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Revolutionizing Health: Vagus Nerve Stimulation and the Future of Medicine
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In this engaging episode, Dr. Peter Staats—chief medical officer and cofounder of ElectroCore, and a trailblazer in the fields of pain management and neuromodulation—shares his compelling journey and the emerging science that’s reshaping how we approach healing. Rather than relying solely on pharmaceuticals or surgical intervention, Dr. Staats introduces a transformative model centered on neuromodulation: the use of electrical stimulation to influence bodily systems in targeted, noninvasive ways.
At the heart of this model is the vagus nerve. Known as a master regulator, it plays a crucial role in managing inflammation, stress responses, and emotional well-being. When the vagus nerve isn’t functioning optimally, the body can exhibit a wide range of symptoms—from migraines and digestive issues to depression and fatigue—making it clear that many of our chronic struggles may stem from nervous system dysregulation rather than isolated organ problems.
Learn more about the vagus nerve here: https://www.polyvagalinstitute.org/vagusnerve
Dr. Staats explores both ancient and modern methods of vagus nerve stimulation (VNS). From cold exposure and humming to cutting-edge wearable devices, the tools for nervous system regulation are becoming increasingly accessible. Noninvasive VNS is showing promise for conditions such as depression, PTSD, rheumatoid arthritis, and even sleep disorders—with significantly fewer side effects than traditional drug therapies.
Whether you’re a therapist, coach, or simply someone seeking more integrative approaches to health, this conversation invites a broader lens on healing—one that honors the body’s innate capacity to regulate and repair when given the right support. Stay curious, stay connected, and keep listening for more grounded insights into the science of connection and wholeness. CONNECT WITH PVI
Instagram: @polyvagalinstitute
Email: community@polyvagal.org
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Transcript
Paradigm Shift in Healthcare
00:00:00
Speaker
and So, no, it's interesting, you know, I think we're in the midst of what what we call a paradigm shift in healthcare. Over, you know, the 1950s to 2000s, the paradigm has really been about drugs and cutting it out.
00:00:15
Speaker
You know, that's what we do. If you if you have a problem, you're depressed, go on a drug. If you have cancer, cut it out.
Introduction to Dr. Peter Statz
00:00:24
Speaker
And I think we're moving to a paradigm of neuromodulation, which is the use of electricity to control diseases in addition to drugs.
00:00:35
Speaker
This is Dr. Peter Statz, who is a pioneering physician and thought leader in the field of pain management and neuromodulation. As the chief medical officer and co-founder of ElectroCore, founder of the Division of Pain Medicine at John Hopkins University, and founder of the Vegas Nerve Society, he has been at the forefront of exploring innovative, non-invasive approaches to treating pain and improving health.
Vagus Nerve Stimulation (VNS) Unveiled
00:01:00
Speaker
especially through the power of the vagus nerve. In this episode, we explore how vagus nerve stimulation, also known as VNS devices, are shaping the future of medicine and how they can help regulate stress, enhance recovery, and support whole body health.
00:01:17
Speaker
and lot of this is still science Welcome to Wired4Connection, a polyvagal podcast. I am your host and my name is Travis. yes nerve Peter, I'm so excited to have you on today to kind of jump in on what we're doing here at PVI and for Wired for Connection.
00:01:34
Speaker
And having you on as part of these first few episodes, kind of the core foundation of what we're building here, I think is so important given the work that you're doing and the overlap. with tech, vagus nerve stimulation.
00:01:48
Speaker
But before we jump into kind of the tech part, which is i'm I'm actually really excited to hear about this tech and how we can use technology to help us holistically. I'm wondering kind of what led you to jump into studying the vagus nerve and then what inspired you to start the vagus nerve society?
00:02:06
Speaker
Sure. So this is a long journey. So thank tre Travis, thank you very much for having me on your podcast. This is wonderful to be with you. It's been a long
Dr. Statz's Background and Influence
00:02:14
Speaker
journey. So my my background was I am the son of two psychologists. My dad was a very well-known psychologist, and created a unified theory in psychology, and invented timeout and other aspects of behavioral learning,
00:02:29
Speaker
ah that were very important back in the 50s and 60s. um I became a physician, so fast forward a number of years, became a physician and anesthesiologist, and I started the pain division at Johns Hopkins University for the Department of Anesthesia.
Neuromodulation Innovations
00:02:45
Speaker
And in that capacity, I started implanting a fair number of spinal cord stimulators and other neuromodulatory approaches, became president of the North American Neuromodulation Society, the big society that oversees the field of electricity and medicine.
00:03:03
Speaker
And about the same time, I learned my son had peanut allergies. And I recognized the power of electricity in controlling diseases such angina, peripheral vascular disease, and wondered, could we figure out a way of stimulating the nervous system to block the airway reactivity or the anaphylaxis that we see with peanut allergies?
00:03:30
Speaker
and um And embarked on a series of studies to try to figure that out. Worked with my friends up at Columbia University, where we in fact figured out how to create a model of airway reactivity and then block the airway reactivity in a guinea pig and started studying humans. Initially it was a percutaneous device. So basically we had to place an electrode under ultrasound onto the vagus nerve Then along the way, we figured out how to do this non-invasively, which opened up a lot of different aspects.
00:04:02
Speaker
But I get ahead of
Electricity in Modern Medicine
00:04:04
Speaker
myself. While we were studying the people with airway reactivity, patients started to say, my headache went away. Hmm. And we then started to do some real deep studies on the vagus nerve central neurotransmitters in the brain that occur with vagus nerve stimulation, the peripheral aspects of vagus nerve stimulation, and a whole world difference.
