Vagal Nerve Stimulation for Patients With Stress-Related Psychiatric Disorders and Addictions

Abstract

Posttraumatic stress disorder (PTSD) is a highly prevalent disorder that is often linked to addictions due to common links in childhood trauma and efforts at self-medication. Treatments for PTSD including medications have limitations due to side effects and imperfect efficacy. Vagus nerve stimulation (VNS) is a non-pharmacological alternative approach that targets the excessive sympathetic and inflammatory conditions that characterize the neurobiology of the disorder. These properties of VNS also lend themselves to the treatment of addictions, such as with opioid withdrawal. This paper provides an overview of VNS for stress-related psychiatric disorders and addictions with a focus on new non-invasive forms of VNS that have the potential to have widespread application to psychiatry due to lower cost and increased convenience.

Keywords: vagus nerve stimulation, VNS, PTSD

Funding: The work cited in this paper was sponsored by the Defense Advanced Research Projects Agency (DARPA) Biological Technologies Office (BTO) Targeted Neuroplasticity Training (TNT) program through the Naval Information Warfare Center (NIWC) Cooperative Agreement No. N66001-16-4054 with sham and device support from ElectroCore LLC provided free of charge. The work cited here was also funded by the Department of Defense Small Business Technology Transfer (DOD STTR) Program Army A21c-t024-0283, and investigator initiated grant awards from ElectroCore LLC and the Brain and Behavior Foundation. Additional support comes from NIH R01 MH120262 and UG3 DA048502 and VA Merit I01 RX003418 and I01 CX002331.

Disclosures: J.D.B has had research funding support from ElectroCore LLC and joint DOD funding with Evren Technologies for whom he is on the Scientific Advisory Board. Both active and sham stimulation devices used in this study were provided by ElectroCore free of charge.