Vagus nerve

The vagus nerve plays a crucial role in bidirectional communication between the brain and gut, with its afferent and efferent branches serving as a critical pathway. We can see it as a 'highway' between those two.

The vagus afferent fibers can detect and transmit signals from the gut microbiota to the brain, potentially leading to brain disorders such as depression. In addition, the vagal efferents can mediate gut hyperpermeability and inflammation in response to stress, which may contribute to depression. However, restoring proper vagus nerve function has been shown to have anti-inflammatory properties and can effectively treat depression.

How to know that vagus nerve is not working at optimal level?
 
- gastrointestinal disorders (abdominal pain, bloating, acid reflux,  gastroesophageal reflux disease, GERD and other symptoms),
- stress, depression, anxiety,
- headaches, migraines,
- epilepsy, fibromyalgia, 
- changes to heart rate, blood pressure or blood sugar,
- difficulty swallowing or loss of gag reflex,
- dizziness or fainting,
- hoarseness, wheezing or loss of voice,
- loss of appetite, feeling full quickly or unexplained weight loss,
- nausea and vomiting,
- the vagus nerve innervates so many organs and structures in the body that problems with it can cause many different disorders and symptoms.
How to improve vagus nerve condition?
- deep diaphragmatic breathing, what happens here: the diaphragm that lowers activates vagus nerve and stretches it gently. Reach out to this section to teach how to breathe properly 
- long walks - they have a calming effect, fresh air also helps 
- yoga, as well as many stretching positions for neck, shoulders and thoracic cage
- minerals: potassium, magnesium, sodium
- physical therapy, osteopathy, acupressure, manual therapy - all the techniques that allows to release the tension alongside the vagus nerve
References:

1. Murray C, Lopez A. Cambridge, MA: Harcourt University Press; 1996. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. []
2. Sackeim HA. The definition and meaning of treatment-resistant depression. J Clin Psychiatry. 2001;16:10–7. [PubMed] []
3. Trivedi M, Rush A, Wisniewski S, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006;163:28–40. [PubMed] []
4. DeRubeis RJ, Hollon SD, Amsterdam JD, et al. Cognitive therapy vs medications in the treatment of moderate to severe depression. Arch Gen Psychiatry. 2005;62:409–16. [PubMed] []
5. Husain MM, Rush AJ, Fink M, et al. Speed of response and remission in major depressive disorder with acute electroconvulsive therapy (ECT): A Consortium for Research in ECT (CORE) report. J Clin Psychiatry. 2004;65:485–91. [PubMed] []
6. Prudic J, Olfson M, Marcus SC, et al. Effectiveness of electroconvulsive therapy in community settings.[see comment] Biologic Psychiatry. 2004;55:301–12. [PubMed] []
7. Groves DA, Brown VJ. Vagal nerve stimulation: A review of its applications and potential mechanisms that mediate its clinical effects. Neurosci Biobehav Rev. 2005;29:493–500. [PubMed] []
8. Harden CL, Pulver MC, Ravdin LD, et al. A pilot study of mood in epilepsy patients treated with vagus nerve stimulation. Epilepsy Behav. 2000:93–9. [PubMed] []
9. Elger G, Hoppe C, Falkai P, et al. Vagus nerve stimulation is associated with mood improvements in epilepsy patients. Epilepsy Res. 2000;42:203–10. [PubMed] []
10. Krahl SE, Clark KB, Smith DC, Browning RA. Locus coeruleus lesions suppress the seizure-attenuating effects of vagus nerve stimulation. Epilepsia. 1998;39:709–14. [PubMed] []
11. Ben-Menachem E, Hamberger A, Hedner T, et al. Effects of vagus nerve stimulation on amino acids and other metabolites in the CSF of patients with partial seizures. Epilepsy Res. 1995;20:221–7. [PubMed] []
12. Rush AJ, George MS, Sackeim HA, et al. Vagus nerve stimulation (VNS) for treatment-resistant depressions: A multicenter study.[see comment] Biologic Psychiatry. 2000;47:276–86. [PubMed] []
13. Sackeim HA, Rush AJ, George MS, et al. Vagus nerve stimulation (VNS) for treatment-resistant depression: Efficacy, side effects, and predictors of outcome. Neuropsychopharmacology. 2001;25:713–28. [PubMed] []
14. Rush AJ, Marangell LB, Sackeim HA, et al. Vagus nerve stimulation for treatment-resistant depression: A randomized, controlled acute phase trial. Biologic Psychiatry. 2005;58:347–54. [PubMed] []
15. Marangell LB, Rush AJ, George MS, et al. Vagus nerve stimulation (VNS) for major depressive episodes: one year outcomes. Biologic Psychiatry. 2002;51:280–7. [PubMed] []
16. Neurological Devices Panel of Medical Devices Advisory Committee FaDA. Report of 17th Meeting. 2004:1-433. Available at: www.fda.gov. Access date: December 1, 2005
17. George MS, Rush AJ, Marangell LB, et al. A one-year comparison of vagus nerve stimulation with treatment as usual for treatment-resistant depression. Biologic Psychiatry. 2005;58:364–73. [PubMed] []
18. Nahas Z, Marangell LB, Husain MM, et al. Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes. J Clin Psychiatry. 2005;66:1097–104. [PubMed] []
19. Carlat D. Vagus nerve stimulation: Is the evidence convincing? Carlat Report on Psychiatric Treatment. 2006;4:1–8. []
20. Device Won Approval Though F.D.A. Staff Objected. New York Times. February 16, 2006
21. Maisel M. Medical device regulation: An introduction for the practicing physician. Ann Intern Med. 2004;146:296–302. [PubMed] []
22. Chai J. Medical device regulation in the United States and the European Union: A comparative study. Food Drug Law J. 2005;55:57–80. [PubMed] []
23. Ben-Menachem E. Vagus nerve stimulation, side effects, and long-term safety. J Clin Neurophysiol. 2001;18:415–8. [PubMed] []
24. Rush AJ, Sackeim HA, Marangell LB, et al. Effects of 12 months of vagus nerve stimulation in treatment-resistant depression: A naturalistic study. Biologic Psychiatry. 2005;58:355–63. [PubMed] []
25. Rudolph R. [December 1, 2005]. Food and Drug Administration Neurological Devices Panel Web site. Executive summary and discussion of the vagus nerve stimulation (VNS) therapy depression indication clinical data (updated to include information from deficiency letter response). Available at: www.fda.gov/ohrms/dockets/ac/04/briefing/4047b1_01_Clinical%20Executive%20Summary-FINAL.pdf.
26. Sackeim HA, Keilp JG, Rush AJ, et al. The effects of vagus nerve stimulation on cognitive performance in patients with treatment-resistant depression. Neuropsychiatry Neuropsychol Behav Neurol. 2001;14:53–62. [PubMed] []

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