There Are Drugs, Then There Are Nutraceuticals, Electroceuticals

By Eva Briggs

Much of the practice of medicine involves finding ways to persuade the body to make something happen or to stop happening. The bone marrow might need to be persuaded to make more red blood cells in the anemic patient. Or the brain must be prompted to stop seizures.

How do you communicate that to the body?

The most familiar way is through drugs, more formally called pharmaceuticals

Another way to send a message is through therapeutic food substances. Think Alice and the mushrooms she eats to grow larger or smaller in the book “Alice in Wonderland.”

Called nutraceuticals, these are regulated as dietary supplements or food additives. Some familiar examples are probiotics and antioxidants.

The body can also be persuaded through the power of electricity. Anyone who has ever accidentally touched an electric fence can attest to that. Electroceuticals are devices that harness the power of electricity to treat illness via electrical impulses.

You might not recognize that term, but some electroceutical devices have been around for a long time and are familiar to most people. Take the pacemaker. The first implantable pacemaker dates back to 1958. For trivia buffs, the very first patient treated with an implantable pacemaker ultimately received a total of 26 different pacemakers before dying at the age of 86. He outlived both the inventor and the surgeon.

A newer but also familiar technology is the cochlear implant. This electronic device stimulates the nerve cells in the cochlea of the inner ear, enabling profoundly deaf people to perceive sound. The very first cochlear implants were developed back in the 1950s.

Deep brain stimulators connect electrodes to brain regions. They are approved to treat a host of central nervous system disorders: Parkinson’s disease, epilepsy, dystonia, essential tremor and obsessive-compulsive disease. They are being studied in a host of other conditions such as addiction, chronic pain, multiple sclerosis, Tourette syndrome and Huntington’s disease.

One type of electroceutical poised to take off in future years to treat assorted conditions is the vagus nerve stimulator (VNS).

The vagus nerve is one of 12 cranial nerves arising from the brain stem. The name vagus comes from the Latin word for wandering — think vagrant or vagabond. The name fits. It’s the longest cranial nerve, extending all the way from the brainstem down to the colon. Many branches wander off to different parts of the body and affect a variety of functions. It detects sensations in areas of the skin, as well as receiving sensory input from internal organs (throat, larynx, esophagus, trachea, heart, and digestive tract). The vagus nerve also controls muscles in the pharynx, larynx, soft palate, heart, and digestive tract.

Recent discoveries show that the vagus nerve produces chemicals that regulate the immune system. Electrically stimulating the vagus nerve might someday treat autoimmune and inflammatory conditions. Existing drugs to treat these conditions often cause serious side effects.  By targeting the vagus nerve, more effective and safer treatments could be developed for autoimmune diseases like rheumatoid arthritis and Crohn’s disease.

Vagus nerve stimulation might potentially treat some diseases with inflammatory components, such as cardiovascular disease or lupus. There might be applications to preventing immune rejection of transplanted tissues.

Most currently used vagus nerve stimulators are implants. The device is inserted under the skin below the collarbone. Wires wrap around a branch of the vagus nerve and deliver electrical signals.

But there are noninvasive handheld vagal nerve stimulators approved to treat migraine headaches and cluster headaches. They deliver mild electrical stimulation to the nerves via the skin of the neck or ear.

Challenges to the wider adoption of electroceuticals include the cost of implants and the need for surgery. As technology improves and becomes less invasive, these problems should ease. More research is still needed to determine how vagus nerve stimulation affects various conditions and what is the best way to target electrical impulses.

Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

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