Understanding neuromodulation - An evidence-based path to self-regulation 05 - Vagus nerve stimulation and neuromodulation: support for drug or neurological therapy for chronic fatigue, long Covid and ADHD, in pain therapy or psychiatric illnesses

Series: Understanding neuromodulation - an evidence-based path to self-regulation

Introduction to the series

The regulation of our autonomic nervous system is at the centre of many modern health debates - but there is often a big gap between viral biohacks and sound science. This new blog series is dedicated to closing this gap. Step by step, chapter by chapter, we'll show you how the nervous system, self-regulation and neuromodulation really work together - based on evidence-based research, not marketing promises.

These contributions pave the way for a larger project that will be published at the end of the year: a practical guide for people with post-viral syndromes, chronic fatigue, attention problems or psychosomatic complaints - and for anyone who wants to learn to trust their nervous system.

What you can expect:

Each article in this series focuses on a chapter of the upcoming book. We shed light on the basics of the autonomic nervous system, debunk common myths, present scientifically proven methods of neuromodulation and show how to implement practical strategies in everyday life. Whether you are new to the subject or already have experience with topics such as vagus nerve stimulation, HRV measurement or polyvagal theory - this series offers orientation, clarification and concrete steps for action.

The following chapters await you:

1 Change the nervous system? A critical introduction to the topic of self-regulation.

2. how your nervous system really works.

3. why many theories are more hypothesis than help.

4. what scientifically validated neuromodulation can achieve today.

5. misconceptions about HRV, vagus and biohacking uncovered.

6. practical strategies for better regulation in everyday life.

7. how to develop your own personalised self-regulation concept.

Future special chapters:

- The science of neuromodulation - A deeper insight into taVNS and related methods.

- Exercise as therapy - how targeted training strengthens the brain.

- Syndrome specific strategies - Long COVID, ADHD, CPTSD, chronic pain & cognitive decline.

Stick with it - because knowledge is the best basis for trust in your own body. And trust is the first step towards healing.

Introduction: How targeted stimulation of the nervous system such as VNS, tDCS or rTMS opens up new avenues in the treatment of chronic diseases - without a reset or biohack promise

In cases of chronic fatigue, long Covid, ADHD or post-traumatic stress experienced on a daily basis, conventional methods such as medication and cognitive approaches alone are often not enough. Those affected feel overwhelmed, misunderstood or "functional but empty inside". What these people lack is not discipline, but real support on a biological level - gentle, repeatable and customisable.

This is where neuromodulation comes into play - using targeted stimuli to regulate the nervous system. This does not involve invasive interventions or technical gadgets for self-optimisers, but rather simple but evidence-based procedures that support the autonomic nervous system. The focus is particularly on stimulating the vagus nerve (nervus vagus), the most important parasympathetic cranial nerve. Studies show that targeted stimulation of the vagus nerve can improve stress processing, digestion, sleep quality, emotional stability and energy availability - without the side effects of some medications.

What it's all about

·         how vagus nerve stimulation (VNS) and other neuromodulation methods work in the body,

·         for which diseases non-invasive VNS is useful - e.g. fatigue, irritable bowel syndrome, pain, migraine or mental exhaustion,

·         a safe, everyday protocol for taVNS that can be integrated into the real rhythm of your life - without implanted devices, pressure or demands for perfection, but with a noticeable effect on the central nervous system.

Stimulation of the vagus nerve and how it works in the body

Vagus nerve stimulation (VNS) is a form of electrical stimulation in which a specific cranial nerve is stimulated: the vagus nerve. This nerve runs through the body from the brain stem to the abdomen. It controls functions such as breathing, heart rate and digestion as well as inflammatory reactions and emotional balance - and is considered the body's most important "relaxation nerve".

Stimulation of the vagus nerve has an effect on the central and peripheral nervous system. It can dampen activation, strengthen parasympathetic tone and thus contribute to better regulation and alleviation of symptoms of chronic fatigue, ADHD, depression, trauma disorders or post-viral dysfunction.

What taVNS is

Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive method. A small electrical device is connected to an area of skin on the ear. It stimulates the left vagus nerve, which runs directly under the skin, without any surgical intervention. The signal reaches the brain stem via ascending (afferent) pathways and influences vagal centres there - with effects on heart rate, digestion, mood and inflammation.

This form of neuromodulation is safe, can be used on an outpatient basis and is now being investigated in studies for therapeutic use in long Covid, ADHD, depression, chronic pain and fatigue.

