Vagus Nerve Stimulation Works - in Sjogren's Syndrome

Cort

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So it;s Sjogren's Syndrome - not ME/CFS but you know what? There may be a lot of undiagnosed SS in ME/CFS and this SMALL study does look at the effects of non-invasive vagus nerve stimulation on fatigue.

The non-invasive aspect is key - few people can afford or want to have a stimulator inserted into their necks but non-invasive VNS simply requires attaching something to your ear.

The VNS stimulators are coming to the U.S. I don;t think they are here yet but they are coming. I believe Ben Natelson is doing a non-invasive VNS study in FM now.


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.

(Numerous blogs and resources on vagus nerve stimulation exist on Health Rising)
 

Moof

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@Cort – I think gammaCore is already prescribe-able for migraine. It certainly is in the UK (NICE cleared them for use in 2016), and as it's a US-made product, it would surprise me if it weren't available there too.
 

anne_likes_red

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I read this in a recent review paper too..
Nexeon MedSystems (Dallas, TX, USA) recently announced its completion of an initial series of clinical studies evaluating the utilization of its tVNS device for the treatment of atrial fibrillation.
http://nexeonmed.com/
 

sb4

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@anne_likes_red Just wandering how long it took you to notice effects on motility. I am 3 days in yet I had the worst episode of gastroparesis I had in months. I am sure it was eating fatty pork that did this as I have had that reaction before to the same food, still though, slightly disappointing that the tVNS has had no noticeable effect. I intend to keep at it until at least next year regardless though.