Reborn II: Vagus Nerve Stimulation and Inflammation

Discussion in 'General' started by Cort, Jun 15, 2015.

  1. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    (The first part of this blog is taken from an article called "Hacking the Nervous System" published by the Huffington Post)

    Maria Vrind's superb level of fitness offered her no protection against the insidious immune process taking place in her body. By her late forties, this former gymnast had to give up her athletic coaching job. By her early fifties she was in severe pain, couldn’t walk and her knees, wrists, ankles, elbows and shoulder joints felt like they were on fire. She had a severe case of rheumatoid arthritis.

    It took a cocktail of powerful drugs (including methotrexate - a chemotherapy agent) simply keep her functioning. One day - one moment, really - in 2011 the drugs mysteriously stopped working. Unable to walk and in terrible pain she was rushed to the hospital hospital where an IV dripped a chemotherapy agent into her veins.

    The drug worked but she dreaded a life of disability and monthly chemotherapy treatments. As it turned out chemotherapy drugs were not n her future. A new treatment from an entirely different source offered her relief beyond her wildest dreams.

    The Vagus Nerve

    The genesis of that treatment began decades earlier when a young neurosurgeon, Kevin Tracey, injected an anti-inflammatory agent into a mouse brain. To his surprise it reduced inflammation in the mouse's internal organs.

    Suspecting the vagus nerve - that long nerve stretching from the brain to organs - had something to do with it, Tracey cut the nerve and then supplied the anti-inflammatory agentt again. This time it had no effect. Then he ditched the anti-inflammatory and stimulated the nerve electrically and watched the inflammation in the body go down. The vagus nerve was the brains conduit to the immune system.

    Chronic Fatigue Syndrome, Fibromyalgia and the Vagus Nerve

    The yin to the sympathetic nervous system's (SNS) yang, the vagus nerve controls the "rest and digest" or parasympathetic nervous system (PNS). The default for human beings is to have the SNS or fight or flight system on all the time. If not for the vagus nerve stepping in and turning the SNS down we would continually be enveloped in a fight or flight response. Feelings of peace, calmness and relaxation would evaporate, digestion would suffer, our hearts would race and we'd be unable to sleep.

    Heart rate variability studies suggest that an under-active vagus nerve is allowing the SNS to stay turned on much of the time in ME/CFS and FM. These studies suggest that the overactive "fight or flight" system may be contributing to the "wired and tired" feelings, and fatigue, pain, sleep and cognitive problems found in these diseases. It may even affect mood. According to the Huffington post article people with a high vagal tone tend to be socially and psychologically stronger, are better at concentrating and remembering things, suffer less from depression and are happier and more likely to have close friendships.

    The Vagus Nerve and Inflammation

    Tracey spent over a decade tracing anatomically how the vagus nerve effects the immune system in the body. By the time he was done he was ready to test his hypothesis by surgically implanting a vagus nerve stimulator in patients high rates of inflammation.

    Marina Vrinds was one of the first to try. The researchers and participants hoped for some relief. What they got astonished them. Within a few weeks Marina went from her chemotherapy dependent disabled state to being not just functional but active. Shortly after turning the stimulator on she was back riding her bicycle and participating in gymnastic for the first time in years.

    Now 68 Vrind is a very active senior. She plays and teaches seniors volleyball several times a week, cycles at least an hour a day, does gymnastics, and plays with her eight grandchildren. All this from turning on a stimulator six times a day for thirty seconds using a magnet she waves across her throat.

    Not everybody in the trial experienced such miraculous recoveries but the stimulation essentially wiped out the RA in a solid third of the participants of the trial. The levels of inflammatory markers went down in 80% of the patients.

    Neither ME/CFS or FM patients typically display anywhere near the kind of inflammatory levels occurring in rheumatoid arthritis patients. Our understanding of inflammation is, however, changing. Inflammatory disorders need not necessarily display the swollen, reddened joints found in RA. Much of the inflammation found may be hidden in the central nervous system or is simply not being detected by current testing protocols.

