from Hacker News

Growing scientific interest in vagus nerve stimulation

by acallaghan on 8/23/23, 10:37 AM with 148 comments

by tempaway43355 on 8/23/23, 11:12 AM
One of my children has severe epilepsy and has a Vagus Nerve Stimulation device implanted - Sentiva 1000
https://www.livanova.com/epilepsy-vnstherapy/en-gb/hcp/produ...
It has really helped although obviously it took surgery and then also nine months of slowly tweaking the settings.
Before the VNS they could (for example) not go on a trampoline for more than a few minutes without having a seizure, but now they're fine all day. They did still have seizures at night after the VNS but we tackled those with a different treatment.
The Sentiva 1000 sends regular soft pulses (for one minute every 3.5 minutes) and can also react to heart rate rising suddenly (which might mean a seizure) by automatically increasing its pulses. During a seizure if we want to manually activate the device we swipe over its location with a strong magnet and that activates it to send stronger pulses for a minute or so.
Batteries last about eight years. A few times a year we go to check the battery, the nurses have an ipad and a wand-type thing that they hold over the implants location, it uses some sort of low power NFC to read data and diagnostics from the implant. When we do need to change the battery that will be an operation. But less complicated than the initial operation (and even that was in-and-out in one day)
All pretty amazing.
by blueyes on 8/23/23, 4:07 PM
For me, the amazing thing about the Vagus nerve is that you can stimulate it with your breathing. And since the Vagus nerve affects the autonomic nervous system (involuntary, not consciously controlled) while breathing choices are conscious, this is one of the few ways that humans can directly impact important aspects of their psychology and physiology, like how calm they feel. Mindfulness + breath choices + vagus nerve => altered state. And that's why traditions including yoga and buddhism empathize breathing. Couple great books that touch on this are:
Breath: The New Science of a Lost Art https://www.amazon.com/Breath-New-Science-Lost-Art/dp/073521...
and
Altered Traits: Science Reveals How Meditation Changes Your Brain https://www.amazon.com/Altered-Traits-Science-Reveals-Medita...
by jwestbury on 8/23/23, 11:22 AM
Nerve stimulation implants are really exciting. I have sleep apnea, and while I take to CPAP therapy pretty well, I hate having to travel with the device and I hate its limitations. When we travel, I have to ensure there's an outlet somewhere near my bed; I can't camp without a massive battery pack for my CPAP; I can't go backpacking; and even cuddling my wife at night is a challenge because of the hose hanging off my head.
There's now a sleep apnea implant available, which also functions based on nerve stimulation, and is apparently quite effective. It's still a bit large, so not ideal for those of us who can deal with a CPAP, but in another 10 years maybe I can stop using my CPAP and just get a relatively straightforward surgical procedure every 5-10 years. I'd absolutely do it.
by theshrike79 on 8/23/23, 11:19 AM
I have acid reflux and possibly a mild hiatal hernia. When it triggers in Just The Right Way, I also get severe panic attack symptoms.
When I started investigating it (my coping mechanism during panic attacks) I discovered that the vagus nerve travels next to the esophagus through the diaphragm.
So my complete layman explanation was that the stomach pushes through the diaphragm during a hiatal hernia -> it rubs against the vagus nerve -> panic attack symptoms.
I might need to add the study of vagus nerve to "why haven't we studied this about the human body more" -list along with gut bacteria composition.
by robg on 8/23/23, 1:44 PM
The automatic feedback loop between heart and lungs is really cool. The more you slow your breathing the more you slow your heart. You are choosing to breathe slower via your vagus nerve. The heart responds accordingly.
By contrast the adrenal cortex, a little brain on top of the kidneys, automatically triggers fight or flight with threat detection. By the time you realize it your heart rate is already increasing. Breathing slowly, preferably through your nose, counteracts that physiological stress.
See also the last 100 years of research on the autonomic nervous system.
by jbandela1 on 8/23/23, 3:38 PM
> One thing that makes the vagus nerves so attractive is surgical accessibility in the neck. “It is quite easy to implant some device that will try to stimulate them,” says Dr Benjamin Metcalfe at the University of Bath, who is studying how the body responds to electrical vagus nerve stimulation.