00:04:27
Speaker
opened up for me of the possibilities of what the vagus nerve controls and how vagus nerve stimulation could potentially be helpful in a variety of diseases as well as in wellness and optimizing health.
00:04:46
Speaker
Wow. So really, i mean, a pioneer very much so of let's figure this stuff out and experiment. And your your son was this, you know, kind of a catalyst to you already doing work, but really kind of sounds like shifted you into a different gear to test things out and electricity. I mean, it really fascinating. I don't think most people are thinking about that.
00:05:05
Speaker
I know i'm I'm typically not thinking about that my day to day of you know, how can electricity help this? This is not my world, but when I'm hearing it I'm like, it's fascinating. blows my mind that we can we can help people in a way that isn't really what most people walk around pondering about. um Yeah, I'm weird.
00:05:25
Speaker
Yeah. and So, no, it's interesting. You know, um I think we're in the midst of what what we call a paradigm shift in health care over, you know, the 1950s to 2000s. The paradigm has really been about drugs and cutting it out.
00:05:40
Speaker
You know, that's what we do. If you if you have a problem, if you're depressed, go on a drug. If you have cancer, cut it out. And I think we're moving to a paradigm of neuromodulation, which is the use of electricity to control diseases in addition to drugs.
00:06:00
Speaker
So when when you stop and you think about from a medical perspective, and i know a lot of yeah your listeners are are psychologically oriented, as am I, but when you stop and you think about the best thing that we have for a variety of different disorders,
00:06:16
Speaker
it's electricity.
VNS for Mental Health and Sleep
00:06:17
Speaker
If it's back pain, it's a spinal cord stimulator. If it is um ah incontinence, it's a sacral nerve stimulator. If it's bradycardia or arrhythmia, it's a pacemaker.
00:06:29
Speaker
And what we're learning now is how to harness this in a non-invasive way to control a myriad of symptoms from rheumatoid arthritis, to post-traumatic stress disorder and everything in between. And a lot of this is still science and lot of still ah research projects going on. But there has been an explosion of interest in the vagus nerve and vagus nerve stimulation in controlling diseases that we didn't used to think was just neurologic.
00:07:00
Speaker
like rheumatoid arthritis, for example. I mean, we didn't used to think of that, but now there's great research going on on curing rheumatoid arthritis with electricity and patients who have failed the biologics.
00:07:14
Speaker
So just it's it's just a fascinating area. Yeah, no, it's funny. You said rheumatoid. My brother had has rheumatoid arthritis and you know some pretty intense medications he had to take, which really has helped.
00:07:24
Speaker
yeah But I know that there's also some possible side effects or some of these medications and stuff. um So, I mean, that my mind went there. was like, wow, fascinating. We could use this vagus nerve stimulation you know for some to cure it rather than a medication. And is it, I'm curious, side effects of that. Is it is it different, differ from ah typical medication, same?
00:07:47
Speaker
Yes, it actually appears to be much, much safer in terms of side effects and risks. All the biologics knock out a whole system. They may knock out your TNF system or they might knock out, you know, entire system of cytokines.
00:08:03
Speaker
Whereas electrical stimulation normalizes. So patients with rheumatoid arthritis may have elevated levels of TNF alpha. this, some of the biologics may knock it out, whereas this may just stabilize it and keep it at a normal level.
00:08:20
Speaker
So I don't think we're ever gonna be in a position of no no drugs, but I do think we're going to prioritize electricity to a greater extent.
00:08:32
Speaker
Einstein, Albert Einstein in 1934 said, the physician of the future will be the master of both the chemical side, drugs, and the physical side, electricity.
00:08:44
Speaker
And we're now just getting to the point of realizing his vision, you know, close to 100 years ago ah embracing electricity in medicine to optimize health and in any number of different domains. Yeah. Yeah.
00:09:00
Speaker
Well, that paradigm shift too, speaking with some other colleagues, is that I think there's even an approach from a psychological perspective as well that I've talked with psychiatrists, friends, psychologists, therapists, and in this industry of more of holistic approach too. Like, hey, medications can be and can be very much life-giving and effective for for people. And sometimes this may not be the right course, but I think it's it's been that's been a little more of a narrowed view, but now we're opening up to other possibilities and even hearing in the medical industry, there we're looking at expanding and it's probably due to technology and things we now know versus what we knew 30, 40, 50 years ago, yeah which is really promising to see, wow, this we're opening up a myriad of ways of healing and integration
00:09:44
Speaker
for again, variety of things that maybe we never thought were possible to be healed. And specifically in your case with the research you're doing, which is very fascinating, is the use of electricity to bring balance. I like that. It's not eliminating, it's it brings it into new balance, a new homeostasis that might be more integrative.
00:10:04
Speaker
you know I just recently committed finished ah working on a documentary, Hacking the Vagus Nerve. um And what we talk about in that is that we're looking for the root cause problem.
00:10:19
Speaker
Lots of Western medicine is used to treating symptoms. I'm anxious, take a pill. we're more interested in understanding what is the physiological underpinnings of anxiety and then how electricity may modify that.
00:10:34
Speaker
It's not symptom control, but it's it is really understanding the disease at its root cause and then how our body, which is chemical being,
00:10:46
Speaker
chemical being fires on electricity and how that electricity sometimes goes off and that distorts the chemical side of things and how we may to renormalize things by boosting electrical function.
