Saturday, March 2, 2024

Vagus Nerve Stimulation And Parkinson’s

Whos A Candidate For Nerve Stimulation

Use of Vagus Nerve Stimulation in Reversal of Brain Injury

DBS works for people who have tremors that do not always respond to medication. It also helps with motor fluctuations, slowness, and rigidity. Its not ideal for those with dementia, uncontrolled psychiatric problems, or walking problems. Fewer than 5 percent of people with the disease are good candidates for DBS.

DBS is not the initial treatment option when a person is first diagnosed, Ramdhani said.

We dont look at DBS early in the disease, he said. In fact, its often deployed six or seven years into the disease progression. In the past, doctors didnt use the technology until about a decade after diagnosis. Now, they are finding better results when it is used sooner.

To determine who can receive treatment, Machado said his organization gathers a committee to evaluate each person.

Read More: New Research Partnership Is a Parkinsons Game Changer »

In general, were offering this for patients that already have advanced Parkinsons, he said. In many cases, the disease was initially well managed but the neurologist eventually turned to DBS in order to improve the persons quality of life. DBS also can help during the late stages of life.

Were now seeing 10 years after, that the results are still good, Machado said.

Now that we know that its possible and safe we are exploring how it may help many, many other disorders, he added.

Xen By Neuvana: First

WEST PALM BEACH, Fla., Nov. 2, 2021 /PRNewswire/ — U.S.-based Neuvana LLC, a wellness company and leader in neuroscience technology, announces the much-anticipated release of its new product, Xen, is now available to consumers in the 27 countries that make up the European Union and United Kingdom. This is the next step in the company’s international launch, which started shipping to Canada last month and expects to add more countries in the coming months.

Xen by Neuvana is a pocket-sized device that connects to your mobile phone through an app and sends a gentle electrical signal through patented earbuds to stimulate the vagus nerve in the ear. Invented by a leading cardiac surgeon and supported by science, Xen’s innovative design targets the vagus nerve, the longest cranial nerve in the body, which acts as the information highway from the brain to most of the body’s major organs. When stimulated, the vagus nerve activates the parasympathetic nervous system by signaling the brain to release calming neurotransmitters such as acetylcholine and norepinephrine. This natural chemical process can help the body feel calmer, more focused, increase mood, and achieve better sleep too.

Starting this week, consumers can preorder their Xen product starting at 444.70 EUR online at www.neuvanalife.com. The company will start shipping to all EU countries and the UK beginning November 15.

Science Behind Vagus Nerve Stimulation

Backed by Research

About Neuvana LLC

Harvard Neuroscientist Dr Michael Van Elzakker: Chronic Fatigue Vagus Nerve Link

“The vagus nerve is really a fascinating organ. Its one of the cranial nerves and its a unique cranial nerve in that it innervates the trunk, the torso, the organs. It actually innervates all of the major trunk organs and its a bi-directional nerve. We call it a mixed nerve. Its got fibers going from the brain to the organs, controlling them, and then its got fibers going from the organs to the brain, which is a way of letting the brain know whats happening in the torso, in the body.”

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What Happens In The Vagus Nerve: The Pd Gut

The gut-brain relationship is real. Stomach or intestinal distress can lead to anxiety or depression. However, those gut-brain connections go much further: evidence from recent studies strongly suggest a link between the gut and Parkinsons disease .

In the PD research field, the Braak Hypothesis states that the earliest signs of Parkinson’s are found in the enteric nervous system . This theory is supported by evidence that in PD, non-motor symptoms, such as constipation, may appear before motor symptoms. Braak hypothesized that abnormal alpha-synuclein can spread from the gut via the vagus nerve to the midbrain, where it selectively kills dopamine neurons.

Get to Know the Brain

Alpha-synuclein: a protein found in the brain, central to Parkinsons.

Central Nervous System:controls most functions of the body and mind. Consists of the brain and the spinal cord.

Prion: a protein that can harm a normal protein, causing damage to healthy brain cells. Some scientists believe alpha-synuclein can become a prion and lead to Lewy body clumps, the hallmark of PD.

Vagus Nerve: a nerve that connects the brain to the gut. Regulates organ functions, such as digestion, heart rate, respiratory rate, coughing, sneezing and swallowing.

