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Physiology of Trauma, Fear, and Anxiety
Published in Alice Bullard, Spiritual and Mental Health Crisis in Globalizing Senegal, 2022
Clinical therapists, especially those in trauma-informed practice, have integrated PVT into treatments. J.M. Karemaker, who largely agrees with Grossman’s criticism of PVT, pointed to why PVT nonetheless continues to be powerful: [W]e know that the vagus nerve is involved not only in heart rate control, but also in efferent and afferent control of the gastro-intestinal tract and other organs (liver, lungs, etc). On top of that it is probably the link between the brain and the immune system… . In particular the electroceutical use of vagus nerve stimulation is finding more and more applications, not only for its peripheral effect on the heart but also for central effects, where it had already been in use for suppression of epileptic seizures… . [L]et us now look at the broader picture of what the vagus nerve might be capable to do, the functions that have escaped us while we were looking in the other direction.(Grossman 2019)
Electrical Stimulation of the Vagus Nerve
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
J. Kiffin Penry, J. Christine Dean
The adverse effects of vagal nerve stimulation were transient and occurred concomitantly with signal on/off vagal nerve stimulation. These were hoarseness and stimulation sensation in the neck. One patient experienced uncontrolled hiccups on one occasion. None of the patients experienced bradycardia or a significant increase in gastric acid due to the device.
Vagal nerve stimulation: effects on seizures
Published in Hans O Lüders, Deep Brain Stimulation and Epilepsy, 2020
Frequent side effects occurring in the first 3 months of vagal nerve stimulation (VNS) are listed in Table 20.3. Most common are hoarseness (53%), cough (31%) and throat pain/pharyngitis (22%), all occurring only during the ‘on time’ periods of stimulation. These symptoms are due to activation of the recurrent laryngeal nerve branch of the vagus, and can be alleviated by reducing the stimulation pulse width setting.33 Side effects became less common with longer treatment intervals. After 3 years of VNS, only 2% of patients reported hoarseness.18
Is vagal stimulation or inhibition benefit on the regulation of the stomach brain axis in obesity?
Published in Nutritional Neuroscience, 2022
Işınsu Alkan, Berrin Zuhal Altunkaynak, Elfide Gizem Kivrak, Arife Ahsen Kaplan, Gülay Arslan
Vagus nerve stimulation is generally preferred in the treatment of epileptic disorders. In a 1938 study of Bailey and Bremer on cats, vagal stimulation showed changes in electroencephalogram readings [3]. In another study by Dell and Olson in 1951, it was reported that stimulation of the broken cervical vagus nerve affects the ventroposterior and intralaminar responses of the thalamus [24]. In 1985, Zabara et al. reported that electrical stimulation of the vagus nerve prevents neural processes that can end seizures in dogs and alter the electrical activity of the brain, and as a result of this study, vagus nerve stimulation occurs in various clinical situations [4,5]. Although the use of vagus stimulation usually involves the resolution of epileptic problems, the level of severe weight loss observed in patients supports the hypothesis that it may be effective in food intake [25,26]. In the clinical study of Pardo et al., it was reported that, after the vagus stimulation, the patients lost weight in the 6th and 12th months with amount varying between 7–23 kg [26]. Moreover, the same study found that this weight loss was more pronounced in severely obese patients. Stephens et al. reported that vagus activation caused discomfort in the stomach and decreased the feeling of hunger in healthy or fasting individuals [27].
Endotracheal Tube Electrode Neuromonitoring for Placement of Vagal Nerve Stimulation for Epilepsy: Intraoperative Stimulation Thresholds
Published in The Neurodiagnostic Journal, 2022
Gennadiy A. Katsevman, Darnell T. Josiah, Joseph E. LaNeve, Sanjay Bhatia
Risks for intraoperative vagal nerve stimulation are scarce aside from the standard VNS adverse effects, most of which are transient, stimulation-related, and generally well-tolerated (Heck et al. 2002; Kahlow and Olivecrona 2013; Rychlicki et al. 2006). Given that the electrodes are situated on the ETT, risk of injury to the vocal cords or vocalis muscles is small. Potential surgical complications from VNS implantations include vocal cord palsy and rare cardiovascular events such as bradycardia or asystole, so it is possible that repetitive electrical stimulation of the vagus nerve may cause similar issues, although again the risks are low (Giordano et al. 2017; Heck et al. 2002; Kahlow and Olivecrona 2013). On the contrary, neuromonitoring may help protect vocal cord function by aiding in the localization of the vagus nerve, limiting unnecessary dissection, and allowing for preservation of the blood supply to the area.
Device profile of the Nerivio™ for acute migraine treatment: overview of its efficacy and safety
Published in Expert Review of Medical Devices, 2019
The external trigeminal nerve stimulation device (Cefaly) is applied to the head to trigger a local stimulus-response that relies on the older gate-control theory [28]. The 2 hours pain free therapeutic gain (difference between active stimulation and sham stimulation) is 10% (17% for active stimulation and 7% for sham stimulation) [16]. Vagus nerve stimulation (gammaCore) is applied to the neck to activate an autonomic-somatic inhibitory interaction. The 2 hour pain free therapeutic gain of this device is 10.7% (30.4% for active stimulation and 19.7% for sham stimulation) [17]. This was, in fact, the primary endpoint of the study and it was not met. The 2-hour pain relief therapeutic gain of vagus nerve stimulation is 13.2% (40.8% for active stimulation and 27.6% for sham stimulation). Transcutaneous magnetic simulation (sTMS Mini) is applied to the occiput to inhibit cortical spreading depression. The 2 hour pain free therapeutic gain is 17.0% (39.0% for active stimulation and 22.0% for sham stimulation) [15]. Nerivo™, in the double-blind, sham-controlled, multicenter study demonstrated pain freedom at 2 hours in 37.4% vs. 18.4% of subjects, producing a therapeutic gain of 19.0%; p = 0.003).