00:11:02
Speaker
Yeah, that's, again, so fascinating, this this shift of of, yeah, not just the the symptoms that kind of one, like the medical model, of which, again, has, for again, there's a point and a purpose of treating symptoms and symptomatology as well as, you know, we got to get to that root. and that's how I even, when I work with clients in my practice is,
00:11:23
Speaker
Hey, yeah, I want to understand what's happening now and maybe give you some tools or skills now, maybe a medication if I think it's depending on where they are, like just to kind of help now. And it's always about figuring out where's this root cause. If I don't find the root cause, the bandaid is eventually going to fall off. And so I'm always as well thinking of that kind of both and like now and we still need to come back here and and address deal, bringing it and into alignment. Because if we don't, I find, and even the research and what you're doing is, it doesn't really fully fully bring into that kind of, that integration. It just kind of comes back up again, rather than giving them and equipping and changing the narrative of the story.
00:12:02
Speaker
um i do a lot of story, you know, narrative as well when I work with clients and that story is powerful and often starts somewhere. And it's manifesting now and maybe anxiety or depression or, You know, isolation or, you know, manifestation addiction issues, things like that. But there's a story as to why. And, and you know, from the polyvagal perspective, there's a reason. It's a it's a you know regulatory response to trying to deal with a dysregulated nervous system. And they found it's beneficial even the short term.
00:12:29
Speaker
So it's all, it's all, it's so exciting to hear that there's this shift in, in all aspects of, of the health of healing, both in medical and psychological. And you know you said something, which is kind of this next, this next part that I want to dive into is this, the role of the nerve, the vagus nerve and kind of anxiety and stress and inflammation. I'm wondering, you know, how does that vagus nerve, how does it influence anxiety, inflammation in the body, stress, and, and what are some common signs of like vagus nerve dysfunction that you're seeing in the work that you, do?
00:12:59
Speaker
Let's start with anxiety and stress. You know, it's, well, let's, let's step one step back. Let's start with inflammation. Inflammation is incredibly important.
00:13:11
Speaker
It's good for you. If you get an acute bacterial infection, it is extraordinarily damaging. If you are exposed to chronic inflammation, this is a backdrop that we all have to get on the same page about it.
00:13:25
Speaker
yeah That's why people tell you to not to eat an anti-inflammatory diet, to lose weight, to do certain things that keep your inflammatory levels down. It's associated with cardiovascular disease. It's associated with cancer. It's associated with pulmonary disease.
00:13:39
Speaker
It's associated with a myriad of different disorders.
Vagus Nerve and Inflammation Control
00:13:42
Speaker
So acute inflammation can be good. Chronic inflammation is extraordinarily damaging.
00:13:50
Speaker
Now, what people don't recognize is that you're, teleologically, your body has recognized that this is bad and has developed ways of blunting the inflammatory response.
00:14:02
Speaker
The key one that people don't know about is the vagus nerve. The vagus nerve has both central, going up to the brain, and peripheral, going to the spleen, the gut, and other areas.
00:14:15
Speaker
Direct projections to the various cells in your body, what's called the macrophages and the microglial cells in your spleen and in your gut and other areas, that these cells produce inflammation.
00:14:30
Speaker
There's a reflex that when there's inflammation going on, the brain gets information up to the nucleus tractus solitarius, which you will know if you're a PVI person, it's the area of the vagus nerve cell bodies.
00:14:43
Speaker
It goes up there. There's information that's processed and then information that goes right back down. And in that information, it says, turn off that inflammatory response. Turn it down, turn it down.
00:14:54
Speaker
And that is incredibly important in mitigating the, what's called the cytokines that are associated with stress responses. So, so,
00:15:08
Speaker
Studies are going on, and we talked about rheumatoid arthritis. There are studies with inflammatory bowel disease. There are ah studies with diabetes and control with efferent vagus nerve stimulation.
00:15:20
Speaker
But interestingly, there's also work going on with afferent stimulation. Back in 1997, the first implanted vagus nerve stimulator was approved for epilepsy.
00:15:32
Speaker
And they realized very shortly thereafter that patients with major depression were getting better. They actually got an FDA approval for depression back in 2005 because with an implanted vagus nerve. stimuli Now it's rarely used because they're very expensive, they carry risks, et cetera.
00:15:55
Speaker
However, it's been recognized for quite some time that the VMS, the vagus nerve actually controls depression. Also, we've published a paper, I don't actually think it's out yet, but it's just it was accepted for publication on external VNS, noninvasive vagus nerve stimulation in patients with sleep and anxiety disorders.
00:16:19
Speaker
And on average, when people are asked on a scale of one to 10, how much did you help with your anxiety and your depression and your and your sleep disorders? They reported on average about eight out of 10. So really profound improvement.
00:16:35
Speaker
A group in Alabama, at the University of Alabama, have studies, a small study on depression. And there's things rolling out all the time on the use of VNS for non-invasive approaches to controlling anxiety, depression, sleep disorders.
00:16:52
Speaker
And it's there's a tremendous amount out there.
Vagus Nerve Dysfunction and Disorders
00:16:56
Speaker
Now, you get to a very, very interesting question about vagus nerve dysregulation.
00:17:03
Speaker
ah My last book just put came out on vagus nerve stimulation. That's you know not too exciting of a title, but it's vagus nerve stimulation. It's very direct. very Yeah, you know you you're very clear.
00:17:14
Speaker
Yeah. And chapter one is on what we call vagus insufficiency syndrome. And it's interesting that if you take a look at patients who come into a medical clinic that, you know, got primary primary migraine disorders, it's rare that they just have a migraine.
00:17:34
Speaker
They also have anxiety. They also have depression. They also have gastrointestinal disorders. They have a number of these sets of different problems that on the surface are completely unlinked.
