Targeting Vagal Tone through Vagus Nerve Stimulation in Auriculotherapy
The gut communicates bidirectionally with the brain through the microbiota-gut-brain axis. A perturbation of this axis is involved in the pathogeny of irritable bowel syndrome (IBS) and inflammatory bowel diseases (IBD) which are biopsychosocial diseases. The vagus nerve (VN), a key component of the parasympathetic nervous system, can sense the microbiota, transferring this gut information to the central nervous system which is integrated and generates an adapted or inappropriate response perpetuating a pathological condition of the gut. A dysbiosis is observed in IBS and IBD. Stress is involved in the pathogeny of IBS and IBD and modifies the gut microbiota, stimulates the sympathetic nervous system, and inhibits the VN. The VN has anti-inflammatory properties through its afferents and efferent fibers, activating respectively the hypothalamic-pituitary adrenal axis and the cholinergic anti-inflammatory pathway. The VN modulates intestinal permeability, which is perturbated in IBS and IBD. A reduction in vagal tone is observed in IBS and IBD. Monitoring vagal tone would be an interesting marker of the microbiota-gut-brain axis. Targeting vagal tone through vagus nerve stimulation, auriculotherapy, microbiota modulation, drugs activating the cholinergic system, hypnosis, meditation, cognitive behavioral therapy, deep breathing, physical activity, could restore a homeostatic microbiota-gut-brain axis.
Pr Bruno Bonaz, MD-PhD1,2
Bonaz B. Anti-inflammatory effects of vagal nerve stimulation with a special attention to intestinal barrier dysfunction. Neurogastroenterol Motil. 2022 Oct;34(10):e14456.
Bonaz B, Sinniger V, Pellissier S. Therapeutic Potential of Vagus Nerve Stimulation for Inflammatory Bowel Diseases. Front Neurosci. 2021 Mar 22;15:650971.
Bonaz B, Lane RD, Oshinsky ML, Kenny PJ, Sinha R, Mayer EA, Critchley HD. Diseases, Disorders, and Comorbidities of Interoception. Trends Neurosci. 2021 Jan;44(1):39-51.
Sinniger V, Pellissier S, Fauvelle F, Trocmé C, Hoffmann D, Vercueil L, Cracowski JL, David O, Bonaz B. A 12-month pilot study outcomes of vagus nerve stimulation in Crohn's disease. Neurogastroenterol Motil. 2020 Oct;32(10):e13911.
Bonaz B, Bazin T, Pellissier S. The Vagus Nerve at the Interface of the Microbiota-Gut-Brain Axis. Front Neurosci. 2018 Feb 7;12:49.
Bonaz B, Sinniger V, Pellissier S. The Vagus Nerve in the Neuro-Immune Axis: Implications in the Pathology of the Gastrointestinal Tract. Front Immunol. 2017 Nov 2;8:1452.
Pellissier S, Bonaz B. The Place of Stress and Emotions in the Irritable Bowel Syndrome. Vitam Horm. 2017;103:327-354.
Bonaz B, Sinniger V, Pellissier S. Vagal tone: effects on sensitivity, motility, and inflammation. Neurogastroenterol Motil. 2016 Apr;28(4):455-62.
Rubio A, Pellissier S, Picot A, Dantzer C, Bonaz B. The link between negative affect, vagal tone, and visceral sensitivity in quiescent Crohn's disease. Neurogastroenterol Motil. 2014 Aug;26(8):1200-3.
Bonaz BL, Bernstein CN. Brain-gut interactions in inflammatory bowel disease. Gastroenterology. 2013 Jan;144(1):36-49.
Pellissier S, Dantzer C, Canini F, Mathieu N, Bonaz B. Psychological adjustment and autonomic disturbances in inflammatory bowel diseases and irritable bowel syndrome. Psychoneuroendocrinology. 2010 Jun;35(5):653-62.
Taché Y, Bonaz B. Corticotropin-releasing factor receptors and stress-related alterations of gut motor function. J Clin Invest. 2007 Jan;117(1):33-40.