The Vagus Nerve, Pain, FM and ME/CFS- a cause of central sensitivity?

[Cort]

The vagus nerve is so interesting. From Wikipedia:

Besides output to the various organs in the body the vagus nerve conveys sensory information about the state of the body's organs to the central nervous system. 80-90% of the nerve fibers in the vagus nerve are afferent (sensory) nerves communicating the state of the viscera to the brain.[1]

http://www.wisegeek.com/what-is-the-vagus-nerve.htm

The vagus nerve helps to regulate the heart beat, control muscle movement, keep a person breathing, and to transmit a variety of chemicals through the body. It is also responsible for keeping the digestive tract in working order, contracting the muscles of the stomach and intestines to help process food, and sending back information about what is being digested and what the body is getting out of it.

Without the functions of the vagus nerve, you would find it difficult to speak, breathe, or eat, and your heartbeat would become extremely irregular.

So far there isn't evidence of overt vagus nerve dysfunction in ME/CFS. There is, however, evidence of reduced parasympathetic activity - which the vagus nerve controls. Check out the below article which suggests that reducing vagal nerve functioning causes an FM like condition; ie it causes greatly enhanced pain sensitivity.

(Interestingly neural therapist like Mike's doctor think the autonomic nervous system plays a far more important role than the medical community realizes)

: Neuroscience. 2009 Sep 19. [Epub ahead of print] Links
Subdiaphragmatic vagotomy promotes nociceptive sensitivity of deep tissue in rats.

Furuta S, Shimizu T, Narita M, Matsumoto K, Kuzumaki N, Horie S, Suzuki T, Narita M.Department of Toxicology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan.

To verify whether vagal dysfunction is associated with chronic pain, we evaluated the effects of subdiaphragmatic vagotomy (vgx) on the sensitivity toward noxious stimuli in rats.

Note that there's no tissue damage - no overt injury! One of the big problems for IBS and FM patients (and ME/CFS) is that there's no tissue damage but increased pain = which in the eyes of many means a psychological interpretation of their illness. This suggests it could be due to a damaged vagal nerve. Interestingly if I remember correctly Dr. Perrin believe poor vagal nerve functioning plays a key role in ME/CFS

Vgx rats showed sustained hyperalgesia (increased pain) in the gastrocnemius muscle without tissue damage (no increase in vgx-induced plasma CPK or LDH levels) accompanied by hypersensitivity to colonic distension.

We found a dramatic increase in the levels of metabotropic glutamate receptor 5, protein kinase C (PKC) gammaand phosphorylated-PKCgamma within the spinal cord dorsal horn in vgx rats, which suggests that vgx may evoke sensory nerve plasticity.

Interestingly Neurontin (gabapentin) which some ME/CFS patients find helpful did help to lower the pain level.

Muscle hyperalgesia in vgx rats was also attenuated by gabapentin and amitriptyline, but was not affected by diclofenac, dexamethasone or diazepam. These findings indicate that subdiaphragmatic vagal dysfunction caused chronic muscle hyperalgesia accompanied by visceral pain and both gabapentin and amitriptyline were effective for subdiaphragmatic vagotomy-induced pain, which are partially similar to fibromyalgia syndrome.

Furthermore, this chronic muscle pain may result from nociceptive neuroplasticity of the spinal cord dorsal horn.

 

[Sushi]

Hi Cort,

I can't quote research on vagus nerve dysfunction but the first doctor to treat me was a specialist in autonomic dysfunction and he felt that the vagus nerve was often a culprit. My tilt table test also showed that the vagus nerve was too stimulatated. The pattern he saw in me was a sort of turf war between the sympathetic and the parasympathetic, with both over revved and competing for jobs.

I have one patient friend who had an experimental vagus nerve "pacer" put in for three days and all her symptoms disappeared--she felt totally well. There are others who have had "pacers" (that is a crude term for what it actually does) put in permanently and this operation caused them more grief.