How neurostimulation helps

People with chronic dysregulation of the nervous system often have an imbalance between tension (sympathetic nervous system) and relaxation (parasympathetic nervous system). The vagus nerve is an important lever here. If it is stimulated, the autonomic nervous system can switch more easily from excitement to relaxation.

VNS brings rhythmic, targeted impulses into this balance - without pressure. Studies show:

·         Heart rate variability improves with regular stimulation.

·         Symptoms such as brain fog or restlessness can be reduced by vagus nerve stimulation, as can digestive disorders or insomnia.

·         Resilience to stress increases after repetitive transcranial stimulation.

Which diseases can benefit from VNS in therapy?

Targeted stimulation of the vagus nerve is being clinically investigated in the following areas and is already being used in some cases:

·         Long Covid & Postviral Fatigue: Improvement of fatigue, orthostasis problems and cognitive impairment,

·         ADHD & concentration disorders: Improvement of executive functions and impulse control,

·         Chronic pain & fibromyalgia: Reduction of painkillers because pain intensity can be reduced by repeated transcranial stimulation,

·         Depression & anxiety disorders: Improving neural plasticity and emotional processing through transcranial stimulation, and

·         Epilepsy (invasive VNS already in use for decades).

Differences between invasive and non-invasive VNS

·         Invasive: implantation of a stimulator below the collarbone, connected to electrodes on the left vagus nerve. Procedure under general anaesthetic, long-term use, mainly for epilepsy and treatment-resistant depression.

·         Non-invasive (taVNS): electrode on the ear, portable device, daily use at home, fewer side effects, ideal for chronically exhausted or sensitised nervous systems.

The effect of vagus nerve stimulation on chronic overexertion

People with ADHD, Long Covid, trauma or burnout are often in a state of constant tension and ultimately exhaustion. Stimulus processing is disturbed and recovery is no longer possible on its own.

The electrical stimulation of the vagus nerve acts as an external support for internal self-regulation:

·         Increase in heart rate variability (HRV),

·         Reduction of rising alarm signals ("danger" messages),

·         Increase in parasympathetic activity.with enhancement of the resting response through vagus nerve stimulation, and

·         Regulation of inflammatory signals in the central or peripheral nervous system and in the body's tissues.

Research results on the effectiveness of taVNS

The findings on taVNS are growing rapidly. Initial clinical studies show:

·         Positive effects on fatigue, sleep disorders, pain and cognitive impairment,

·         Improved stress tolerance and emotional balance,

·         Fewer side effects than with drug treatments

At the same time, it is clear that the effectiveness depends on regularity, individual dosage and accompanying factors. Activities such as exercise or breathing rhythm can support transcranial stimulation.

Application of taVNS in everyday life

Recommended application:

·         daily 1-2 × 15-30 minutes

·         Best in the morning or before going to bed

·         Accompanying calming activities: drinking tea, reading, breathing work

·         Location: left ear, on the cartilage above the ear canal opening (tragus) or sometimes in the upper part of the pinna (cymba conchae)

Important:

·         Do not use if you have a pacemaker, active epilepsy or unstable heart disease (if in doubt, consult your doctor).

Side effects of VNS

VNS is considered to be well tolerated. Nevertheless, the following side effects may occur in rare cases:

·         slight tingling or feeling of pressure on the ear,

·         temporary headaches or tiredness,

·         If the stimulus intensity is too high: irritability, drowsiness.

The following therefore applies: start slowly, adjust the stimulus intensity individually and listen to your body.

VNS in psychotherapy and self-regulation

Of particular interest is how taVNS can be combined with other procedures:

·         Psychotherapy: VNS can facilitate access to emotions, emotional stabilisation and calming.

·         Breathing and movement therapy: The effect of the VNS is intensified in synchronisation with breathing or movement.

·         Pacing for CFS/ME and Long-Covid: taVNS helps with energy management through parasympathetic activation.

 Getting started

You don't need much to get started:

·         a certified taVNS device with ear clip

·         15 minutes a day for one application

·         Ideally a diary to record changes in symptoms

The setting is simple: taVNS during coffee or tea in the morning, before going to sleep or even on a walk.

Key findings at a glance:

·         Stimulation of the vagus nerve is a promising component for regulating chronic overload in the nervous system.

·         taVNS is non-invasive, suitable for everyday use and has no side effects.

·         The targeted application of vagus nerve stimulation shows promising results. It can alleviate symptoms of migraine, fatigue (CFS/ME), ADHD, long COVID, pain, depression and trauma.