ResultsIn normal mice:

In the mice with no alpha-synuclein:

  • Injecting abnormal alpha-synuclein into their gut successfully made it into the brain, but nothing happened. Since there was no normal alpha-synuclein, it was not able to start the clumping.

Prevention And Treatment Of Diseases Via Vagal Regulation Of Auricular Acupuncture

Antidepressants

The nuclei of the vagus nerve in the brainstem have been implicated as one of the earliest regions in the pathophysiological process of both Alzheimer’s and Parkinson’s diseases. Far-field potentials from brainstem after transcutaneous vagus nerve stimulation at the auricle have been utilized as a noninvasive method in the early diagnosis of neurodegenerative disorders . We suggest that further study is needed on whether auricular acupuncture plays a role in the prevention and treatment of these neurodegenerative disorders via activating the vagal nuclei in the brainstem.

Vagus nerve stimulation has been approved by FDA as an alternative treatment for neuropsychiatric diseases such as epilepsy and depression. In order to avoid the disadvantages of cervical vagus nerve stimulation, less invasive methods including transcutaneous vagus nerve stimulation and electrical auricula-vagus stimulation to stimulate vagal afferences have been proposed. In a pilot study, an overall reduction of seizure frequency was observed in five of seven patients after 9 months of electrical stimulation of the ABVN. It is also found that the electrical stimulation of the ABVN is safe and well tolerated . As a complementary method, it is also proposed that auricular acupuncture may suppress epileptic seizures via activating the parasympathetic nervous system .

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Dr Diana Driscoll Interview: Vagus Nerve And Pots/mast Cell Activation

Dr Driscoll appears to have been on a similar, parallel journey to myself through her own set of symptoms.

When I had POTS, I assumed all of these symptoms would be viewed as part of my autonomic dysfunction… I came to realize that my specialist viewed these additional symptoms as basically being unrelated. That was my first hint that we were dealing with an illness that had no answers at the time.”

She also firmly concluded that the Vagus Nerve has an absolutely central role in these types of syndromes. Indeed, she has gone so far as to develop a line of isupplements for directly supporting and maintaining VN health.

Given that syndromes like POTS and EDS are often complicating factors in Parkinson’s Disease, the new understandings which Dr Driscoll has provided are also extremely relevant for PwP . Indeed, I’m sure PwP everywhere will recognize they have a lot of symptoms in common with those of POTS:

“Symptoms include lightheadedness, dizziness, weakness, shaking and trembling, nausea, tunnel vision, difficulty speaking, et cetera. Secondly, I view this as a syndrome. Its a cluster of symptoms, if you will, that reaches far beyond orthostatic intolerance and includes such things as headaches, gastroparesis, constipation and IBS, extreme and chronic fatigue, difficulty breathing, hyperadrenergic tendencies, depression, sensitivities to sounds, stress, light, and movement, among other symptoms.”

Extensive Connections Between The Nts With Visceral Organs And Other Brain Structures

The NTS in the brainstem carries and receives visceral primary afferent signals from a variety of visceral regions and organs. Neurons that synapse in the NTS participate into the autonomic reflexes, with a result to regulate the autonomic function. Outputs that go from the NTS are transferred to a large number of other regions of the brain including the paraventricular nucleus of the hypothalamus and the central nucleus of the amygdala as well as to other nuclei in the brainstem . Perhaps, extensive connections between the NTS with visceral organs and other brain structures may elucidate the mechanism of auricular acupuncture.

Therefore, we proposed the auriculovagal afferent pathway both the autonomic and the central nervous system could be modified by auricular vagal stimulation via projections from the ABVN to the NTS .

Auriculovagal afferent pathway : both the autonomic and the central nervous system could be modified by auricular vagal stimulation via projections from the ABVN at the auricular concha to the NTS . NTS: nucleus of the solitary tract DMN: dorsal motor nucleus of the vagus AP: area postrema RVM: rostral ventrolateral medulla LC: locus coeruleus.