    A recent blog recounted a remarkable story of a woman's recovery from severe fibromyalgia using a surgically implanted vagus nerve stimulator. Now, let's take a deeper look at the critical role the vagus nerve plays in immune functioning.

    The Vagus Nerve and the Immune System

    The vagus nerve is primarily composed of sensory nerve fibers that transmit sensory information to the brain. That flow of sensory information provides much more than data on things like temperature, touch and pain. Recent studies indicate the nerve is loaded with immune receptors that also transmit data on inflammation and the presence of pathogens to the brain. In fact, the vast network of vagal nerve endings found in the skin and other mucosal areas is suggested to provide an early warning network that can quickly transmit news of a pathogen attack to the brain.

    Immune signals down the vagus nerve from the brain can initiate what has been termed an "inflammatory reflex" that is designed to tamp down inflammation. Since the vagus nerve does not reach into the spleen how that happened was a mystery.

    Solving that mystery opened up a new form of immune regulation called the cholinergic anti-inflammatory pathway.

    The Cholinergic Anti-inflammatory Pathway

    Signals traveling down the vagus nerve cause nerves in the spleen to release norepinephrine. The NE triggers T-cells to release acetylcholinesterase (Ach), which then turns off the production of pro-inflammatory cytokines such as TNF-a.

    The spleen is not the only area that vagus nerve modulation may effect. Animal models suggest vagal nerve stimulation of the cholinergic anti-inflammatory pathway may be helpful in a variety of inflammatory conditions including colitis, autoimmune and cardiovascular disorders and pain disorders including allodynia.

    The anti-inflammatory actions of the vagus nerve and how it achieves them are complex and not completely understood and some controversy exists.

    Mostly Anecdotal

    Vagus nerve stimulation has produced wonders in some patients with fibromyalgia and rheumatoid arthritis, but the evidence base in humans is still weak and animal studies are common. A recent VNS study in mood disorders, for instance, consisted of five patients (three with positive outcomes.)

    Vagus nerve stimulation trials currently underway using trancutaneous vagal nerve stimulation (no surgery needed) include those on gut motility, irritable bowel syndrome, cluster headaches). Surgically implanted devices are being tested in epilepsy, Crohn's disease, tinnitus, stroke and heart failure. A transcutaneous VNS study in migraine wrapped up a year or so ago. Note that migraine, problems with gut motility and irritable bowel syndrome are common in ME/CFS and FM.

    VNS is a new and developing field. Heart rate variability studies reveal that low "vagal' tone is common in many disorders including arthritis, depression, heart failure, diabetes, asthma, headache, fibromyalgia,ME/CFS and others. Many of these disorders, it should be noted, have an inflammatory component. It should be noted as well that studies have consistently associated low vagal tone with increased risk of mortality. Reduced vagal functioning appears to either set one up for a chronic illness (low vagal tone is a risk factor for diabetes) that reduces ones lifespan or is a common component of chronic illness.

    Finding ways to boost vagal nerve activity and reduce inflammation through drugs (nAChRα7 enhancers), vagal nerve stimulation or mind/body techniques (meditation, mindfulness) will surely continue.

    Dig Deeper:

    Attached Files:

    Last edited: Mar 5, 2016
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  2. Steve

    Steve Active Member

    Very interesting. Also suggests that ACH meds (which is a vast number of meds, including cannabis) already known to cause cognitive decline in folks over 65 (me!) also may intensify my FM/ME by influencing the vagus nerve.
  3. WebDoc

    WebDoc New Member

    Very interesting indeed. But I'm confused about the ACH part: "Signals traveling down the vagus nerve cause nerves in the spleen to release norepinephrine. The NE triggers T-cells to release acetylcholinesterase (Ach), which then turns off the production of pro-inflammatory cytokines such as TNF-a." Wouldn't this mean that ACH drugs or supplementation would decrease inflammation and therefore help CFS/FM/ME?