So maybe, for some, regulating the vagus nerve would make a big difference. Of course there is probably a deeper cause for the vagus nerve not functioning properly too.

Another case of peeling the onion!

Sushi

 

[Wayne]

Cranial Nerves - Vagus Nerve - Digestion - Atlas Profilax

Hi All,

Here's a post I did back in February, '08 regarding the vagus nerve. I'm a big believer in trying to determine whether the vagus nerve may be malfunctioning or compromised in any way. For me, the Atlas Profilax technique helped me immeasurably. I suspect other therapies could also be very beneficial.

Wayne
............................................

Cautionary Note: This is a fairly long post.

Last summer (July 2007), I received an Atlas Profilax treatment and posted fairly extensively about my experience on a thread entitled Atlas Profilax Worked / is Working Very Well for Me. Real briefly, Atlas Profilax is a one-time treatment that permanantly aligns the uppermost vertabra called the Atlas.

One area that I haven't posted on is how I have come to believe this treatment released a lot of compression on my vagus nerve, and perhaps other cranial nerves as well. There's a bit of a story to this, so if you'll bear with me...

I noticed in the days immediately after getting my treatment that I was feeling unusually hungry. And when I did eat, it felt like I was really "wolfing" down my food. In a way, it almost felt sort of primal.

A couple weeks later, Heartprints posted on my above thread and mentioned how she had gotten extremely hungry afterwards. In her words, "I got extremely hungry after and food tasted better than ever. Been pigging out all day."

I eventually did some research on cranial nerves, and discovered there are 12 cranial nerves that descend down from the brain stem through the first cervical vertebra (the Atlas). All of these nerves have numerous functions, but the functions of the vagus nerve caught my attention.

It described how the vagus is the longest of the cranial nerves, traveling downward from the brainstem all the way to the throat, heart, and digestive areas. So it's degree of functionality has a direct impact on all of the organs involved. It described the function of the vagus nerve in the GI tract as having an "innervating" effect, meaning, giving energy to.

So I seemed to have found the answer to the mysterious hunger that both Heartprints and I experienced. But as the weeks and months went by, I noticed more subtle and not so subtle improvements as a result.

Because my digestion was now considerably improved, I was blowing my nose way less and coughing up much less amounts of phlegm. And as my digestion improved, so also did my immune system function. I'm not an expert in this area, but it has long been my understanding that the GI tract is a major portion of our immune system.

I have long dealt with what I have considered to be viral overload symptoms, and was happy to discover that these symptoms improved by approximately 75%. What I feel I've learned from my experience is the following:

Structural problems, especially if it involves the vagus nerve, can cause digestive problems. These in turn can cause absorption problems, create nutritional deficiencies and eventually a degree of immune system dysfunction. This all together I feel can create a vulnerability to all kinds of pathogens...some of which may be responsible or partly responsible for some of the symptoms of ME/CFS and/or FM.

I feel some of this information may relevant to readers here who have done, are doing, or are considering doing anti-viral or anti-biotic treatment for various pathogenic conditions. My understandng is that these treatments are not expected to fully eradicate any infection that may be present in the body, but to reduce the pathogenic load. That in the end, our bodies' own immune system must land the knock out punch.

I'm not an expert on this so I would gladly stand corrected if somebody feels this is not the case. But it would seem that the more we can do to support our digestion and immune system function, including removing associated structural blockages, the greater the likelihood of success for those doing the anti-viral and antibiotic treatments.

Another thing I feel is important to note is that the vagus nerve is also responsible for heart rate and stroke volume. This may be of particular interest to those who are interested in impedance cardiography tests which evaluate heart function and stroke volume.

The following website:

http://www.teaching-biomed.man.ac.uk/resources/wwwcal/cranial_nerves/page2.asp

has a diagram of the 12 cranial nerves and lists some of the functions of each. Any of these many functions can become impaired by a compressed or compromised cranial nerve. Other factors such as Lyme disease, etc. can also have major effects on the cranial nerves. Tansy seems to have good knowledge on some of these factors.

