In recent years, the vagus nerve has become an
object of fascination, especially on social media. The vagal nerve fibers,
which run from the brain to the abdomen, have been anointed by some influencers
as the key to reducing anxiety, regulating the nervous system and helping the
body to relax.
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TikTok videos with the hashtag “#vagusnerve”
have been viewed more than 64 million times and there are nearly 70,000 posts
with the hashtag on Instagram. Some of the most popular ones feature simple
hacks to “tone” or “reset” the vagus nerve, in which people plunge their faces
into ice water or lie on their backs with ice packs on their chests.
Now, wellness companies have capitalized on
the trend, offering products such as vagus massage oil, pillow mists and
vibrating bracelets. These products claim to stimulate the nerve but have not
been endorsed by the scientific community.
Researchers who study the vagus nerve say that
stimulating it with electrodes can potentially help improve mood and alleviate
symptoms in those who suffer from treatment-resistant depression, among other
ailments. But are there other ways to activate the vagus nerve? Who would
benefit most from doing so? And what exactly is the vagus nerve, anyway? Here’s
a look at what we know so far.
What is the vagus nerve?
The term “vagus nerve” is actually shorthand
for thousands of fibers. They are organized into two bundles that run from the
brain stem down through each side of the neck and into the torso, branching
outward to touch our internal organs, said Dr. Kevin Tracey, a neurosurgeon and
president of the Feinstein Institutes for Medical Research, Northwell Health’s
research center in New York.
Imagine something akin to a tree, whose limbs
interact with nearly every organ system in the body. (The word “vagus” means
“wandering” in Latin.)
The vagus nerve picks up information about how
the organs are functioning and sends information from the brain stem back to
the body, helping to control digestion, heart rate, voice, mood and the immune
system.
For those reasons, the vagus nerve — the
longest of the 12 cranial nerves — is sometimes referred to as an information superhighway.
Tracey compared it to a trans-Atlantic cable.
“It’s not a mishmash of signals,” he said.
“Every signal has a specific job.”
Scientists first began examining the vagus
nerve in the late 1800s to investigate whether stimulating it could be a potential
treatment for epilepsy. They later discovered that a side effect of activating
the nerve was an improvement in mood. Today, researchers are examining how the
nerve can affect psychiatric disorders, among other conditions.
What does the research say?
Evidence indicates that stimulating the vagus
nerve can help people with epilepsy, diabetes, treatment-resistant depression
and post-traumatic stress disorder — as well as inflammatory autoimmune
conditions such as Crohn’s disease or rheumatoid arthritis.
“It can sound sort of magical with all the
things it does,” said Eric Porges, an assistant professor in the department of
clinical and health psychology at the University of Florida who studies the
vagus nerve. Our understanding of the vagus nerve “continues to grow in
richness and depth,” he said.
In the early 2000s, researchers started to
show that vagus nerve stimulation could help some patients who were severely
depressed and had not responded to other treatments.
A wave of studies followed.
By 2005, the Food and Drug Administration had
approved implantable pulse-generating devices that sent electrical signals to
the vagus nerve, for use in patients with treatment-resistant depression.
Similar devices have also been approved for obesity — to help control feelings
of hunger and fullness — and for the treatment of epilepsy.
Researchers are now recruiting patients for
the largest clinical trial to date examining to what degree vagus nerve
stimulation may help patients with depression who have been unable to find
relief with other treatments.
Implanting a device may be especially helpful
for those with bipolar depression because so few treatments exist for them,
said Dr. Scott Aaronson, one of the senior psychiatrists involved in the
clinical trial and chief science officer of the Institute for Advanced
Diagnostics and Therapeutics.
Implanted vagus nerve stimulation isn’t
accessible for most people, however, because insurers have declined to pay for
the procedure, with the exception of Medicare recipients participating in the
latest clinical trial.
Tracey’s research, which uses internal vagus
nerve stimulation to treat inflammation, may also have applications for
psychiatric disorders such as PTSD, said Dr. Andrew Miller, director of the
Behavioral Immunology Program at Emory University, who studies how the brain
and the immune system interact and how those interactions can contribute to
stress and depression.
PTSD, he said, is characterized by increased
measures of inflammation in the blood, which “can influence circuits in the
brain that are related to anxiety.”
The activity of the vagus nerve is difficult
to measure directly, especially given how complex it is. But because some vagus
nerve fibers connect with the heart, experts can indirectly measure cardiac
vagal tone — or the way in which your nervous system regulates your heart — by
looking at your heart-rate variability, which are the fluctuations in the
amount of time between your heartbeats, on an EKG.
An abnormal vagal tone — one in which there is
very little heart rate variability — has been associated with conditions such
as diabetes, heart failure and high blood pressure.
A high variability between heart beats may
signify an ideal vagal tone.
How to improve vagal tone
Holding your breath and submerging your face
in cold water can trigger the “diving reflex,” a response that slows the heart
beat and constricts blood vessels. Some people who have tried it report that it
has a calming effect and can even reduce insomnia. Others wrap an ice pack in
cloth and place it on their chest to relieve anxiety.
But Tracey urged caution, adding that it’s
difficult to properly assess the risks and benefits without clinical data.
“I would not advise anyone to do any
intervention without checking with their physician,” he said. “For wellness,
try to maintain high vagus nerve activity through mindfulness, exercise and
paced breathing. These are all very good for you.”
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