Technology in The Neck, Relief in the Mind: New Treatment Eliminates Post-Traumatic Stress Disorder Through Vagus Nerve Stimulation

A new study tested a combination of psychotherapy and a technology called vagus nerve stimulation (VNS) in people with post-traumatic stress disorder (PTSD) who had not improved with traditional treatments. Using a small device implanted in the neck, the patients received stimulation during therapy sessions. The results were promising: all showed significant improvement and were no longer diagnosed with PTSD, with effects lasting at least six months. The treatment was shown to be safe and effective, offering hope for resistant cases.

Post-traumatic stress disorder, known as PTSD, is a mental health condition that can profoundly affect the lives of those who have experienced highly traumatic events, such as violence, serious accidents or war.

An estimated 90% of people in the United States will experience some form of trauma in their lifetime. For most, symptoms such as anxiety, fear or nightmares resolve over time. However, about 8% of the population develops PTSD when these symptoms persist for more than a month and begin to seriously interfere with daily life.

Although there are effective treatments, such as psychological therapies and medication, many people with PTSD do not improve with these approaches. Some experience side effects, others are unable to maintain treatment, and some even get worse after a while. In light of this, researchers are looking for alternatives to treat more difficult cases of the disease.

One of the new strategies involves the use of so-called neuromodulation, which consists of stimulating the brain in a controlled manner to improve its functioning. The idea here was to combine a traditional psychotherapy technique called “prolonged exposure,” in which the patient gradually confronts memories of the trauma, with a technology called vagus nerve stimulation (VNS).

The vagus nerve is a structure that connects the brain to various parts of the body, and when stimulated, it can help the brain learn better and react more healthily to stress.

Vagus Nerve Stimulation: Mechanisms and Factors Involved in Memory Improvement

Previous studies in animals have shown that this combination can improve the treatment of fear and anxiety, helping the brain to "relearn" not to react with panic to certain stimuli. But what works in the laboratory needs to be tested in people to see if it is safe and truly effective.

To this end, scientists have created a modern, small device that can be implanted in the neck in a minimally invasive way. It is activated during therapy sessions using a band placed externally and controlled by a cell phone.

With this technology, they began a small study with nine people suffering from PTSD who had not improved with traditional treatments.

During this new therapy to treat post-traumatic stress disorder (PTSD), a small device is implanted in the patient’s neck and connected to the vagus nerve. This device is so small that it fits in the palm of the hand and does not need an internal battery, as it receives power from an external module, similar to a necklace, worn only during therapy sessions. A cell phone with a special app controls everything: it sends electrical stimuli and records the audio of the sessions. During the treatment, a therapist guides the patient in therapeutic exercises while the stimulus is applied at the right times to help the brain process and overcome the trauma.

These people underwent 12 sessions of prolonged exposure therapy, combined with vagus nerve stimulation. Assessments were performed before, 1 week after, and 1, 3 and 6 months after the end of the therapy.

The results were very promising: all participants had significant improvements in PTSD symptoms, and most impressively, none of them maintained a PTSD diagnosis at the end of the treatment. Furthermore, the positive effects continued for at least six months. And best of all, the treatment was safe, with no serious side effects.

VNS therapy produces robust and lasting improvements in key PTSD metrics. (A, B) CAPS-5 scores are significantly improved after VNS therapy, and the benefits persist for many months after treatment has stopped. (C) A significant proportion of individuals demonstrate lasting loss of PTSD diagnosis after VNS therapy. One, three, and six months after stopping therapy, no participant met criteria for a PTSD diagnosis. (D) Reductions in CAPS-5 scores were observed across all domains, indicating that improvements are not confined to a single construct.

This study shows that this new form of treatment may be a light at the end of the tunnel for those living with PTSD who do not find relief with conventional methods. Larger studies will be needed to confirm these results, but it is an encouraging step toward more effective therapies for difficult-to-treat psychiatric disorders.

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Vagus nerve stimulation therapy for treatment-resistant PTSD

Mark B. Powers,  Seth A. Hays, David Rosenfield, Amy L. Porter, Holle Gallaway,  Greg Chauvette, Jasper A.J. Smits, Anne Marie Warren, Megan Douglas, Richard Naftalis, Jane G. Wigginton, M Foreman, Michael P. Kilgard, and Robert L. Rennaker 

Brain Stimulation. Volume 18, Issue 3P665-675May-June, 2025

DOI: 10.1016/j.brs.2025.03.007

Abstract:

Posttraumatic stress disorder (PTSD) is common and debilitating, and many individuals do not respond to existing therapies. We developed a fundamentally novel neuromodulation-based therapy for treatment-resistant PTSD. This approach is premised on coupling prolonged exposure therapy, a first-line evidence-based cognitive behavioral therapy that directs changes within fear networks, with concurrent delivery of short bursts of vagus nerve stimulation (VNS), which enhance synaptic plasticity. We performed a first-in-human prospective open-label early feasibility study (EFS) using a next-generation miniaturized system to deliver VNS therapy in nine individuals with moderate to severe treatment-resistant PTSD. All individuals received a standard 12-session course of prolonged exposure therapy combined with VNS. Assessments were performed before, 1 week after, and 1, 3, and 6 months after the completion of therapy. ClinicalTrials.gov registration: NCT04064762. VNS therapy resulted in significant, clinically-meaningful improvements in multiple metrics of PTSD symptoms and severity compared to baseline (CAPS-5, PCL-5, and HADS all p < 0.001 after therapy). These benefits persisted at 6 months after the cessation of therapy, suggesting lasting improvements. All participants showed loss of PTSD diagnosis after completing treatment. No serious or unexpected device-related adverse events were observed. These findings provide a demonstration of the safety and feasibility of VNS therapy for PTSD and highlight the potential of this approach. Collectively, these support the validation of VNS therapy for PTSD in a rigorous randomized controlled trial.