There's actually much more I could get into on this subject, but it's late and I'm wearing out. My hope is that this will serve as a catalyst for others to delve into the somewhat fascinating area of cranial nerves and how their functionality can affect our health in numerous ways.

Tansy posted on another thread the 12 cranial nerves and some of the functions associated with each. I pasted this information below for your reference.

Regarding Atlas Profilax: I believe this treatment to be one of the best starting points for addressing some of our health issues. Besides being able to possibly address a degree of immune system dysfunction as mentioned above, other reasons include:

1) Relatively inexpensive ($200-$250) 2) One-time procedure so one-time only expense 3) Has the potential to produce significant improvements 4) Can enhance the effectiveness of many other therapies

Regards to all,

Wayne

P.S. I think it's possible that the Atlas Profilax treatment also reduced pressure on some of my other nerves that are associated with swallowing.

***********************************************************

Twelve pairs of nerves, which branch out from the lower surface of the brain extend around the body, are each associated with a different brain function. At any stage of disseminated Lyme disease, any of these nerves may lose their ability to conduct electrical impulses properly, leading to cranial nerve palsy, commonly called paralysis in areas controlled by that pair of nerves. Cranial nerve palsy is the second most common Lyme neurological condition.

Here is what may go wrong with the twelve pairs of cranial nerves.

I. OLFACTORY: There may be loss of smell, or smells may be overly intense or noxious.

II. OPTIC: Partial or total loss of vision may occur.

III. OCULOMOTOR: The eyelids may droop, the eyeball may deviate outwards, or the pupils may become dilated. Some patients with a malfunctioning oculomotor nerve may squint involuntarily or see double images.

IV. TROCHLEAR: The eyeball may rotate upwards, and outwards or double vision may occur when looking down.

V. TRIGEMINAL: Pain or numbness in parts of the face, scalp, forehead, temple, jaw, eye or teeth has been reported. The muscles used for eating may become paralyzed or dysfunctional, making it difficult to chew, and the jaw may deviate toward the paralyzed side.

VI. ABDUCENS: The eye may deviate outwards, and excessive squinting or double vision may occur.

VII. FACIAL: The improper functioning of these nerves can result in Bell's Palsy on one or both sides of the face. Characteristic problems include facial numbness or pain and paralysis of the muscles, sometimes leading to difficulties in chewing or a tendency to dribble food. Patients are unable to wrinkle their foreheads, the lines on the forehead and nose may become abnormally smooth, and the eye droops. An inability to make tears has also been reported. In addition, the jaw deviates to the paralyzed side, and hearing loss can occur on the affected side. Tooth, ear, and jaw pain has been reported. Disruptions of the mucous membrane in the front two-thirds of the tongue result in loss of taste.

VIII. VESTIBULOCOCHLEAR: Hearing disturbances such as ringing in the ear or full or partial hearing loss may occur. Equilibrium disturbances such as dizziness, vomiting, or reeling are also associated with nerve dysfunction.

IX. GLOSSOPHARYNGEAL: Problems can occur with the mucous membranes in the back one-third of the tongue, leading to abnormal taste sensations, such as excessive sourness or bitterness, in that region. Improper functioning may also result in difficulty swallowing and paralysis of the glottis, a piece of tissue that ordinarily prevents you from inhaling food into your lungs or swallowing air.

X. VAGUS: Dysfunction of the muscles in the throat, shoulders, and back may create difficulty in swallowing or talking. Drooping shoulders and an inability to rotate the head away from the dysfunctional side may also occur. Malfunctions within other branches of this nerve may cause heart problems (including palpitations and a rapid pulse); breathing difficulties (including slow respiration and a sense of suffocation); a persistent cough; paralysis of the glottis; vocal cord spasms or paralysis (possibly resulting in an unusually deep voice, hoarseness, or a weak voice); and gastrointestinal disturbances (typically, constant vomiting). These nerves also affect the liver, spleen, kidney, thyroid, testes or ovaries.