00:17:48
Speaker
And the primary care doctor of the 2000s says, okay, you've got anxiety, go to the anxiety specialist. You've got depression, go to the depression specialist. You've got um you know migraines, go to the neurologist. And they send people out across in multiple different disconnected.
00:18:05
Speaker
its this pla yeah and It's what we call splitters. you know we We split it all up. But interestingly, ah in a study we did in about 2010, when you stimulate the vagus nerve in the patients with migrates plus migraines plus ah GI disorders, migraine plus fibromyalgia, migraine plus, and in the list goes on to things that are linked, yeah the other symptoms kind of just melt away.
00:18:36
Speaker
Yeah. which led me to believe that patients don't have three disorders, they have vagus insufficiency, which you call vagus dysregulation, which actually may be a better name in some ways, but they're not functioning correctly.
00:18:50
Speaker
And it is causing disorders that have been unrecognized, largely unrecognized as such. But if if you do searches out there, you can find medically unexplained symptoms.
00:19:02
Speaker
It's a very pejorative term for patients who have got a really complex problems and doctors to say, well, you're medically unexplained symptom. We've got to learn, we've got to do better. We've got to explain it.
00:19:15
Speaker
And I, and I think, uh, you frequently see these medically unexplained symptoms and things like long COVID, which is shown to be related to a damage of the vagus nerve or the brainstem and the nucleus tract is solitary. So, uh,
00:19:31
Speaker
we're We will get to the point where people recognize these separate disjointed diseases and disorders are actually related back to a central brainstem or va ah vagal problem.
00:19:46
Speaker
Yeah, it made me think of all those interconnectedness with these kind of manifestations of some level of dysregulation or disintegration within the body. And it's being manifested through like si fibromyalgia, migraines, anxiety all these different manifestations. Or I think of working with quite a few people that have like POTS, some these other like inflammation. And you really...
00:20:09
Speaker
you know there There really is an interconnectedness and that splitting, I think, is my opinion. I could be wrong and please, you know people have opinions. But i think I think part of the splitting is I think it's the probably the supply and demand of physicians and people, healthcare care workers and trying to meet the the demand for the need.
Root Causes in Medical Diagnosis
00:20:29
Speaker
so I think there's that, like it's an unintended side effect of like, hey, I can't deal with this, go here, go here. At the same time, I think an unintended side effect is maybe because it's being looked at in isolation, not as a whole, that in a way we might do more damage at times or prolong some of these things or not really get to the root cause. And I think people can stay in limbo for a long time at times, even good intentioned physicians or therapists or whatnot versus looking at that that whole picture.
00:20:58
Speaker
I'm sure you're correct. And i don't I don't mean for a minute to think people are, that the physicians and the therapists aren't doing this with the best intention. But yeah if you don't know to look for something, you're never going to find it. So you have to be able to think differently.
00:21:14
Speaker
about things differently. And I hope one of the messages that we get across in this podcast is when you see these complex patients, it's important that you think that there may be a root cause and understand that. And and maybe I'm wrong. Maybe it's not the Vegas, but stop and think about it because yeah more often than not, you'll find that there is a root cause. It's, you know, high levels of mercury, it's ah inflammation, it's damage to the vagus for a a virus or a trauma. You know, there are a lot of different things that can cause this, but physicians today should be thinking about that, you know.
00:21:52
Speaker
ah vagus nerve dysregulation or dysfunction. And as we begin to address that, we are seeing other manifestations, psychological, physiologicals, begin to reduce significantly and even being reported that, which is very promising to see, wow, there's something powerful here.
00:22:11
Speaker
We need to take this into consideration. Most that I've talked with don't even know about the vagus nerve. It's not that this is their fault. It wasn't part of the training. And so you don't think about these things. I think the need to continue to update, so to speak, our app, our brain of what's the new research showing as and healthcare workers, as clinicians, psychologists, medical professionals, medical doctors, we need to stay up to date with some of the latest research and what's going on because we're missing out so much valuable information.
Natural Methods for Vagus Nerve Stimulation
00:22:41
Speaker
And I'm wondering as we pivot here with this vagus nerve dysfunction or dysregulation kind of
00:22:46
Speaker
ah how we're seeing it manifested and how we need to think differently and have this paradigm shift with the work that you're doing specifically with the VNS or the the vagus nerve stimulation and the devices.
00:22:56
Speaker
A few questions coming. And the first one I want to ask is how can we stimulate that naturally to improve you know vagal toning? that What do what do you find that's functional or effective?
00:23:08
Speaker
Yeah. so So look, there are four general methods of stimulating the vagus nerve. I break it down into natural.
00:23:17
Speaker
implanted biggest nerve stimulators non-imlanted vagus nerve stimulators, stimulators, of which there are different approaches of non-implanted at the neck and then other areas as well.
00:23:29
Speaker
But let's start with the most basic and most ancient of all medicines, which is the natural methods. Every culture...
00:23:41
Speaker
for thousands of years have figured out that stimulating the vagus nerve is helpful for disease and wellness and anxiety. Every every culture that I have ever explored.
00:23:54
Speaker
So the ancient acupuncturists from several thousand of years ago, they would... actually do acupuncture on the vagus nerve, ah interestingly.
00:24:05
Speaker
Pratamaya yoga is a source of deep breathing that is used that activates the vagus nerve. Cold water immersion yeah activates the mammalian diving reflex and activates the vagus nerve.
00:24:21
Speaker
we've We've kind of scientificized it a little bit with box breathing and other types of approaches here, but these are really basic, levels that activate your vagus nerve.
