The Effects of Noninvasive Vagus Nerve Stimulation on Fatigue and Immune Responses in Sjogrens

[Murph]

Neuromodulation. 2018 Oct 17. doi: 10.1111/ner.12879. [Epub ahead of print]
The Effects of Noninvasive Vagus Nerve Stimulation on Fatigue and Immune Responses in Patients With Primary Sjögren's Syndrome.
Tarn J1, Legg S1, Mitchell S1, Simon B2, Ng WF1.
Author information
Abstract
OBJECTIVES:
Primary Sjögren's syndrome (pSS) sufferers have rated chronic fatigue as the most important symptom needing improvement. Emerging data suggest that stimulation of the vagus nerve can modulate immunological responses. The gammaCore device (electroCore), developed to stimulate the cervical vagus nerve noninvasively, was used to assess the effects of vagus nerve activation on immune responses and clinical symptoms of pSS.

MATERIALS AND METHODS:
Fifteen female pSS subjects used the nVNS device twice daily a 26-day period. At baseline, blood was drawn before and after application of the gammaCore device for 90 sec over each carotid artery. The following fatigue-related outcome measures were collected at baseline, day 7 and day 28: EULAR patient reported outcome index, profile of fatigue (Pro-F), visual analogue scale of abnormal fatigue, and Epworth sleepiness scale (ESS). Whole blood samples were stimulated with 2 ng/mL lipopolysaccharide (LPS) and the supernatant levels of IFNγ, IL12-p70, TNFα, MIP-1α, IFNα, IL-10, IL-1β, IL-6, and IP-10 were measured at 24 hours. In addition, clinical hematology and flow cytometric profiles of whole blood immune cells were analyzed.

RESULTS:
Pro-F and ESS scores were significantly reduced across all three visits. LPS-stimulated production of IL-6, IL-1β, IP-10, MIP-1α, and TNFα were significantly reduced over the study period. Patterns of NK- and T-cell subsets also altered significantly over the study period. Interestingly, lymphocyte counts at baseline visit correlated to the reduction in fatigue score.

CONCLUSION:
The vagus nerve may play a role in the regulation of fatigue and immune responses in pSS and nVNS may reduce clinical symptoms of fatigue and sleepiness. However, a sham-controlled follow-up study with a larger sample size is required to confirm the findings.

© 2018 International Neuromodulation Society.

KEYWORDS:
Fatigue; Sjögren's syndrome; immune reflex; noninvasive vagus nerve stimulation

 

[Murph]

Michael van Elzakker at Harvard is the MECFS vagus nerve guy. I wonder what he thinks of this.

On the one hand, the results are terrific. Getting a clinicial result and a lab results to line up is amazing.

On the other hand, the sample is small and the study is unblinded and one of the four listed authors seems to be involved in the company that makes these things.

(I'm not someone who thinks commercial involvement means things are corrupt or biased - one reason to quit your professorship and gather your patents and start a private company is that you know the tech works!) But still. This paper does not in itself constitute high-quality evidence

 

[ScottTriGuy]

Looks like they did an IPO in the summer at $20 and the stock price has only gone downhill to $12 - fwiw.

 

[Murph]

Looks like they did an IPO in the summer at $20 and the stock price has only gone downhill to $12 - fwiw.

So that's a buy recommendation from the analysts at TriGuy Capital?

 

[xrayspex]

Michael van Elzakker at Harvard is the MECFS vagus nerve guy. I wonder what he thinks of this.

On the one hand, the results are terrific. Getting a clinicial result and a lab results to line up is amazing.

On the other hand, the sample is small and the study is unblinded and one of the four listed authors seems to be involved in the company that makes these things.

(I'm not someone who thinks commercial involvement means things are corrupt or biased - one reason to quit your professorship and gather your patents and start a private company is that you know the tech works!) But still. This paper does not in itself constitute high-quality evidence

I was diagnosed with Sjogrens in 2011 after having some form of chronic pain and fatigue for a long time--also have cervical stenosis--but I had improvements on energy and pain from using frequency specific microcurrent in the last year and a half---that is known to increase ATP. Anyway, I mention it because wondering if this modality could effect ATP too and if that could be reason for energy improvement....not sure how vague nerve would relate in, will have to explore that

 

[xrayspex]

oh looking at their website, neuromodulation, yea that is bit different than microcurrent. i tried a form of that with the flexy system by Len Ochs some years ago had some limited help