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How Is Vagus Nerve Stimulation Used

The neurologist programs the strength and timing of the impulses according to each patient’s individual needs. The settings can be programmed and changed without entering the body, just by using a programming wand connected to a laptop computer. For all patients, the device is programmed to go on for a certain period and then to go off for another period . The device runs continuously, usually with 30 seconds of stimulation alternating with 5 minutes of no stimulation. The patient is usually not aware that it’s operating. Holding a special magnet near the implanted device causes the device to become active outside of the programmed interval. For people with warnings before their seizures, activating the stimulator with the magnet when the warning occurs may help to stop the seizure. Many patients without auras also experience improved seizure control, however. Settings set by the neurologist typically include a stimulation amplitude of 1.0 to 3.0 mA , a stimulation frequency of 30 Hz , and a pulse width of 500 microseconds. By adjusting these settings, the doctor not only may be able to control more of the patient’s seizures, but often can also relieve side effects. One study, for instance, found that changing the pulse width eliminated pain that some patients were experiencing. The battery for the stimulator lasts approximately 5-10 years.

Vagus Nerve Stimulation Dramatically Reduces Inflammation

What is Vagus Nerve Stimulation (VNS) Therapy?

explains more about how inflammation in the body can be significantly reduced by activating the VN and promoting relaxation via improvement of Vagal Tone. This ties in well known psychological aspects such as positive mindset and meditation practices to health and wellness via the VN.

“These findings suggest a new approach to fighting diseases that are currently treated with relatively expensive drugs that have a host of side effects. VNS gives healthcare providers a potentially more effective way to improve the lives of people suffering from chronic inflammatory diseases.”

I found this extremely relevant to my thinking about PD, because as we now know, Parkinson’s, at its most fundamental level, is an inflammatory disease, as I explored in depth in

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Semiquantitation Of Staining Density

For analysis of the each of the immunohistochemical markers, the analyzer was blinded to treatment conditions.

Density measures of TH-immunoreactivity in the striatum and Iba-1-ir in the LC and SN , were conducted as previously described using a QImage R3 camera system with Image J software that measured optical density on a scale from 0 to 1.0 . Measures were obtained by subtracting background from mean staining intensity using every 12th section through the striatum, every 3rd section through the LC, and every 6th section through the SN.

VNS effects on TH in the LC, striatum, and SN of lesioned ratsIba-1-ir was reduced by VNS in the LC and SN of lesioned rats

The measurement area for microglia density analysis is outlined for the LC and the SN . Photomicrographs of LC and SN . VNS had no effect on Iba-1-ir in the LC of saline rats , but resulted in reduced Iba-1-ir in the SN . Lesioned rats had significantly higher Iba-1-ir . VNS reduced Iba-1-ir in lesioned rats . Quantification of results in I and J .

Using an Olympus Fluoview confocal setup, four sections through the SN were imaged to create TH/-synuclein Z-stacks for density analysis in ImageJ. By scrolling through the TRITC channel of each Z-stack, fifteen TH-positive cells were outlined , and density measurements were taken from the corresponding cells in the FITC channel to obtain an individual average for each animal. Data are reported as a percentage of saline non-VNS control rats.

Relationship Between The Abvn And The Nucleus Of The Solitary Tract

The anatomical relationship between the ABVN and the nucleus of the solitary tract has been investigated. After applying horseradish peroxidase to the central cut end of the ABVN in the cat, some labeled neuronal terminals were seen in the interstitial, dorsal, dorsolateral, and commissural subnuclei of the NTS some of these terminals may be connected monosynaptically with solitary nucleus neurons which send their axons to visceromotor centers in the brainstem .

The auricular concha is mainly innervated by the ABVN. The relationship between the acupuncture stimulation at auricular concha and the NTS has also been investigated. In an animal study, acupuncture stimulation at auricular concha induced the hypoglycemic effect by activating the firing activities of the neurons in NTS . It is also found that acupuncture-like stimulation at auricular acupoint CO15 activates the cardiac-related neurons in the NTS to evoke cardiovascular inhibition, whereas the inactivation of the NTS with local anesthetics decreased the cardiovascular inhibitory responses evoked by auricular acupuncture .