XI. SPINAL ACCESSORY: This nerve pair can be associated with disrupted function or paralysis of the upper back and neck. Back spasms and the inability to tilt the head to the shoulder or to rotate the head in either direction can also occur.

XII. HYPOGLOSSAL: One side of the tongue may be partially or fully paralyzed, and the tongue or larynx may deviate toward the paralyzed side, with a resulting slowed articulation, thick speech, and difficulty swallowing.

Other nerve-related symptoms that can occur at any time during the course of Lyme disease include:

Diminished reflexes.

Sharp, shooting pains that radiate down the arms, legs or back.

Areas of numbness, tingling, prickling or heightened sensitivity.

Poor muscle coordination, muscle weakness or paralysis, involuntary muscle twitching, progressive muscle weakness, and movement disorders, including abnormal movements of the arms and legs and gait problems.
................................................................

Here's the link to this thread on the PH board where some of this was discussed in more detail.

http://www.prohealth.com/fibromyalgia/blog/boardDetail.cfm?id=1226021&b1=CHWEBO#1226021/

Wayne

 

[Dreambirdie]

my experiences with the vagus nerve

Thanks Wayne--that was very informative.

I had an experience in 1993, after cranial work done by my chiropractor, where my chronic headaches, along with related digestive issues, became much improved. Now I understand more about the dynamics as to why this would happen.

Also... in regard to the vagus nerve, I have many memories of my father taking my pulse as a kid (he was a doctor and that was one of his ways of showing affection--yes a little weird, but sweet), and laughing at what a "sensitive vagus nerve" I had. He used to tell me that he knew if I was about to have a bowel movement from how my hyped up pulse felt. And he also said my pulse was very sensitive to my breathing, more than is usual. So this must have something to do with the parasympathetic system in my body being overly stimulated and reactive, which I had LONG before I ever got sick with CFS.

 

[jenbooks]

Wayne, that link doesn't work for me. Can you tell me where to go for that info?

I agree the vagus nerve is very important. I have some gentle massage techniques that I'm pretty sure help it shift me into parasympathetic (on the sternum and the coccyx).

I would add though that most folks with fibro probably have small fiber neuropathy, which is rarely tested for (by biopsy). Dr Younger at NYU does find it often in lymies anyway. The nerves when impaired (damaged) actually give greater pain signals.

 

[Wayne]

Wayne, that link doesn't work for me. Can you tell me where to go for that info?

I agree the vagus nerve is very important. I have some gentle massage techniques that I'm pretty sure help it shift me into parasympathetic (on the sternum and the coccyx).

I would add though that most folks with fibro probably have small fiber neuropathy, which is rarely tested for (by biopsy). Dr Younger at NYU does find it often in lymies anyway. The nerves when impaired (damaged) actually give greater pain signals.

Hi Jen,

The link doesn't work for me either. Too bad, because it was good, and after searching around, I can't seem to find one that's similar. About the best I came up with was Wikipedia.

While searching, I did find an interesting website where they were advertising a book entitled: "Manual Therapy for the Cranial Nerves." I found it pretty interesting, and may see if I can perhaps get an inter-library loan on it. I'll paste some of the captions about the book below.

Wayne
............................................

Manual Therapy for the Cranial Nerves

* Incorporates new techniques that have an effect on the most precious part of the cranium, the brain.
* Teaches you how to manipulate this delicate neural system safely.
* Has over 100 full color line illustrations showing the anatomy underlying the techniques, while accompanying full color photographs demonstrate the techniques themselves.
* Will make you aware of the brain as the primary target of your action as practitioner.

