Vagus Nerve Stimulation for Treating RA – Possibilities and Limitations

In a recent edition of the Mirror, a gossipy newspaper in the United Kingdom, the headline read “Arthritis miracle cure: Tiny electrical implant brings hope to millions of rheumatoid arthritis sufferers.”¹ The article reported on an experimental procedure using electric stimulation of the vagus nerve to reduce RA symptoms and was replete with words like “cure”, “magic”, “ground breaking”, and “pioneering”. But a careful examination of the scant research behind the treatment reveals a potentially promising treatment system that is far from being a cure. Let’s move beyond the shoddy journalism that promotes hype and examine what’s really going on.

The vagus nerve is the largest and most extensive cranial (head) nerve with a large network of branches that run to the heart and digestive system. Because of its large and diverging system, it is oftentimes called the “wanderer” (Rice University).[2] Parts of the vagus nerve directly impact the heart, digestive system, speech systems, and ears. It has been linked to brain function, mood disorders, ears, the gastrointestinal system, and now inflammatory diseases.

Vagus nerve stimulation involves sending “regular, mild pulses of electrical energy to the brain via the vagus nerve, through a device that is similar to a pacemaker” (American Association Neurological Surgeons).³ It was originally approved for treating epilepsy in 1997.⁴ It is now approved for treatment-resistant depression (University of Michigan)⁵ but not without controversy due to conflicting research results (Union of Concerned Scientists).⁶ Some scientists advocate using nerve stimulation for treating ear ringing or tinnitus (University of Texas Dallas).⁷

Vagus nerve stimulation is now being proposed as a possible treatment for inflammatory illnesses due to a link between inflammatory chemicals and the vagus nerve (Das, 2006; Corcoran, et al., 2005; Andersson & Tracey, 2012).^8-10 Given these possible connections, researchers set out to conduct pilot studies on patients. In one small study, Koopman and her colleagues demonstrated some positive impact on RA patients in 2012.¹² These theories and pilot studies are a strong first step towards developing possible new treatments for RA.

At the end of the Mirror article, some cautionary statements were finally made including the small sample size of studies, lack of peer-reviewed publications, and the fact that only a portion of patients showed an improvement in symptoms. While vagus nerve stimulation may hold promise of a possible treatment for RA, it is not a miracle cure, it is not currently approved and available for use by patients, and much more research is needed.