Vagus nerve stimulation for autoimmune rheumatic diseases

The vagus nerve is the primary parasympathetic nerve of the autonomic nervous system, providing an extensive network of afferent and efferent parasympathetic innervation of the viscera. 1 Berthoud HR Neuhuber WL Functional and chemical anatomy of the afferent vagal system. Auton Neurosci. 2000; 85: 1-17 Summary Full Text Full Text PDF PubMed Scopus (709) Google Scholar The vagus nerve comprises a bundle of approximately 80% afferent fibres and 20% efferent fibres, which control essential visceral functions including gastrointestinal motility, secretions, and heart rate. 1 Berthoud HR Neuhuber WL Functional and chemical anatomy of the afferent vagal system. Auton Neurosci. 2000; 85: 1-17 Summary Full Text Full Text PDF PubMed Scopus (709) Google Scholar Vagus nerve activity is also a prominent component of several homeostatic axes including the cholinergic anti-inflammatory pathway, the brain–gut axis, and the hypothalamic–pituitary–adrenergic axis. Safety and efficacy of neurostimulation with a miniaturised vagus nerve stimulation device in patients with multidrug-refractory rheumatoid arthritis: a two-stage multicentre, randomised pilot studyVNS with a miniaturised neurostimulator was safe and well tolerated and reduced signs and symptoms of rheumatoid arthritis in patients with multidrug-refractory disease. These results support further evaluation in a larger randomised sham-controlled study. Full-Text PDF