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= Vagus Nerve Stimulation (VNS) =
{{Infobox medical intervention
| name        = Vagus Nerve Stimulation
| image        = Vagus nerve stimulation.jpg
| caption      = Vagus nerve stimulation device
| ICD10        =
| ICD9        =
| MeshID      = D000000
| MedlinePlus  =
| eMedicine    =
| other_codes  =
}}


'''Vagus Nerve Stimulation (VNS)''' is a medical treatment that involves the use of a device to deliver electrical impulses to the vagus nerve, one of the cranial nerves that extends from the brainstem to the abdomen. VNS is primarily used to treat epilepsy, particularly in cases where seizures are not well-controlled by medication. It has also been explored as a treatment for depression and other disorders.
'''Vagus Nerve Stimulation''' (VNS) is a medical treatment that involves delivering electrical impulses to the [[vagus nerve]]. It is primarily used to treat [[epilepsy]] and [[treatment-resistant depression]].


== Overview ==
==Overview==
The vagus nerve plays a crucial role in regulating various bodily functions, including heart rate, digestion, and mood. VNS leverages this influence by delivering regular, mild electrical stimulations to the nerve, aiming to reduce the frequency and intensity of seizures in epilepsy patients and to improve symptoms in other conditions.
The vagus nerve is the tenth cranial nerve and is responsible for various functions, including heart rate, gastrointestinal peristalsis, sweating, and muscle movements in the mouth, including speech. VNS therapy involves the use of a device that is surgically implanted under the skin in the chest, with a wire that connects to the left vagus nerve in the neck. The device sends regular, mild pulses of electrical energy to the brain via the vagus nerve.


[[File:Vagusstimulator bei Lennox-Gastaut-Syndrom 17M - CR ap - 001.jpg|thumb|500px|Diagram illustrating the path of the vagus nerve in the human body.]]
==History==
Vagus nerve stimulation was first approved by the [[Food and Drug Administration]] (FDA) in 1997 for the treatment of epilepsy. In 2005, it was also approved for the treatment of [[major depressive disorder]] in patients who have not responded to traditional therapies.


== Mechanism of Action ==
==Mechanism of Action==
The precise mechanism by which VNS exerts its effects is not fully understood, but it is believed to modulate neurotransmitter levels and neural circuits involved in seizure generation and propagation. By stimulating the vagus nerve, VNS may help to stabilize the brain's electrical activity and prevent seizures.
The exact mechanism by which VNS exerts its effects is not fully understood. However, it is believed that the electrical stimulation of the vagus nerve affects neurotransmitter levels in the brain, including [[serotonin]] and [[norepinephrine]], which play a role in mood regulation and seizure activity.


== Indications ==
==Clinical Applications==
VNS is typically indicated for individuals with:
===Epilepsy===
* Drug-resistant epilepsy, where seizures are not adequately controlled by antiepileptic drugs.
VNS is used as an adjunctive therapy for patients with refractory epilepsy, meaning their seizures are not controlled by medication alone. Studies have shown that VNS can reduce the frequency and severity of seizures in some patients.
* Chronic or recurrent depression that has not responded to several different treatment methods.


== Procedure ==
===Depression===
The VNS procedure involves the surgical implantation of a small device, similar to a pacemaker, under the skin in the chest. A wire from the device is wrapped around the left branch of the vagus nerve in the neck. The device is programmed to deliver electrical impulses at regular intervals to the nerve.
For patients with treatment-resistant depression, VNS can be an option when other treatments, such as medication and psychotherapy, have failed. Clinical trials have demonstrated that VNS can lead to improvements in mood and overall functioning in some patients.


[[File:Vagus nerve stimulation.jpg|thumb|500px|A Vagus Nerve Stimulation device and its placement in the human body.]]
==Procedure==
The implantation of a VNS device is a surgical procedure that typically takes about 1 to 2 hours. It is usually performed under general anesthesia. After implantation, the device is programmed to deliver electrical impulses at specific intervals. The settings can be adjusted by a healthcare provider using a special programming device.


== Benefits ==
==Side Effects==
Patients undergoing VNS may experience:
Common side effects of VNS include hoarseness, throat pain, cough, and shortness of breath. These side effects are often related to the stimulation of the vagus nerve and may decrease over time.
* A significant reduction in seizure frequency and intensity.
* Improved mood and quality of life, especially in individuals with treatment-resistant depression.
* A decrease in the use of antiepileptic medications in some cases.


