tVNS in Austism

Pediatric neurology specialist Associate Professor Dr. Barış Ekici shares his insights and experiences with transcutaneous vagus nerve stimulation therapy:

"Vagus stimulation is a technique that works on stimulating the vagus nerve. It has been an approved treatment for epilepsy since 1997 and for resistant depression since 2005. Vagus stimulation creates an impulse that travels from the brainstem to higher centers in the brain, carrying an electrical signal from the brainstem to the amygdala, hippocampus, and frontal lobe. Initially, devices placed on the vagus nerve through surgery were used. The human ear has an extensive network of nerve stimuli. Specifically, there are branches of the vagus nerve that intensely travel to the brain in the concha, the hollow part of our ear. Using this device, we deliver some repetitive stimuli at microampere levels and microsecond durations to the ear, thereby carrying a signal from the brainstem to the brain.

Vagus stimulation alters brain chemicals and activates the GABAergic system, which we know functions poorly in children with autism. Studies have shown that following vagus stimulation, GABAergic metabolites increase, and glutamate decreases in brain fluid. It also stimulates and regulates the serotonergic and noradrenergic systems. Additionally, it calms the brain and reduces neuroinflammation. With vagus stimulation, we expect children with autism to be calmer, more focused, have improved sleep quality, reduced obsessions, and increased speech.

The feedback from our patients aligns with these expectations. Thanks to state-of-the-art devices, we now have the opportunity to apply this method to children via the ear, and we begin to see positive effects after a month of stimulation. The good aspect is that after planning the stimulation according to the child's EEG, it is a method that the family can apply at home on their own. We do not see many side effects. Mild side effects such as redness in the ear and occasional headaches are reported. For now, our patients are satisfied with vagus stimulation. We generally receive feedback from parents that their child is calmer, more focused, and has increased speech. When you increase the activity in children with autism, you lose functionality. Therefore, I believe that vagus stimulation, which works from the brainstem to the brain and helps the child find their balance in a calming manner, is very suitable for children with autism."