·        

However, effectiveness requires rhythmic repetition, adaptation and integration into life.

·         The focus is on rhythm, not perfection: weak signals, reliably repeated.

Frequently asked questions about vagus nerve stimulation & neuromodulation

What is the vagus nerve?

The vagus nerve is the tenth cranial nerve and plays a central role in the autonomic nervous system. It runs from the brain stem through the neck, chest and abdomen and is involved in the regulation of heart rate, digestion, breathing and emotional balance.

What is vagus nerve stimulation?

Vagus nerve stimulation (VNS) is the targeted activation of the vagus nerve using electrical impulses. The aim is to strengthen autonomic balance and alleviate the symptoms of chronic illnesses.

What is transcutaneous vagus nerve stimulation (taVNS)?

taVNS is a non-invasive form of VNS. It stimulates the left vagus nerve via the skin on the ear, without surgical intervention. Electrical signals are sent to the brain to reduce inflammation, stress and dysregulation.

What are the differences between invasive and non-invasive VNS?

Invasive VNS requires surgery with implantation of a stimulator and electrodes. Non-invasive taVNS uses external devices on the ear. It is less risky, flexible and suitable for everyday use.

How does the SSF work in practice?

A taVNS device is worn up to twice a day for 15-30 minutes, usually in the morning or evening. The stimulation is applied gently via the left ear and can be combined with quiet activities.

What types of therapeutic neurostimulation are there?

In addition to taVNS, repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS) and spinal cord stimulation are also among the most important neurostimulation procedures. Neurostimulation is carried out electrically or magnetically and can be used invasively, with an implanted device, or non-invasively, with a portable stimulator.

What is the difference between neurostimulation and brain stimulation?

Neurostimulation includes all targeted stimulation procedures on the nervous system - both central (brain) and peripheral (e.g. vagus nerve). Brain stimulation refers specifically to the brain, for example with TMS or deep brain stimulation.

What do plasticity, modulation and stimulation mean?

Plasticity refers to the brain's ability to adapt. Modulation is the targeted influencing of neuronal patterns. Stimulation is the method by which this modulation takes place - electrically or magnetically, for example.

Which clinical pictures can be treated with neuromodulation?

Chronic fatigue syndrome (CFS/ME), long Covid, ADHD, depression, anxiety disorders, chronic pain, fibromyalgia, epilepsy and autonomic dysfunction - among other neurological and psychiatric disorders - are among the most common indications.

Who is vagus nerve stimulation suitable for?

People with chronic overload of the nervous system who suffer from fatigue, sleep problems, sensitivity to stimuli or emotional instability and are looking for a gentle, scientifically based method.

Who benefits most from the SSF?

According to studies, patients with highly sensitive stimulus processing (also known as high sensitivity or Sensory Processing Sensitivity - SPS), CFS/ME, Long Covid, ADHD, (C)PTSD, chronic pain, depressive states or autonomic dysregulation often show positive reactions.

What are the possible side effects of VNS?

Occasional: tingling in the ear, headache, slight irritability. If the dose is too high: tiredness, dizziness. Recommendation: start slowly, dose individually.

Chronic abdominal pain without findings - what to do?

Chronic abdominal pain may be related to dysregulation of the vagus nerve. VNS can help to regulate digestion and alleviate visceral hypersensitivity.

Vagus nerve and intestine - what is the connection?

The vagus nerve regulates motility, blood flow and immune response in the digestive tract. Healthy vagal activity supports a functioning gut-brain axis.

Why is the vagus nerve so important for the psyche?

It influences emotional balance, the ability to react to stress and social security. A healthy vagus function can reduce depressive symptoms and anxiety.

Is it true that VNS was not originally developed to treat depression?

Yes. It was originally developed to treat severe epilepsy - only later were the positive effects on mood and emotional regulation discovered. taVNS has since been seen as a beacon of hope because it is non-medicinal, well tolerated and can be effective in the long term - especially in combination with psychotherapy or exercise.

Does VNS help with chronic pain?

VNS is an innovative support for pain therapy and can help to alleviate chronic pain, change the way pain is processed and calm the nervous system. It offers an effective, drug-free supplement to pain therapy.

Can vagus nerve stimulation help with migraines?

Initial studies suggest that taVNS can reduce migraine attacks and cluster headaches or alleviate their severity - presumably through anti-inflammatory and pain-modulating effects.

How widespread is VNS?

VNS has been well studied clinically, but authorised devices are relatively expensive. Not all indications are yet authorised in Germany, which is why it is less widespread than psychotherapy, for example.