== Side Effects and Considerations ==
==Research and Future Directions==
While VNS is generally safe, it can cause side effects, including:
Ongoing research is exploring the use of VNS for other conditions, such as [[anxiety disorders]], [[Alzheimer's disease]], and [[chronic pain]]. The potential for VNS to modulate brain activity and improve symptoms in these conditions is an area of active investigation.
* Hoarseness or changes in voice tone.
* Throat pain or discomfort.
* Shortness of breath, especially during physical activity.
* Coughing or tingling sensation in the skin.


== Impact on Epilepsy and Other Conditions ==
==Also see==
Clinical studies and patient reports indicate that VNS can be an effective adjunct treatment for reducing the burden of epilepsy and improving the management of treatment-resistant depression. Ongoing research continues to explore the potential of VNS in treating other conditions, such as anxiety disorders, obesity, and chronic pain.
* [[Epilepsy]]
* [[Major depressive disorder]]
* [[Cranial nerves]]
* [[Neurostimulation]]


== External Links ==
{{Medical interventions}}
* [https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/devices/vagus-nerve-stimulation-vns Epilepsy Foundation - Vagus Nerve Stimulation (VNS)]
* [https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies National Institute of Mental Health - Brain Stimulation Therapies]
 
== References ==
<references/>
* ''Vagus Nerve Stimulation'' edited by Elliot Krames, P. Hunter Peckham, and Ali R. Rezai
* ''The Vagus Nerve Stimulation Story: A Decade of Progress'' by Paul E. Greene


[[Category:Neurosurgery]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Treatments]]
[[Category:Psychiatry]]
[[Category:Epilepsy]]
{{stub}}

Revision as of 02:54, 11 December 2024

  
Vagus nerve stimulation device
Pronunciation
Other names
Medical specialty
Uses
Complications
Approach
Types
Recovery time
Other options
Frequency



Vagus Nerve Stimulation (VNS) is a medical treatment that involves delivering electrical impulses to the vagus nerve. It is primarily used to treat epilepsy and treatment-resistant depression.

Overview

The vagus nerve is the tenth cranial nerve and is responsible for various functions, including heart rate, gastrointestinal peristalsis, sweating, and muscle movements in the mouth, including speech. VNS therapy involves the use of a device that is surgically implanted under the skin in the chest, with a wire that connects to the left vagus nerve in the neck. The device sends regular, mild pulses of electrical energy to the brain via the vagus nerve.

History

Vagus nerve stimulation was first approved by the Food and Drug Administration (FDA) in 1997 for the treatment of epilepsy. In 2005, it was also approved for the treatment of major depressive disorder in patients who have not responded to traditional therapies.

Mechanism of Action

The exact mechanism by which VNS exerts its effects is not fully understood. However, it is believed that the electrical stimulation of the vagus nerve affects neurotransmitter levels in the brain, including serotonin and norepinephrine, which play a role in mood regulation and seizure activity.

Clinical Applications

Epilepsy

VNS is used as an adjunctive therapy for patients with refractory epilepsy, meaning their seizures are not controlled by medication alone. Studies have shown that VNS can reduce the frequency and severity of seizures in some patients.

Depression

For patients with treatment-resistant depression, VNS can be an option when other treatments, such as medication and psychotherapy, have failed. Clinical trials have demonstrated that VNS can lead to improvements in mood and overall functioning in some patients.

Procedure

The implantation of a VNS device is a surgical procedure that typically takes about 1 to 2 hours. It is usually performed under general anesthesia. After implantation, the device is programmed to deliver electrical impulses at specific intervals. The settings can be adjusted by a healthcare provider using a special programming device.

Side Effects

Common side effects of VNS include hoarseness, throat pain, cough, and shortness of breath. These side effects are often related to the stimulation of the vagus nerve and may decrease over time.

Research and Future Directions

Ongoing research is exploring the use of VNS for other conditions, such as anxiety disorders, Alzheimer's disease, and chronic pain. The potential for VNS to modulate brain activity and improve symptoms in these conditions is an area of active investigation.

Also see

Template:Medical interventions