Vagus Nerve Stimulation (VNS)

Vagus nerve stimulation (VNS) is a medical treatment that involves delivering electrical impulses to the vagus nerve, which is a complex nerve that runs from the brain to various parts of the body, including the heart, lungs, and digestive tract.

History

VNS was first approved by the US Food and Drug Administration (FDA) in 1997 for the treatment of epilepsy, specifically for patients with partial onset seizures that are resistant to antiepileptic medications. Since then, it has also been approved for the treatment of treatment-resistant depression.

Procedure

The VNS procedure involves implanting a small device, called a pulse generator, under the skin in the chest area. The device is connected to a wire (lead) that is wrapped around the vagus nerve in the neck. The pulse generator delivers electrical impulses to the vagus nerve at regular intervals, which can be adjusted by a healthcare provider.

How it Works

The exact mechanism of VNS is not fully understood, but it is thought to work by:

• Stimulating the brain's neurotransmitters, such as serotonin and dopamine, which play a role in mood regulation and seizure control
• Affecting the brain's electrical activity, which can help to reduce seizures and improve mood
• Influencing the body's autonomic nervous system, which regulates various bodily functions, such as heart rate and blood pressure

Indications

VNS is currently approved for the treatment of:

• Epilepsy: specifically for patients with partial onset seizures that are resistant to antiepileptic medications
• Treatment-resistant depression: VNS has been shown to be effective in reducing symptoms of depression in patients who have not responded to other treatments

Benefits and Risks

The benefits of VNS include:

• Reduced frequency and severity of seizures in patients with epilepsy
• Improved mood and reduced symptoms of depression in patients with treatment-resistant depression

The risks and side effects of VNS include:

• Surgical complications, such as infection or bleeding
• Hoarseness or changes in voice
• Coughing or shortness of breath
• Pain or discomfort at the implant site
• Tiredness or fatigue

Contraindications

VNS is not recommended for patients with certain medical conditions, including:

• Pacemakers or other implanted medical devices
• History of neck surgery or trauma
• Certain lung or breathing disorders