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Unravelling the secrets of the vagus nerve will revolutionise medicine

Vagus nerve stimulation is used to treat conditions ranging from inflammation to migraine. Mapping the nerve's complex structure of more than 160,000 fibres could usher in a new era of precision treatments

By Grace Wade

22 August 2023

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Rachel Tunstall

AS I peered at its sinewy, tentacle-like tendrils, I thought the pale structure splayed on the table before me resembled a huge tapeworm, or perhaps a scrawny squid.

Its lacklustre appearance didn’t match with the wonder of what I knew it to be: a human vagus nerve, the sensory superhighway that connects our brain to most of our vital organs and helps regulate everything from the movement of food through our intestines to the steady beating of our heart.

I was at the Feinstein Institutes for Medical Research in New York, viewing one of 30 vagus nerve samples being diced, sliced and imaged by Stavros Zanos and his colleagues. The goal? To create a detailed map of the roughly 160,000 nerve fibres along its structure.

This ambitious effort comes after recent research has revealed the vagus nerve’s role in a wider array of processes than we ever realised – not only monitoring organ function, but helping discern facial expressions and even regulating mood. Most enticingly, we are starting to understand how it governs inflammation, the immune response that runs rampant in conditions ranging from heart disease to Parkinson’s.

Already, electrical devices called vagus nerve stimulators are used to treat epilepsy, depression, migraines and obesity. But they are limited by our rudimentary understanding of the nerve’s complex structure. Now, efforts to untangle its mysteries are allowing us to map each of its branches and even discover specialised cell types we never knew existed. Not only might these insights enable us to control inflammation, they could open a whole new frontier for precision medicine.

What is the vagus nerve?

The vagus…

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