The brain, although protected by cerebrospinal fluid, is sensitive to all variations in pressure. In this text you will find ways for modifying intra-cranial pressure, which has vascular and cerebral consequences. To function at its best, the brain requires malleability and plasticity. By manually modifying intra-cranial pressure, we obtain promising effects on the hydromechanics of the brain.

The central focus of the book is on the practical application of cranial nerve manipulation. Thanks to the wealth of illustrations it is also an excellent guide with which to visualize the cranial nerves and to understand their many functions.

 

[Wayne]

And he also said my pulse was very sensitive to my breathing, more than is usual. So this must have something to do with the parasympathetic system in my body being overly stimulated and reactive, which I had LONG before I ever got sick with CFS.

Hi Dreambirdie,

Very interesting comments. Makes me wonder if Mike's doctor is able to do the same kind of "sensing" of neural impulses as your father. It might explain why he's able to pinpoint his treatments to what's going on at any specific moment and tailor his approach accordingly.

I wonder if the pulses that acupuncturists check for also includes cranial/vagus nerve impulses. Any idea?

Wayne

 

[Cort]

My recollection of talking with Dr. Perrin at the Reno conference was that he believed the vagus nerve is very important and that manipulations or massages or whatever in that area could be very helpful. He does have techniques outlined in his book.

Dr. Lapp has said that most ME/CFS patients have really tightened upper bodies and I wonder if that could contribute in some way. That's been true for me for years but I have to very careful about stretching my neck is it can quickly bring on nausea and all sorts of weird symptoms - this suggests to me that some structural problems are indeed involved.

My recollection is that Dr. Klimas believes this is a disorder of an overactive parasympathetic nervous response trying to muffle an overactive synthetic nervous system response. Staci Stevens just believes the autonomic nervous system is a mess; she's not sure which is dominant. I'm sure there will be varying degrees and types of dysfunction.

 

[Sing]

Vagus Suspicions

Dear Cort and Others,

I quote:

http://www.wisegeek.com/what-is-the-vagus-nerve.htm


"Quote:
The vagus nerve helps to regulate the heart beat, control muscle movement, keep a person breathing, and to transmit a variety of chemicals through the body. It is also responsible for keeping the digestive tract in working order, contracting the muscles of the stomach and intestines to help process food, and sending back information about what is being digested and what the body is getting out of it.

Quote:
Without the functions of the vagus nerve, you would find it difficult to speak, breathe, or eat, and your heartbeat would become extremely irregular.

So far there isn't evidence of overt vagus nerve dysfunction in ME/CFS. There is, however, evidence of reduced parasympathetic activity - which the vagus nerve controls. Check out the below article which suggests that reducing vagal nerve functioning causes an FM like condition; ie it causes greatly enhanced pain sensitivity. "

I got suspicious of the vagus nerve as a possible source of my dysfunction when I had three very severe day of vomiting within one month. The only commonality seemed to be that I ate breakfast in a hurry, under stress. The vomiting went on for hours and nausea was not relieved in between times so I couldn't leave the bathroom floor, where I happened to be very cold. This was in December three years ago. Soon afterwards I got an extreme diarrhea illness. The illness went away but the diarrhea did not. For 18 months until I totally eliminated a number of my basic foods, I had diarrhea. Now I am on reprieve with only a great deal of gas; my body ready to resume the diarrhea if I go back on those foods. I was given the major antibiotics for bacterial, fungal or parasitic infections on a sustained basis (3-4 months) which produced no healing whatsoever.

In the past year I have to make an effort to breathe. Digestion doesn't happen automatically or well at all. It is some time after finishing a meal too that I even know I have eaten. My heartrate I am not sure of. I think it is usually quite slow. I am dizzy and faint often and benefit from lots of salt. If I try to hurry while dizzy I go into a racing heart and even more fatigue. I have more pain than ever. Can't tolerate many fabrics or anything tight. This frightens me for the upcoming winter because wool, fleece and heavy cotton are all offenders. And I am much colder than others. Arthritis is racing through my body this year at the same time.

What next?

Cecelia