Table 2 Evidence and feasibility of therapeutic strategies for precision vagus neuromodulation in different disorders
Disorder | Targeted organ/ process | Targeted anatomical element of vagus | Evidence for/Feasibility of Targeting Strategies | ||
|---|---|---|---|---|---|
Cervical VNS | Near-organ (at-branch) stimulation | At-organ ultrasound stimulation | |||
Epilepsy | Brain cortical excitability | Afferent vagus fibers | Feasible | Unclear/ Not feasible | Unclear/ Not feasible |
Depression | Brain monoamine system | Afferent vagus fibers | Feasible | Unclear/ Not feasible | Unclear/ Not feasible |
Headaches (Migraine and Cluster) | Neurovascular | Afferent/efferent vagus fibers | Feasible | Unclear/ Not feasible | Unclear/ Not feasible |
Stroke Rehabilitation | Cortical plasticity | Afferent vagus fibers | Feasible (Dawson et al., 2021; Dawson et al., 2016; Engineer et al., 2019) | Unclear/ Not feasible | Unclear/ Not feasible |
Multiple Sclerosis | Brain and spinal cord, inflammation | Afferent/efferent vagus fibers | Feasible (Marrosu et al., 2007) | Unclear/ Not feasible | Unclear/ Not feasible |
Tinnitus | Cochlea | Afferent vagus fibers | Feasible | Unclear/ Not feasible | Unclear/ Not feasible |
Heart Failure | Heart | Efferent autonomic vagus fibers (B-type, C-type), cardiac n. | Feasible | Feasible | Feasible |
Arrhythmias | Heart | Efferent autonomic vagus fibers (B-type, C-type), cardiac n. | Feasible | Feasible | Unclear/ Not feasible |
Hypertension | Carotid body | Afferent vagus fibers (Αδ-type and C-type), aortic depressor n. | Feasible (Annoni et al., 2019) | Feasible (Gierthmuehlen & Plachta, 2016) | Unclear/ Not feasible |
Pulmonary Hypertension | Lung vessels, right ventricle, inflammation | Efferent vagus fibers, bronchial n., splenic n. | Feasible | Feasible | Feasible |
COVID-19 ARDS | Lungs, inflammation | Afferent/efferent vagus fibers, bronchial n., splenic n. | Feasible (Fudim et al., 2020; Li, Qi, Li, Deng, & Wang, 2021; Mastitskaya, Thompson, & Holder, 2021) | Unclear/ Not feasible | Unclear/ Not feasible |
Rheumatoid Arthritis | Spleen, inflammation | Afferent/efferent vagus fibers, splenic nerve | Feasible (Koopman et al., 2016) | Feasible | Feasible (Zachs et al., 2019) |
Gastroparesis | Stomach | Afferent/efferent vagus fibers, subdiaphragmatic vagus | Feasible | Feasible (Malbert, Mathis, & Laplace, 1995) | Feasible |
Inflammatory Bowel Disease | GI tract, inflammation | Afferent/efferent vagus fibers, subdiaphragmatic vagus | Feasible (Bonaz, Sinniger, Hoffmann, et al., 2016) | Feasible (Caravaca, Levine, Drake, Eberhardson, & Olofsson, 2021; S. C. Payne et al., 2019) | Feasible (Nunes et al., 2019) |
Postop. Intestinal Obstruction | GI tract motility | Afferent/efferent vagus fibers, subdiaphragmatic vagus | Feasible (N. Stakenborg et al., 2017) | Feasible (N. Stakenborg et al., 2017) | Feasible |
Diabetes | Liver and pancreas | Afferent/efferent vagus fibers, hepatic and pancreatic n. | Feasible | Feasible(Chen, Pasricha, Yin, Lin, & Chen, 2010; Jon J. Waataja, 2021; Lee & Miller, 1985; Sophie C. Payne et al., 2022; S. C. Payne et al., 2020) | Feasible (Cotero et al., 2022) |
Fibromyalgia | Inflammation | Afferent/efferent vagus fibers | Feasible (Lange et al., 2011) | Unclear/ Not feasible | Unclear/ Not feasible |
Lupus | Inflammation | Afferent/efferent vagus fibers | Feasible (Mathis, Stauss, Pham, Kim, & Kulp, 2018) |  Feasible | Feasible |
Obesity | Liver (porta hepatis) | Afferent vagus fibers, subdiaphragmatic vagus, hepatic n. | Feasible (Bodenlos et al., 2007; Val-Laillet, Biraben, Randuineau, & Malbert, 2010; Yao et al., 2018) | Feasible (Ikramuddin et al., 2014) | Feasible (Huerta et al., 2021) |