    Obviously we are a long way from this treatment being common or even obtainable by a select few of us. Are there other ways to stimulate the vegas nerve?
  4. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    Yes it does! Drugs have been developed and are being tested that enhance ACH receptor activity in order to decrease inflammation.
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  5. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    Actually drugs are being worked on to enhance specific ACH receptors. There are a bunch of ACH receptors. I know with regards to adrenergic receptors they can do vastly different things. The specific receptor they're interested in is nAChRα7.
  6. Juana Rogers

    Juana Rogers New Member

    It started with a flu in 1988 and after two years of eliminating other possibilities, I was diagnosed with Chronic Fatigue Syndrome in 1990 when I was 43 years old. For 25 years I've been trying to live with it.
    The day I realized I was truly ill, I awakened with a racing, pounding heart and other symptoms of "fight or flight."
    Since that critical occurrence, among the many symptoms I experience one of the most consistent is what I call "adrenaline poisoning."
    As if I am a car up on blocks but my engine is racing.
    Problems with the vagus nerve could account for this symptom.
    I'm encouraged. I'm 68 years old now and I hope a treatment is found before I die.
    Thank you, Health Rising Forums, for all you do for us.
    Cecelia and Tami like this.
  7. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    Yes, transcutaneous vagal nerve stimulation using a TENS unit or other stimulator has worked for some people. Check out the first reborn blog for more. Deep breathing also stimulates the vagus as does other forms of meditation.

    (I know a pdf on manual techniques, I think it was, was sent to me by the way but I can't find it - by the way. Can someone resend it?)
  8. Katherine Autry

    Katherine Autry Active Member

    I don't have the article but I remember that in addition to deep breathing with the glottis partially closed (think snoring or gargling), suggestions for stimulating vagus nerve included singing and the maneuver where you pinch your nose shut and blow - like to clear your ears on a flight.
  9. Katherine Autry

    Katherine Autry Active Member

    Where would one get a TENS?
  10. Diana Maus

    Diana Maus Member

    You have described my onset exactly. 1990 after severe flu. Racing heart and brain were my first symptoms that I could not stop. I would wake up in the idle of the night with fight or flight so bad I thought I was going to die. I often dreamed I died and there was a thump where I hit the ground that would wake me and I would sit there with such severe panic I thought I should go to the ER. I started taking a calcium channel blocker a few years later for this symptom. I still can't tolerate epinephrine either, in novacaine or antihistamines.

    I too, hope we find the answers before my life is over.
  11. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    I swear these anxiety-like symptoms are all biological. How much did the calcium channel blocker help?
  12. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    There's an Andrew Weil video in the media section that explains one technique. The key is holding on the inbreath and then exhaling through the mouth slowly on the outbreath.
  13. Steve

    Steve Active Member

    Sorry, folks,fibro fog, I meant anticholinergic in my post, not anticholinesterase. Most meds are anticholinergic, bad in a number of ways.
  14. Tami

    Tami Active Member

    My doctor prescribed it, provided it, and thankfully my insurance covered it.
  15. Tami

    Tami Active Member

    This isn't what you're referencing, but lists some maneuvers. It doesn't include the breathing techniques (which I think are important). And instead of doing what they recommend; I fill the sink with ice water and plunge my head for ten seconds (with doctor okay).
  16. Tami

    Tami Active Member

    I need to read posting info, hope it's okay for me to include a link.
  17. Tami

    Tami Active Member

    My doctor prescribed and provided my TENS unit; thankfully it was covered by insurance.
  18. tandrsc

    tandrsc Well-Known Member

    Last edited: Jun 16, 2015
  19. WebDoc

    WebDoc New Member

    I thought the article was referencing vegas nerve stimulation via implanting a device via surgery.

    Does attaching a TENS unit to your ears stimulate the vegas nerve?
  20. tandrsc

    tandrsc Well-Known Member