Vagus Nerve Stimulation, Fibromyalgia and Chronic Fatigue Syndrome (ME/CFS)

By | October 18, 2016

Many of the participants in that study no longer met the criteria for FM after it: that’s a criteria for success that few FM studies are willing to even contemplate using.The study also required the surgical implantation of a vagus nerve stimulator. That’s an option – running somewhere around 30-40K – that’s available to few. Thankfully non-invasive vagus nerve stimulators worn on the ear have and are being developed.See “Reborn” – Reversing Fibromyalgia with Vagus Nerve StimulationWhen a recent three part review did an overview of our understanding of what the vagus nerve does, how vagus nerve stimulation works and how it effective it is, I jumped on it. This blog took the following papers as a foundation. Vagus Nerve and Vagus Nerve Stimulation, a Comprehensive Review: Part I. Yuan H, Silberstein SD. Headache. 2015 Sep 14. doi: 10.1111/head.12647. [Epub ahead of print] Review. Vagus Nerve and Vagus Nerve Stimulation, a Comprehensive Review: Part II. Yuan H, Silberstein SD. Headache. 2015 Sep 18. doi: 10.1111/head.12650. [Epub ahead of print] Review. Vagus Nerve and Vagus Nerve Stimulation, a Comprehensive Review: Part III. Yuan H, Silberstein SD. Headache. 2015 Sep 14. doi: 10.1111/head.12649. [Epub ahead of print] Review.Besides the fibromyalgia study, the vagus nerve is of particular interest in both fibromyalgia and chronic fatigue syndrome (ME/CFS) because of the role it plays in regulating the autonomic nervous and immune systems providing sensory and other information to the brain and Michael Van Elzakker’s Vagus Nerve Hypothesis – Van Elzakker suspects small infections in or around the vagus nerve could be triggering it to tell the brain to produce flu-like symptoms in people with chronic fatigue syndrome (ME/CFS). A pilot study to assess that possibility is underway now.The Wanderer Called the wanderer, the vagus nerve is the longest “cranial nerve” (a nerve that emanates from the head) in the body. Attaching at the medulla at the bottom of the brainstem, the many fingers of the vagus nerve reach down our torso to infiltrate most of our organs. The extensive network it forms – it’s the largest neural network in the body – provides a pathway through which information is sent to the brain regarding the status of our organs.Vagus nerves densely innervate every ‘sensing area’ of the body with a particular focus on the walls of the blood vessels throughout the body and the digestive system. The vagus nerve regulates our heart and breathing rates, blood pressure and blood flow via receptors in the blood vessels that monitor O2, CO2, and pH levels in the blood and blood pressure.Autonomic-nervous-systemIn the gut the vagus nerve controls gut movements (motility), secretions, inflammatory responses, the integrity of the gut lining and even appetite. Reflexive movements like coughing, gagging and vomiting are all controlled by the vagus nerve.If a pathogen is present the vagus nerve will let your brain know that. If you’ve cut your finger, are feeling hot or cold, or have just eaten something – the vagus nerve will let your brain know that.Ultimately information on touch, heat/cold, pain and chemical, metabolic, and hormonal operations of the organs is all transmitted via the vagus nerve to the brain. It effects the functioning of every system – from the immune to endocrine to the hormonal system – in our body.Immune Regulator The last ten or twenty years have revealed that the vagus nerve (VN) is a significant immune system regulator. The cholinergic anti-inflammatory immune response it regulates mostly takes place in the spleen.Think of the spleen as an enormous lymph node which dictates much of the innate or early immune response. Besides filtering blood the spleen synthesizes antibodies, removes bacteria and plays host to half the monocytes found in the body. These monocytes – which turn into dendritic cells and macrophages play a key role in the innate or early immune response, which plays a key role in producing many inflammatory states.The cholinergic anti-inflammatory response has been shown to reduce the levels of a wide variety of inflammatory cytokines. Studies are underway to assess the ability of VNS to reduce inflammation in diseases such as rheumatoid arthritis and inflammatory bowel disease.Autonomic Nervous System Regulator The vagus nerve’s effects on autonomic nervous system functioning could easily account for the benefits thus far seen in fibromyalgia and other pain disorders. The vagus nerve boosts the activity of the parasympathetic nervous system (rest and digest) and reduces sympathetic nervous system (fight or flight) system.Reduced heart rate variability findings suggest that reduced parasympthetic nervous system functioning is present in both ME/CFS and FM. Reduced HRV has been associated with increased sympathetic nervous system activity, pain and sleep and cognitive problems in ME/CFS and/or FM.Because VNS increases heart rate variability it’s possible tha

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