00:24:35
Speaker
Going a little bit deeper, singing, phonation. My good friend, Steve Porges has a safe and sound protocol where he's developed specific frequencies that activate the vagus nerve.
00:24:52
Speaker
And when you think about the nervous structure, the vagus nerve has four branches that come into your voice box. And these branches are are activated with singing and talking.
00:25:05
Speaker
And so so laughing, singing, all of these activate your vagus. All of them have good, you know, healthy benefits. And what frankly, we've known about this for a long time. We've known that laughter is ah nature's best medicine.
00:25:20
Speaker
We may not have it specified why. So so it's me vagus nerve stimulation is in fact a great unifier from the past to today, from holistic medications to Western and the best science.
00:25:36
Speaker
This all comes through the vagus. And I think one of polyvagal's great contributions history will reflect is an understanding that the trauma can damage or can impair the functioning of the vagus nerve.
00:25:55
Speaker
And that has been a really a great ah contribution, I think, for us understanding and linking things that we've not really understood before. And so for example, when I was a pain physician, one of the first things that I was taught was one of the predictors of chronic pain is abuse as a child.
Trauma and Vagus Nerve Impact
00:26:17
Speaker
On the surface, you have to say, why is that? But you know better than I here that if in fact your vagus has been traumatized, your body's not able to heal itself.
00:26:32
Speaker
And so this is a link from what we've recognized in Western medicine and it's just been kind of out there, wow. But this is mechanistically integrating Western observations with psychological approaches to include the polyvagal approach with most modern approaches of electrically stimulating the nervous system.
Integrating Ancient Practices with Science
00:26:52
Speaker
And it's it's you know pulling things together, which I think is an important thing.
00:26:57
Speaker
Yeah, and I think that's the piece, how I describe it to myself or you know people I work with or talk, it's like the puzzle piece that connects, makes all these things make sense in a way. Like, oh, that's why it works. That's why we know it works in these ancient, you know for thousands of years, they've been practicing from all different cultures have found a way And they may not have had a scientific, they didn't have they couldn't scan their brain and they didn't have the technology, but there was this, they saw it and they experienced it and they knew. And they probably had a felt sense, I'm i'm assuming, um you know of like, oh, wow, this does work and we're seeing people get better. Let's keep doing this. And now come to what we're doing in the West and is that now we could see it.
00:27:40
Speaker
We could see this this cranial nerve and and where it goes and how it works. And we can now do... brain scan imaging, when apped you know pre and post. And so now we could, in a way, science, Western science at least, essentially is, I think, validating what we've kind of known in a way and saying, yeah, we've known this. Now we could just, in a way, science is catching up to like what people have been doing before you know Western medicine, Western science, which is fascinating. I think it's really, you know like i say like truth is truth.
00:28:09
Speaker
And eventually comes out, like eventually the ultimate truth, like everything starts to come into alignment across cultures, across you know time, yeah which is so kind of exciting time to be in, I feel like at this time with this kind of shift.
00:28:23
Speaker
And yeah, and there's all these natural ways from different backgrounds, and which is really, really amazing. There's so many ways that we could naturally improve Eagle Tone, that is to restore and I'm assuming heal. Like, would you say that through this vagal toning for the the listeners, you know as we do natural, does that bring, can that bring some healing and balance and integration to the vagus nerve by doing these?
00:28:44
Speaker
I'm a Western clinical scientist and I'll say that my language is a little bit different, but, but the short answer is yes. And the one of the things that we take a look at is,
00:28:57
Speaker
Your body has different parts of your nervous system. And just to you know level set people, there's the autonomic nervous system, which has three point components. It's got the sympathetic, the fight or flight.
00:29:09
Speaker
It's got the enteric nervous system, which is your GI tract and information coming up and giving information to the brain from your microbiome. And there is the parasympathetic nervous system, which is largely the vagus nerve.
00:29:24
Speaker
yeah Most people think about the autonomic nervous system in the two, the sympathetic and the parasympathetic. And sympathetic being fight or flight. With a fight or flight, it shunts the blood away from your organs and ability to heal, but it allows you to run away from a saber-toothed tiger if that was chasing you back a few thousand years ago.
00:29:45
Speaker
The parasympathetic is rest, relax, and recover. And I believe that when we activate the parasympathetic nervous system, we provide an opportunity for your mitochondria to be adequately energized and healed.
00:30:03
Speaker
And so that is, in fact, how I would use those terminologies of of healing, not anthropomorphizing a cell, but it is allowing the cell structure to work optimally.
00:30:16
Speaker
Yeah. Yeah. one And I love that explanation. Again, I think being true to your language and it it's saying the same thing. It's just different language, right? And I think it's important to to stay true. But what I'm hearing is that, yeah, it can. It does. that these things These practices...
00:30:32
Speaker
do have an impact, which is why they've been practiced and we saw healing happen. And now it's one of many. We might need more. And that kind of leads us into the the second part of, well, that's some natural ways.
00:30:43
Speaker
And there's tons of them. And that's why actually sing on the way home ah often because I know for me and I used to do choir as a kid. And so like i and I always feel better when I sing. always feels good, right? yeah Even when you're angry, just kind of get that energy out like, oh, now I can relax, right?
00:30:56
Speaker
So many uses of singing um and my kids love it. So it's such a fun way for them to play and and have fun and release and shift shift states.
VNS Devices: Internal and External
00:31:03
Speaker
That's natural. So what are some of the the, tell me more about these devices and the ones between surgically implanted versus external. Can you talk about like the function, how they help?
