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Stimulation of the vagus nerve has been effective in treating cases of epilepsy that do not respond to medication. Surgeons place an electrode around the right branch of the vagus nerve in the neck, with a battery implanted below the collarbone.
The electrode provides regular stimulation to the nerve, which decreases, or in rare cases prevents, the excessive brain activity that causes seizures, according to the Epilepsy Foundation. Europe has approved a vagus nerve stimulator that does not require surgical implantation, according to the Mayo Clinic. Research has also shown that vagus nerve stimulation could be effective for treating psychiatric conditions that don't respond to medication. The FDA has approved vagus nerve stimulation for treatment-resistant depression and for cluster headaches.
A study published in the journal Brain Stimulation found that vagus nerve stimulation resulted in an improvement in symptoms for patients with treatment-resistant anxiety disorders such as obsessive-compulsive disorder, panic disorder and post-traumatic stress disorder.
Because the vagus nerve influences the immune system, damage to the nerve may have a role in autoimmune and other disorders. Scientists have long known that chronic conditions such as alcoholism and diabetes can damage nerves, including the vagus nerve, although why this damage happens is not well understood. People with insulin-dependent diabetes may develop neuropathy in many nerves.
If the vagus nerve is damaged, nausea, bloating, diarrhea and gastroparesis in which the stomach empties too slowly may result. Robert Lustig, a pediatric endocrinologist at UC San Francisco and one of the lead investigators in a patient clinical trial of vagotomy for weight loss.
But this potential was discovered almost by accident in the s, when surgeons treating intractable ulcers tried vagotomy to help reduce stomach acidity. The method worked, and soon became widely used drug therapy eventually superseded it. But the operation had an unexpected side effect: It made obese patients lose weight. Early vagotomy surgeries cut the entire vagus nerve as well as some stomach muscles. This drastic method caused undigested food to be dumped into the intestines, leading to a range of unpleasant side effects, such as diarrhea, vomiting, flushing and dizziness.
The modern form of the procedure is much more refined: It cuts only the parts of the vagus that control hunger and weight gain, leaving the stomach muscles and the rest of the nerve intact. As a result, the side effects of vagotomy are now much milder and tend to disappear after a few months, Lustig says.
The trial is sponsored by EndoVx, a Napa-based company that is developing a device to simplify the vagotomy procedure. He got rid of 60 pounds more over the next year after starting a regular exercise program, and is down to a manageable pounds. In fact, he adds, he feels that his whole attitude toward food has changed for the better after his vagotomy. The technique they are using is called vagal nerve blocking, which has been developed by St.
Paul, Minn. Turning off the signal restores vagus function, he adds. This procedure is now being evaluated in a patient placebo-controlled study underway at several U. Patients in both arms of the EnteroMedics-sponsored trial are implanted with the device. But it is not turned on in the placebo group. And judging by the result, he thinks he is getting the therapy, not the placebo. Both vagotomy and vagal nerve blocking have advantages and drawbacks.
Both treatments are done using a technique called laparoscopic surgery, which is much less invasive than most weight loss surgeries.
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