Vagus nerve stimulation is a newly studied methodology to regulate the body’s stress and recovery systems. Access to this treatment approach was limited to specific clinical conditions given the costs and risks associated with an invasive surgery for an implanted device. Now researchers are uncovering a simpler alternative to leverage the homeostatic capabilities of this nerve: non invasively stimulating a small branch of the vagus nerve located in the ear.
This approach, known as auricular VNS (aVNS), is creating buzz in the healthcare community and is being studied for its potential to support cardiovascular fitness, immune balance and recovery after a psychological or physical stress, all without the risks of invasive surgery.
The vagus nerve: The highway connecting the brain and organs
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The vagus nerve is the body’s longest cranial nerve, stretching from the brain stem through the chest and abdomen. It acts as a central communication line or “highway” between the brain and major internal organs, implementing the majority of the regulating functions of the parasympathetic division of the autonomic nervous system. When the vagus nerve functions well, the body can better recover after a stress response restoring the body’s homeostatic status quo.
A faltering parasympathetic system can have a range of negative impacts on mental and physical health, from persistent anxiety and impaired digestion, to elevated heart rate and blood pressure and chronic inflammation.
By delivering small pulses of electricity to vagal fibers, VNS activates neural circuits that signal the brain to dial down excessive “fight-or-flight” activity and restore a calmer “rest-and-digest” state. This shift has measurable downstream effects: slowing heart rate, reducing pro-inflammatory cytokines and improving interoceptive communication between the brain and key organs.
Research suggests that neuromodulation and VNS may influence brain activity patterns and neurotransmitter systems, which could play a role in regulating mood and resilience. As a signal of that, VNS has shown to enhance heart rate variability (HRV) which serves as a marker of the body’s resilience to stress.
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Earlier patients could only access VNS through a surgically implanted device. Now, advances in non-invasive stimulation are drawing attention to a more accessible access point — the ear.
The ear as a gateway to the nervous system
One of the most promising methods to stimulate the vagus nerve is auricular vagus nerve stimulation (aVNS). Unlike other approaches that target the nerve through the chest or neck, aVNS uses the ear’s tragus as a precise, non-invasive access point. Importantly, stimulating the nerve at the ear avoids complications sometimes reported with cervical stimulation, such as painful muscle spasms or heart rhythm disturbances, while offering a more targeted and tolerable approach.
The method involves delivering mild, imperceptible electrical impulses through the skin. By targeting a nerve branch with a direct line to the brainstem, researchers believe aVNS offers a more reliable way to influence autonomic balance, inflammatory pathways and neuroplasticity . Its non-invasive approach also allows users to use it while working, traveling or resting.
The growing evidence base
What began as a niche line of inquiry in neuroscience has evolved into a growing body of clinical evidence. Multiple randomized, placebo-controlled trials now point to aVNS as a safe, non-invasive way to influence clinical outcomes across cardiovascular, neurological, psychiatric, autoimmune and post-viral conditions but also boost cognitive capabilities, mental health and cardiovascular fitness in healthy individuals.
- Cardiovascular health: Vagal tone is tightly linked to heart rhythm and inflammatory processes. Early studies indicate that low-level tragus stimulation may influence heart rate variability and inflammatory markers, prompting exploration of its potential role alongside existing cardiology approaches.
- Long Covid and fatigue syndromes: Post-viral syndromes have shown long lasting symptoms ranging from brain fog to exercise intolerance. Early clinical trials report that aVNS may improve fatigue, cognitive function and autonomic regulation in patients with Long Covid and postural orthostatic tachycardia syndrome. While these are pilot studies, the consistency of early findings has fueled calls for larger-scale trials.
- Blood pressure and metabolic outcomes: Hypertension remains one of the most pervasive chronic conditions worldwide. In a controlled trial, brief daily tragus stimulation significantly reduced blood pressure in young adults with hypertension. This raises the possibility that neuromodulation may be explored further as part of ongoing research into metabolic and cardiovascular health.
- Cognitive performance: Beyond treating illness, research is exploring whether neuromodulation can optimize healthy brain function. Placebo-controlled studies have shown that two weeks of aVNS improved memory and executive performance in non-clinical adults. These findings showed improved immediate recall and short-term memory score.
From cardiology to psychiatry to post-viral care, early aVNS research is generating interest in how it might contribute to new approaches for stress, recovery and chronic conditions.
AVNS adoption for today’s patients and providers
AVNS has the potential to impact not only individual outcomes but also population-level challenges. It has the potential to provide health systems with a scalable, low-risk tool to address some of today’s most pressing challenges: rising rates of anxiety and depression, persistent post-viral syndromes and the long-term burden of stress-related chronic conditions.
For providers, aVNS raises the possibility of integrating neuromodulation into routine care without the risks of surgery. For patients, it gives them the power to continue therapeutic efforts at home on their own time.
At the same time, the landscape of neurotechnology is shifting rapidly. Consumers are already experimenting with wellness-focused devices, and regulators will need to distinguish between consumer-grade tools and clinically validated interventions.
What is clear is that the ear is no longer an overlooked site in neuroscience. A small flap of tissue once thought unremarkable is now being studied as a promising pathway for supporting nervous system balance and overall wellbeing.
Photo: SimpleImages, Getty Images
Dr. Elisabetta Burchi is the Head of Research at Parasym, the creators of Nuropod. She is a physician, psychiatrist and neuromodulation expert who has led 100+ research collaborations with institutions including Harvard and UCLA, resulting in 50+ peer-reviewed studies. A summa cum laude graduate of the University of Florence and former post-doctoral fellow at Montefiore / Albert Einstein College of Medicine, she also holds an MBA from INSEAD. Her work — published in The Lancet Psychiatry, Neurology and Frontiers in Behavioral Neuroscience — underpins the science behind Nuropod, the most studied non-invasive vagus nerve stimulation device.
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