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Vagus nerve stimulation for the management of obesity, type 2 diabetes mellitus, and metabolic syndrome

Vagus Nerve Stimulation, Page: 327-341
2025
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Book Chapter Description

The vagus nerve is the longest cranial nerve, contains both motor and sensory fibers, and has the widest distribution in the body. Its somatic and visceral afferent fibers and its special visceral efferent fibers contribute to several of its actions. The vagus nerve communicates information about the volume and type of nutrients between the gut and the brain. It is stated that chronic ingestion of a calorie-rich/high-fat diet reduces sensitivity of vagal afferent neurons to peripheral signals and their expression of orexigenic receptors and neuropeptides, leading to hyperphagia and obesity. This implies that neuromodulation of the vagus nerve could be useful in the treatment of obesity and its associated type 2 diabetes mellitus and metabolic syndrome. The principal vagal mediator acetylcholine (ACh) is known to have antiinflammatory actions. Thus the vagus nerve may have modulatory influence on obesity and type 2 diabetes mellitus (type 2 DM) and associated inflammatory events. Clinical studies have revealed that vagus nerve stimulation promotes weight loss by inhibiting aberrant orexigenic signals. It is likely that the vagus nerve and ACh may have modulatory influence on the actions of GABA, leptin, serotonin, GLP-1, ghrelin, α-MSH, catecholamines, dopamine, cholecystokinin, and other neurotransmitters, and thus may have a role not only in obesity and type 2 DM but also in several neurological disorders such as Parkinson’s, Alzheimer’s, Huntington’s, and other conditions. Based on the current evidence, it is important to investigate how vagal nerve modulatory influence on various organs and tissues can be exploited to develop newer therapeutic strategies in their prevention and management.

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