00:31:13
Speaker
Sure. So the OG, the original vagus nerve stimulator, the electrical vagus nerve stimulator, was a implanted vagus nerve stimulator in the neck that is connected to a pacemaker in the chest.
00:31:31
Speaker
that stimulated the vagus nerve pretty consistently and constantly over a 24-hour period. And these were implanted for children with epilepsy after aggressive measures had failed, many medications, even cutting out the foci of abnormal brain tissue, going in and doing brain surgery.
00:31:51
Speaker
After that, these therapies still seem to work. And they are effective. They are really good tools, but they're invasive.
00:32:03
Speaker
The vagus nerve runs within what's called the carotid sheath, which is where your main blood supply to your brain goes. And there is a small but real incidence of hoarseness after an implant because you could potentially damage some of those nerves that go to your vuln cords.
00:32:20
Speaker
And they're expensive. So, I'm a big fan of them, but I also recognize that there are limitations of expense and risk of these approaches. We developed a non-invasive approach of stimulating the vagus nerve in the neck, whereby we created a frequency that doesn't hurt, that is safe, that doesn't activate the fibers that cause your heart to slow,
00:32:45
Speaker
And it is just gets the other fibers by simply placing ah device over the neck, placing it ah with a little bit of conducting gel, turning it on for two minutes and that's it.
00:32:58
Speaker
So it is a biohack of activating the vagus nerve. And hear about 160,000 fibers on average in the, in the neck on either side.
00:33:11
Speaker
And we can, We optimally stimulate maybe 85% of the ones we want to stimulate. Wow. So how long have these been around this device that you guys have, you guys have created this device, which is yeah sounds like, you know, very high tech. So how long have these been?
00:33:28
Speaker
Yeah. the The first approval was in Europe in 2011 and it's been, and it's been used by the National Center for Clinical Excellence there for patients with cluster headache.
00:33:39
Speaker
They found that not only does it help the cluster headache, but it actually saves them money to use it because they stopped doing other things. You know, they stopped getting oxygen and injections and other types of things that are otherwise done.
00:33:52
Speaker
So they've covered it since about two, that I don't know exactly when they started covering but it was approved via what's called a CE mark in 2011. In the United States, we got a FDA clearance, a de novo process for episodic cluster headache back about 2017 and subsequently have approvals for prevention of cluster headache, acute treatment of migraine, prevention of migraine, treatment of adolescents with migraine,
00:34:21
Speaker
Parachysmal hemicrania, hemicrania continuum. In 2022, we got a breakthrough designation for post-traumatic stress disorder from the FDA, which is not the same as a full approval, but it's recognized the studies that have been done for PTSD and thought this is going to be something that's of value.
00:34:42
Speaker
And we're still working with the FDA on that topic. During COVID, we got a emergency use authorization for difficulty breathing due to COVID. I basically cleaned off all of the old data that we had from many, many years ago when I was working on this on the guinea pigs and early humans with asthma. And the FDA said, yeah, and look, people are dying from this. like Let's let you use this trick during the time period of COVID.
VNS Applications in Various Conditions
00:35:09
Speaker
Now that COVID no longer exists or the emergency exists, that EUA has expired. But we did some really interesting studies looking at those cytokines we were talking about at the outset, you know, in the cytokine response, which was associated with people's death.
00:35:25
Speaker
So ah lots of different areas and lots of research going on from... yeah preventing a stroke from occurring in situ, getting worse and worse after someone's had a stroke to there's a company that's not, not us, but working on patients who had a stroke stalled in their recovery using vagus nerve stimulation to improve neuroplasticity in the brain to allow the body to start functioning again.
00:35:51
Speaker
so lots of different areas there. Then there's auricular devices. There are devices that go on the ear. And interestingly, there's a small branch of the vagus nerve that goes to the ear.
00:36:02
Speaker
if If you're only stimulating that nerve, it's probably not as effective as stimulating the main branch in the neck because it only goes one way into the brainstem, whereas this one goes up and down and et cetera.
00:36:15
Speaker
But there's interesting work going on on multiple nerves. So not just stimulating the tragus or the vagus nerve in the ear, but stimulating the trigeminal nerve, the tragus, the upper cervical nerve roots.
00:36:27
Speaker
And you can get to a lot of those nerves in the ear, which we're looking at diabetic neuropathy and treatment of diabetes. So things that have traditionally not been considered part of an electrical domain, but rethinking things.
00:36:44
Speaker
Yeah. so Yeah. I mean, very like ah going back to what I said earlier about the work you've already done ah and it's, it's still pioneer. It's like you're paving the way and looking through how else can we,
00:36:56
Speaker
help and do think differently think outside the box to be more effective with less side effects and maybe be more maybe be more effective you know and you said something about the the ptsd caught my ear because you know i i do a lot of trauma work too and i do emdr and other somatic stuff and polyvagal you know kind of incorporate these things together and and i'm curious with these vagus nerve stimulators at least the ones that even you designed What what else have have you seen it being effective in treating like anxiety, depression, stress? Like do you see the efficacy there?
00:37:29
Speaker
Yeah, so so so this is a lot of Doug Bremner's work out of the Veterans Affairs at Emory University. But he was able to show ah improvement in the PTSD checklist scores, so the patient's experience.
00:37:44
Speaker
He was able to show an improvement in the clinical global impression of change. was able to show changes in blood flow to various areas of the brain, He was able to show improvement in the size of areas in the brain, like the insula, which kind of you know seems to shrink and kind of be regrounded.