Did these (with supervision) during residency. As far as neurosurgeries go, fairly simple. You just have to be careful when you expose the vagus nerve as it lies between the carotid artery and the jugular vein.
This is in contrast to Deep Brain Stimulation which involves making a hole in the skull, exposing the brain, and inserting electrodes deep within the brain.
by yamrzou on 8/23/23, 11:43 AM
The vagus nerve can also be stimulated by diaphragmatic breathing exercises and longer exhalations, see [1] and [2].
[1] https://www.psychologytoday.com/intl/blog/the-athletes-way/2...
[2] https://www.psychologytoday.com/intl/blog/the-athletes-way/2....
by dentalperson on 8/23/23, 4:25 PM
There is also 10+ years research for tinnitus using Vagus Nerve Stimulation to stop it [1]. Results seem mixed. Many other drugs/neuro-stimuli for T have gotten mixed results and passed clinical trials such as Leniere only to flop in actual usage. It's interesting that the community anecdotal evidence such as r/tinnitus and TinnitusTalk are so useful for these cases because they are more likely to report negative results at the post-approval stage.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7951891/
by thenerdhead on 8/23/23, 2:01 PM
You don't need to buy a $750 USD device to do this either. You can get away with a very cheap TENS device that has ear clips such as:
https://www.tenspros.com/intensity-micro-combo-tens-microcur...
And then look at a study like https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199464/table/T... to determine what settings to use for your condition.
by bgribble on 8/23/23, 12:06 PM
I have this dream scenario where they discover that the gentle swirling of a cotton swab in the ear canal stimulates the vagus nerve and has these tremendous health benefits, allowing the sanctimonious anti-cotton-swab-in-the-ear brigade to sit down and shut up for a minute.
by crtxcr on 8/23/23, 4:36 PM
>Further research revealed that the brain communicates with the spleen – an organ that plays a critical role in the immune system – by sending electrical signals down the vagus nerve. These trigger the release of a chemical called acetylcholine that tells immune cells to switch off inflammation. Electrically stimulating the vagus nerve with an implanted device achieved the same feat.
One might also achieve comparable effects by drinking baking soda.
>"We think the cholinergic (acetylcholine) signals that we know mediate this anti-inflammatory response aren't coming directly from the vagal nerve innervating the spleen, but from the mesothelial cells that form these connections to the spleen," O'Connor says.
>While there is no known direct connection between the vagal nerve and the spleen -- and O'Connor and his team looked again for one -- the treatment also attenuates inflammation and disease severity in rheumatoid arthritis, researchers at the Feinstein Institute for Medical Research reported in 2016 in the journal Proceedings of the National Academy of Sciences.
O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease.
https://www.sciencedaily.com/releases/2018/04/180425093745.h...
by jasonladuke0311 on 8/23/23, 3:49 PM
Vagus nerve trauma is how liver shot KO's happen in striking arts. I always wondered how this worked. https://middleeasy.com/guides/dissecting-the-liver-shot/
by buescher on 8/23/23, 1:18 PM
Off and on, I've been seeing woo about the vagus nerve for a while. This article was refreshingly balanced. Now I know: "Tracey’s discovery also caught the attention of mind-body practitioners, including the Dutch motivational speaker and “Iceman” Wim Hof". Aha. Indeed.
Where is the rest of this stuff coming from? Is there a deeper dive?
by fidotron on 8/23/23, 11:39 AM
What made me start paying attention to the vagus nerve noise was this: https://www.sciencedaily.com/releases/2020/08/200806092437.h...
This claims to improve language learning through selective non invasive stimulation.
The great confusion with these things is given how the body has a tendency to recalibrate dynamically to new stable levels of stimulation the trick would be finding what sort of on/off routine is needed to create the desired effect.
by photochemsyn on 8/24/23, 4:32 AM
The article and comments don't mention it, but vagus stimulation by hot peppers (maybe wasabi too) has been studied and seems significant with respect to immune-nervous system interactions controlled by the vagus nerve, at least there's some interaction (wishful thinking perhaps, but as I like hot peppers this supports my view that they improve one's digestion and circulation):
(2013) "Capsaicin-sensitive vagal afferent neurons contribute to the detection of pathogenic bacterial colonization in the gut"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4188534/
> "We conclude that activation of the afferent arm of the parasympathetic neuroimmune reflex by pathogenic bacteria in the gut is dependent on capsaicin sensitive vagal afferent neurons and that the release of inflammatory mediators into intestinal tissue can be directly sensed by these neurons."
