There are at least two problems associated with using drugs to treat neurological disorders such as migraine headaches, rheumatoid arthritis, epilepsy and strokes. First, some of these drugs often have significant negative side effects, and second, they can be ineffective. Recently, a new treatment for these conditions has been explored and reported on in both medical and consumer publications. Neuroscientists and physicians who treat central neurologic disorders have found success tapping into the healing power of the vagus nerve.
According to Dr. Akwasi Boah, a neurosurgeon at Texas Back Institute, the vagus nerve is the longest cranial nerve in the body and it comprises a network of approximately 100,000 nerve fibers. It runs from the brain stem to the organs in the chest and abdomen including lungs, heart and liver.
“Its function in the body is to regulate involuntary actions such as breathing, heart beat and digestion,” Dr. Boah noted in a recent interview. “This is known as the parasympathetic nervous system which is the opposite of ‘sympathetic nervous system’ also known as the ‘fight or flight’ response mechanism. We need both in order to stay alive, but where the sympathetic system drives immediate action, increasing heart beat and breathing, the autonomic system slows down this physical response.”
Every Breath We Take
According to a recent article in the Wall Street Journal, “Every breath we take, especially the slow, deep breathing used in meditation, stimulates the vagus nerve to calm the body. Scientists also believe stimulating the nerve with small electrical impulses can have far-reaching potential to treat medical conditions.”
Dr. Boah explained how, from a medical perspective, this occurs.
“Any time a breath is taken, it stimulates the vagus nerve to limit the amount of air that can be inhaled,” he noted. “Without this mechanism, which is known at the Hering-Bauer Reflex, one could continue to inhale until the lungs explode. There are vagus nerve endings throughout the chest, and when a deep breath is taken they notify the heart, which then slows down. A slower heart rate is excellent for relaxation and breath-focused meditation techniques can enable this.
“With regard to neurological conditions such as seizures, epilepsy or treatment resistant depression, this ‘slowing down’ process has the potential of reducing the electrical excitability of the patient, ameliorating the severity of these episodes.”
Electrical Impulses Make the Vagus Nerve Stronger
The National Institute of Health launched a program called Stimulating Peripheral Activities to Relieve Condition (SPARC) in 2016, to fund projects which use small electrical impulses to the vagus nerve to treat migraines, strokes and rheumatoid arthritis. Dr. Boah explains how these electrical impulses can bring about relief for these conditions.
“The applications of stimulating these nerves are so broad that we’ve barely scratched the surface,” Dr. Boah said. “In Europe we’ve seen it used to treat such conditions as asthma and sleep apnea. In this country we’ve used it to treat epilepsy and migraines. There is also research ongoing to use this stimulation for treating ulcerative colitis and Crohn’s disease.
“Basically, when electrical currents are sent through the vagus nerve, they make it stronger,” he said. “This allows it to relax the gut or peripheral vessels even more than it would normally have the capacity to do. In the case of migraines, this condition is a vascular problem. We believe migraines are the result of the blood vessels in the brain clamping down. We can use the vagus nerve to reverse that process – dilating the blood vessels, making them bigger and reducing the symptoms of migraines.
“Rheumatoid arthritis is an inflammatory condition of the joints where the blood flow is increased around the inflammation. By stimulating the vagus nerve, this blood flow can be directed away from the affected joint, reducing the inflammation.”
The Problems with Drugs
Innovative medical experts such as Dr. Boah are interested in using nerve stimulation because the traditional treatments which use drugs have not worked and in many cases, their side effects are more dangerous than the condition. For example, many of these drugs sedate the patient to the point of destroying their normal quality of life.
“Refractory epilepsy offers the most compelling example of how the use of drugs for treatment is problematic,” he said. “This condition is not localized in one part of the brain, so the seizures are not coming from one specific area. Plus, someone with this disorder takes multiple medications for treatment which are known to have significant side effects.
“To make matters more challenging, there is no good surgical approach to this condition because it is impossible to tell from what part of the brain these seizures are originating. Stimulation of the vagus nerve reduces the excitability of this condition by reducing the seizure activity by as much as 60 percent.
“I have used the stimulation of the vagus nerve for the treatment of this condition,” Dr. Boah noted. “It has significantly improved patients’ quality of life.”
The Future of Nerve Treatment
“I would say the future in this area of medicine is going to be very interesting,” he smiled. “There have been attempts to stimulate the other cranial nerves to correct neurological disorders but these efforts are still in the research stage. There have been no randomized tests and publication of results in the medical literature yet. We have also seen some work with the trigeminal and the facial nerves, but the results are still only anecdotal.
“There are many exciting possibilities on the horizon as we try to determine how we can use our own anatomy, in lieu of medications which might not be that beneficial, to heal patients,” he concluded.
If you would like to learn more about the use of the vagus nerve in the treatment of neurological conditions, contact us to set an appointment with Dr. Boah or our other neurosurgeons at Texas Back Institute.