. His clinical reasarch studies primarily focus on understanding the impact of neurotechnologies (e.g. spinal cord stimulation, vagal nerve stimulation, and other central and peripheral nerve stimulation) on pain, learning and mental health disorders.. Dr. Lerman is a founding board member of the American Interventional Headache Society, faculty and founding member of the Regenerative Medicine special interest group within the American Society of Regional Anesthesiology and Pain Medicine, and faculty member for the World Academy of Pain Medicine Ultrasonography.
Affiliations and expertise
Assistant Professor of Anesthesiology, UCSD Center for Pain, La Jolla, CA, USAAA
Alaa Abd-Elsayed
Dr. Alaa Abd-Elsayed joined the faculty of the Anesthesiology Department at the University of Wisconsin in 2014 to provide Chronic Pain Medicine Services as part of the Interventional Pain Program. He received his medical training at Assiut University Medical School in Egypt, completed a master’s degree in Public Health, research fellowship at Cleveland Clinic, and residency in anesthesiology and pain management fellowship at University of Cincinnati. As part of the Interventional Pain Program, Dr. Abd-Elsayed evaluates patients at the Pain Clinic, and when an interventional pain treatment is appropriate, performs procedures at the Madison Surgery Center. Over the course of his career, he has received numerous research grants, published more than 70 peer-reviewed manuscripts and authored several editorials and book chapters. He has presented at more than 60 international and national conferences and has earned more than 15 awards at the state and national levels. In addition, he has served as a reviewer for more than 20 journals and as an editor to several journals.
Affiliations and expertise
University of Wisconsin, USARead Vagus Nerve Stimulation on ScienceDirect