00:38:05
Speaker
And very interesting to me and traumatic with me is he showed that patients with PTSD have actual spikes in these inflammatory cytokines, IL-6.
00:38:16
Speaker
The same inflammatory cytokine that was associated with mortality in the COVID patients spikes in patients with PTSD in response to traumatic strip scripts.
00:38:28
Speaker
He was able to blunt that ah significantly with vagus nerve stimulation preemptively. wow So so these you know these are sick patients in the Veterans Affairs with PTSD, but he's linked the mechanism with brain imaging and cytokine response with clinical outcomes, so kind of makes sense of why he's doing it.
00:38:51
Speaker
He's actually done the work to show that the patients are clinically improving and that the brain imaging and and the the blood flow and the cytokines are all significantly improved. So I think this is an incredibly...
Challenges in PTSD Treatment
00:39:05
Speaker
promising area. And you know currently, the only approved therapies for the FDA's perspective for the treatment of ah PTSD are two antidepressants, and they don't work very well.
00:39:22
Speaker
So we we really do need to broaden our approach to this problem. Yeah. Yeah, I think we need to update it significantly. i agree. You know, i with all this, everything going on that has gone on, I'm curious for you personally, what is something that you're most excited about in the work that you're doing with kind of the vagus nerve or the VNS stimulators? Like what is, what gets you most excited right now?
00:39:45
Speaker
Well, I, you know, you know, back to your original question, why did I start the vagus nerve society? I think this is an incredible new wave new way of looking at things for many different disorders from diabetes to PTSD to blocking a stroke in situ. Or you know if someone's having a stroke, keeping it from evolving and the devastating consequences of that.
00:40:14
Speaker
PTSD, you know, we have 15% of our veterans returning from Afghanistan stand and Iraq wars who have PTSD and it's going up every year. We need a better strategy. We need to be able to help these people to a greater degree.
00:40:27
Speaker
But I started the Vegas Nerve Society because I was aware of people, and I co-founded it with Mark Kager, but we were aware of the incredible interest that we're seeing in the vagus nerve from people from cardiology to gastroenterology to psychiatry and Nobody really knew that the others were working on this and
Collaboration in Vagus Nerve Research
00:40:55
Speaker
existed.
00:40:55
Speaker
So I wanted to have a home more for the medically oriented people. But as I got into this, I realized the mind-body interface aspect is extraordinarily important.
00:41:06
Speaker
So it can bring in the the psychologically oriented people as well, but have a home. for people who are interested in that critical structure called the vagus and the nucleus tractus solitarius and learn from each other.
00:41:20
Speaker
Say, okay, this person's working on Parkinson's disease and they found X, Y, or Z. And a very you know stark example is we learned a few years ago that we could alter the evolution of a stroke by stimulating the vagus nerve, but it had to be done in a slightly different paradigm than what we'd been doing for headaches.
00:41:44
Speaker
and when we apply that to Parkinson's, we're learning that that might actually improve Parkinsonian gait and other problems, but we may need to do things a little bit differently. And we can learn from each other and activating the vagus.
00:41:57
Speaker
So but my my goal was to A, have a forum for discussion from between clinicians and scientists, and it's evolving to being, allowing patients to understand that they should be asking questions of their doctors about other strategies that might be helpful for them.
00:42:18
Speaker
Yeah. I love that, that we need to invite, you know, other individuals that have that work in a different similar, but, you know, kind of parallel different area of focus, the psychological and the medical. it's like we need, we need all the mind body. We need everybody to work together to say, Hey, what are you seeing? Hey, I'm doing the research and science of it. So what are you noticing in the room? And you sit with the patient, you know, what are you hearing? And yeah,
00:42:40
Speaker
I think that is that integration of like, we need to bring us together versus being separate entities of being you know splintering or these sectioning out. It's like, no, let's all let's all communicate together because really we care about the this person, the individual, the human. And so we need to learn from one another.
00:42:56
Speaker
um Because everyone has something to offer. And I love that that's what the Vegas Nerve Society is about, is that it which really is the mission too of PVI, Polyvagal Institute as well. is It's about giving away generously and you know bringing in the fold and understanding to learn more.
00:43:13
Speaker
so I love that that's what your society is about. And to kind of wrap up, you know, final two questions here, you're speaking at the upcoming Polyvagal PVI conference. whats what's like a What's one thing or an insight, something you're really hoping to get across or share at that conference?
00:43:30
Speaker
Well, look, I think the Polyvagal Institute has done enormous value in A, looking at the problem from a different perspective, but providing a framework for therapists to understand a new strategy for treating their patients.
00:43:49
Speaker
yeah It turns out that that framework has a lot to offer Western medicine. And what I hope to do is bring in and create a linkage between polyvagal Institute with the therapists who have been working in this field with a unified theory of why this works and how does this all can connect everything from um sexual dysfunction and rheumatoid arthritis and anxiety to post-traumatic stress disorder, but to help create that link.
Broadening Treatment Approaches
00:44:26
Speaker
And then provide one tool, one, one tool in your toolbox to be able to help the patients who need a different approach.
00:44:37
Speaker
yeah And I am, do not believe that this is a, something that, that the devices that I've built or worked on over the years,
00:44:47
Speaker
are going to solve lot of your problem. I don't believe that at all. But I do think it's important to have the tools in the toolbox and to have a framework for looking at the problem such that you think about this. And if it's appropriate, that's great. And if it's not appropriate, let's try something else.
00:45:04
Speaker
But the goal here is to link up. to build on what you've, you know, the tremendous work that's been done from a theoretical orientation and to bring in the 600,000 physicians who might be interested in um learning a little bit more about, you know, why heart rate variability is important and why ah patients with trauma may have a different response to the medical treatments that we're offering and get some new, new suggestions.
