Vagus nerve stimulation

Vagus nerve stimulation
Intervention
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Vagus nerve stimulation or vagal nerve stimulation (VNS) is a medical treatment that involves delivering electrical impulses to the vagus nerve. It is used as an adjunctive treatment for certain types of intractable epilepsy and treatment-resistant depression.

Because the vagus nerve is associated with many different functions and brain regions, research is being done to determine its usefulness in treating other illnesses, including various anxiety disorders, Alzheimer's disease, migraines,fibromyalgia,obesity, and tinnitus.

Other brain stimulation techniques used to treat depression include electroconvulsive therapy (ECT) and cranial electrotherapy stimulation (CES). Deep brain stimulation is currently under study as a treatment for depression. Transcranial magnetic stimulation (TMS) is under study as a therapy for both depression and epilepsy. Trigeminal Nerve Stimulation (TNS) is being researched at UCLA as a treatment for epilepsy.

The value of the FDA's MAUDE database as an early warning system is undermined by two key problems: underreporting of the numerator (the number of adverse events), and the lack of a denominator (the total number of exposures). One cause of underreporting is that manufacturers do not have to report serious adverse events, including deaths, if they decide that the event is not related to the device. Jerome Hoffman, an expert in clinical epidemiology at the University of California, Los Angeles, is critical of the FDA's policy of allowing manufacturers to make that determination. "The manufacturer has a powerful motive to find an alternative explanation for an adverse event. There's always the possibility of a separate cause." Dr Hoffman says that the agency should insist on independent adjudication of serious adverse events.

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