More general current open-source review of the overall topic (2018):
"Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders"
https://www.frontiersin.org/articles/10.3389/fpsyt.2018.0004...
by bjourne on 8/23/23, 6:25 PM
My dad has had deep brain stimulation (not the same as vagnus nerve stimulation, but in the same area) for over ten years. It helps a lot with his dystonia but he has developed severe paranoia which gets progressively worse. Of course you can't say that one caused the other, but I think it is reasonable to be cautious about devices that put electricity in your brain. Benefits are often instant side-effects may slowly accumulate over the years.
by 01100011 on 8/25/23, 4:21 AM
I'm all for folks expounding on the ways in which "current AI" sucks, but I have little patience for people who think that what it is now is all it will ever be.
Sure, it could be 6 months or 6 years before we see real improvements, but no one knows. No one knew that transformers were coming in the months before they arrived.
One thing that I think is encouraging is how fast computing power is increasing, along with languages, frameworks and models which allow you to make use of that power. I think that alone, even without AI, will result in world-changing advancements across many fields. The power to simulate large systems is growing rapidly and will enable prediction and discovery to achieve great societal benefits.
by dghughes on 8/23/23, 1:22 PM
Years ago I read that breathing on your vagus nerve on your wrist can help calm you down. Each breath pulse would do something cause stimulation to calm you more like a feedback loop. I didn't know if it was bunk or not. I tried it but never felt any effect.
by voisin on 8/23/23, 11:40 AM
> Further research revealed that the brain communicates with the spleen – an organ that plays a critical role in the immune system – by sending electrical signals down the vagus nerve. These trigger the release of a chemical called acetylcholine that tells immune cells to switch off inflammation.
Isn’t inflammation an important process for healing? Too much is obviously bad, but if we go turning it off, won’t that lead to longer term issues?
Shouldn’t we be looking to solve what’s causing the inflammation in the first place?
by giantg2 on 8/23/23, 4:29 PM
There are a whole bunch of vagus nerve manipulations in current medicine. Many are quite common to self treat for things like converting episodes of SVT. Although the effectiveness is mixed. If they could find a non-drug treatment for Afib, I bet that would be big money based on the potential population and the current drug cocktail side effects.
by caycep on 8/23/23, 5:15 PM
Vagus nerve shenanigans always remind me of that whole NSA hack of side loading their custom hackey OS into things like embedded USB controllers or other little things on laptops that we never think about. Yea, it's not as flashy as interfacing w/ the CPU/system RAM directly but it could be useful....
by c_o_n_v_e_x on 8/24/23, 12:18 AM
I was a diagnosed with gastritis earlier this year. In the days leading up to my endoscopy, I had horrific reflux which was triggering anxiety. Putting an icepack on my chest to cool down the vagus nerve really helped with the angst and heart palpitations.
by fruit2020 on 8/23/23, 10:10 PM
Does anyone here suffer from vasovagal syncope and has researched the topic more in depth? My last blackout was around one minute during a flight, house doctor says I shouldn’t be concerned.
by pedalpete on 8/23/23, 11:37 PM
Does anyone here have experience with any of the consumer stimulation devices like neuvana or sensate? Keen to hear your thoughts and if you actually use it?
by harvie on 8/23/23, 5:02 PM
So you are basicaly telling me than scientists found out that i can get some more alertness by slaping myself in the face?
by mgarfias on 8/24/23, 1:52 AM
Mine is very angry. It has caused me to die a few times.
by progrus on 8/24/23, 12:41 AM
This place is such a shithole in 2023. Absolutely no interest in anything of import, because that reality banging down your doors is too scary.
We’re in a revolution, nerds. Wake the fuck up.
by jmount on 8/23/23, 4:40 PM
I thought all the Hacker News "smarter than everyone else, self prescribers" were still endorsing Adderall, mild hallucinogens, and poop-swapping. But, by all means, shine on you crazy diamonds.