Review of the Uses of Vagal Nerve Stimulation in Chronic Pain Management.
Recent human and animal studies provide growing evidence that vagal nerve stimulation (VNS) can deliver strong analgesic effects in addition to providing therapeutic efficacy in the treatment of refractory epilepsy and depression. Analgesia is potentially mediated by vagal afferents that inhibit spinal nociceptive reflexes and transmission and have strong anti-inflammatory properties. The purpose of this review is to provide pain practitioners with an overview of VNS technology and limitations. It specifically focuses on clinical indications of VNS for various chronic pain syndromes, including fibromyalgia, pelvic pain, and headaches. We also present potential mechanisms for VNS modulation of chronic pain by reviewing both animal and human studies.
Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Johns Hopkins School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
Krishnan
K
Chakravarthy
Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Johns Hopkins School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
Hira
H
Chaudhry
Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Johns Hopkins School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
Kayode
K
Williams
Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Johns Hopkins School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21287, USA. pchristo@jhmi.edu.
Paul J
PJ
Christo
D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D004195:Disease Models, Animal; D005356:Fibromyalgia / Q000628:therapy; D006261:Headache / Q000628:therapy; D006801:Humans; D059408:Pain Management / Q000379:methods*; D017699:Pelvic Pain / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D055536:Vagus Nerve Stimulation / Q000379:methods
D000893:Anti-Inflammatory Agents
Chronic pain; Fibromyalgia; Headache; Inflammation; Pelvic pain; Vagal nerve stimulation