00:45:36
Speaker
Yeah. I love that. The, Yeah, as we work together um you know and in expanding our toolbox, you know like love I use that analogy all the time. It's like, hey, it's a tool that you may not always use and it may not fix everything, but it's very effective when used correctly. And in certain circumstances, that's exactly what you need, right? It's like the idea of like, hey, hammer's great you know in a lot of ways.
00:45:59
Speaker
Mm-hmm. But we mean we need more than a hammer. you know It's like anything. I'm interested. i want I want this tool of my tool bag. so with The final question is you know those that are interested in VNS devices, those that want to learn more, like what should they consider? Where should they go? like Can you help us point us in a direction to kind of... Well, yes. so there's There's been a lot of interest in the vagus nerve and vagus nerve stimulating devices that have um exploded, as I said earlier, over the last 10 or so years.
00:46:34
Speaker
the The challenge for the consumer is figuring out what's been studied with science and actually works and what is just a marketing ploy. And I can tell you very definitively, if you're using the wrong frequency, this is not going to work.
Critical Evaluation of VNS Technologies
00:46:50
Speaker
um And if you're using a bad frequency, you could actually slow the heart it could be dangerous. So the devices that I've worked on are there's a medical device called GammaCore device.
00:47:04
Speaker
There is a wellness device called Truvega, T-R-U-V-A-G-A, that is just stay classified as in a consumer electronics. And people can go on Truvega.com and buy it and and um use it for themselves.
00:47:21
Speaker
ah And basically that's used for you know sleep problems and mood problems, but there's no medical claims associated with it because it's not an FDA approved device.
00:47:34
Speaker
So my recommendation on the surface is look at the devices and look what's been studied, look at the frequencies of what they're using. And if it's not the frequency that we worked on, make sure that they've actually done the work to show that what they're claiming, and they're not just looking to the papers that we wrote a number of years ago and saying, oh, vagus nerve stimulation works because If they're using the wrong frequency, I can almost tell you there's a very there's a very good chance it's not gonna work.
00:48:08
Speaker
And that's a shame because people will lose out on a viable strategy. Yeah. Yeah. Which, but which is important. i think you put a really important point on it that we need to really be clear with is this marketing and because people do misuse a whole bunch of information on everything to make a sale versus the ones are doing it well and right or linking to research and showing it and,
00:48:32
Speaker
You know, they'd be thinking critically. And ah for your work, is there a way, where can we find the work that you're doing and the research and to point people to like someone doing the work that's showing, hey, here's what we're finding. Where where can we find your your work?
00:48:46
Speaker
Well, look, you can go to the VN society.org. I tend to put up podcasts and webinars that we're doing. We're doing really interesting work on performance enhancement of our super soldiers, you know, the air force and doing work on improvements and learning and decreasing fatigue, et cetera.
00:49:07
Speaker
ah We just did a webinar. the beginning of March on this topic, it's up on the website. There are clinical papers under clinical conditions that we load up to try to just, Hey, if you're interested in, you know, PTSD, here's a series of papers and it's not complete, but it's a good start for people to get started. And there's a poor stuff on polyvagal ah work that's gone, that's up there.
00:49:31
Speaker
And, you know, I would encourage people to jot me a note if they're interested in, you know, X, Y, or Z. I'm trying to get people in the right direction. Yeah, that's awesome. Thank you for that. And I think this is such a rich, like, it's such a, it's a different way of thinking, especially from the medical side and those coming from a psychological side like myself. is it It makes me think differently too, like other ways that we help those that we're working with and other ways of treating really some level of disintegration or dysregulation.
Embracing New Treatment Paradigms
00:50:01
Speaker
and rounding out the the dialogue and inviting in just a different perspective, this paradigm shift. and And i you know for me, I love paradigm shifts to say, wow, I never thought of it that way. And this and my hope for this is that as people are listening to this, it just expands them a bit more, takes them another step deeper in in a different way.
00:50:21
Speaker
And so I thank you so much, Peter, for your time and sharing. And and my hope is that the the work that you're doing and that others have done or are doing around this globally, that we continue to find really more integrative ways to help help each other, to help the world. You know, why not? Like, that's that's a ah wonderful mission to be part of, to to do better work and to treat people better and to to heal more effectively. Like, what a mission and call in life. So...
00:50:49
Speaker
It's also about understanding what's wrong with people and not to throw drugs at people. I'm not a no drug guy, but do think we need to be very circumspect and use of just broadly throwing medications at people for this disorder, that disorder, and really need to understand the root cause of the problem. And I do think that for many disorders, electricity is a wonderful solution as well as symptom control.
00:51:19
Speaker
Yeah. When you take a step back and I think slow things down a bit. Yeah. And that's, i think our whole culture, typically we need to slow down significantly to see that root cause. Otherwise we'll keep doing those quick, which again, do they do work. We're not knocking. It's effective in some cases and and it's very helpful in life giving.
00:51:38
Speaker
It just really depends on the person. We need that space and time to really think critically with people and wonder what else is here. You know, I'm seeing these things. What else might be going on that might be something I can't see with my eyes right now?
00:51:52
Speaker
yeah And so i yeah i'm I'm on that mission and my hope is that we continue to change that. So yeah, again, thank you so much for your time. You have a wonderful day and we'll see you at the conference coming up here Thanks, Trevor. Pleasure to be with you. I look forward to meeting with you in person.
00:52:06
Speaker
Yeah, thank you.