Recommended Reading: Iowa Parkinson’s Disease Association

Assessment Of Brainstem Function With Auricular Branch Of Vagus Nerve Stimulation In Parkinsons Disease

  • Affiliation Department of Neurology, University of Leipzig, Leipzig, Germany

  • Affiliation Department of Neurology, University of Leipzig, Leipzig, Germany

  • Affiliations Department of Neurology, University of Leipzig, Leipzig, Germany, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy

  • Affiliation Department of Neurology, University of Leipzig, Leipzig, Germany

  • Affiliation Department of Neurology, University of Leipzig, Leipzig, Germany

  • Affiliation Department of Neurology, University of Leipzig, Leipzig, Germany

Latest News In Parkinson Disease: Vagus Nerve Stimulation Immunomodulator Treatment And More

Brain pacemaker

An overview of the latest news in Parkinson disease reported across MJH Life Sciences.

An overview of the latest news in Parkinson disease reported across MJH Life Sciences.

Trial Finds Noninvasive Vagus Nerve Stimulation Safe, Effective

Findings from a randomized clinical trial among patients with PD who used electroCores noninvasive vagus nerve stimulation device show the treatment led to decreased levels of serum tumor necrosis factor and glutathione, according to an article published by NeurologyLive®.

Patients also exhibited significant increases in brain-derived neurotrophic factor levels, as well in improvements in walking speed, stance time, and step time when compared with sham treatment. Of the 36 trial participants, 17 were randomized to nVNS and 19 to a sham stimulation.

Researchers noted findings support additional work to further understand the treatments use for patients with PD.

Small Study Demonstrates Impacts of Immunodulator in PD

A small phase 1b study revealed that treatment with 125 mcg/mm2 of sargramostim was safe and well tolerated among patients over a 12-month period. The drug is the only FDA-approved recombinant human granulocyte-macrophage colony stimulating factor, reports NeurologyLive®.

Overall, 4 of 5 patients showed improvements in Movement Disorder Society-Unified Parkinsons Disease Rating Scale part III scores over 12 months.

Importance of Additional Agents to Treat PD OFF Periods

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One Theory To Explain Them All The Vagus Nerve Infection Hypothesis For Chronic Fatigue Syndrome

“Receptors on the vagus nerve that sniff out these alarm signals tell the brain an infection is present, which then shuts the body down by sending out signals that slow the body down, tell it to stop moving, stop eating, stop thinking.”

Since Chronic Fatigue is a major symptom of Parkinson’s Disease too, what this line of research is revealing should therefore be of significance relevance to PwP. Indeed, viral vectors have also been increasingly implicated in the onset of PD over recent years.

Vagus Nerve Stimulation Techniques

Given all of the above, how do these new understandings help us? Well, the good news is the research tells us we can, after all, do something to help ourselves and to improve our condition/minimize our symptoms. This is because, like muscles, an atrophied Vagus Nerve can be strengthened once more through appropriately exercising and stimulating it. In short, we can improve our Vagal Tone to help us begin to escape from being stuck in the “freeze” stress response. In other words, we can learn how to relax our way out of the symptoms of PD.

I first learned about this when I found Cheryl Townsley‘s video on “Sparking” the Vagus Nerve:

I do this exercise daily, using a standard “Pain Gone” pen. This “re-setting” technique demonstrated by Cheryl, shows just how quick and easy VN stimulation techniques can be – I spend just 30 seconds a day on this method.

I also quickly learned that deep breathing exercises are integral to VN stimulation, and practising diaphragmatic breathing for a few minutes a day can end up making a large cumulative difference. I particular recommend the method demonstrated by Ellie Drake:

The next video gives a more in depth explanation about the therapeutic values of VN stimulation in tackling illnesses, and suggests coffee enemas as a method for this

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Conflict Of Interest Statement

UW has received speaker honoraria and travel reimbursement from Merz Pharma, Bristol-Myers Squibb, Daiichi Sankyo, Bayer Vital, and Pfizer, and a research grant from Merz Pharma. He has received royalties from Kohlhammer Verlag and Elsevier Press. He serves as an editorial board member of Stem Cells, Stem Cells International, Open Biotechnology Journals, and jbc The Journal of Biological Chemistry. ML has received speaker honoraria from Bayer Vital.

The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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