Vagal nerve stimulation for cognitive and performance enhancement

Vagus nerve stimulation (VNS) has emerged as a versatile therapeutic approach, utilizing electrical impulses to modulate brain activity through the vagus nerve, with applications spanning epilepsy treatment to stroke rehabilitation. VNS has a long history of use and is now being considered as a tool for cognitive enhancement in patients with dementia, and even those without medical disorders. This chapter provides an overview of VNS, tracing its historical development from pioneering efforts in the late 19th century to contemporary research exploring its role in performance and cognitive enhancement potential.The anatomical and functional significance of the vagus nerve within the autonomic nervous system is elucidated, emphasizing its role in regulating cardiovascular function, gastrointestinal processes, fatigue, and cognitive functions including memory and language acquisition. Mechanisms of VNS in performance enhancement are discussed, highlighting its impact on neurotransmitter release, synaptic plasticity, and inflammatory signaling.Evidence from animal models and human studies suggests that VNS holds promise for enhancing cognitive abilities, with effects on memory, learning, and emotional regulation. Early research with implanted VNS demonstrated cognitive enhancement in patients with seizure disorders [6]. However, more recently the use of noninvasive VNS has opened up avenues of study in patients with cognitive decline, as well as with our military personnel for performance enhancement, mitigation of fatigue due to sleep deprivation, and language acquisition.The use of noninvasive approaches has significantly reduced the barriers to access and risks of any surgical approach.Future research directions are outlined, emphasizing the need for standardized protocols, optimized stimulation parameters, and diverse cognitive tasks to comprehensively assess VNS’s cognitive-enhancing effects.In conclusion, while there is a long history of VNS demonstrating efficacy in treating multiple clinical disorders, newer publications highlighting the cognitive status, performance enhancement, attention, and mood with noninvasive vagus nerve stim in both medically compromised as well as normal individuals, paired with the safety and ease of access of noninvasive approaches, suggest a new direction for both the medically compromised as well as healthy individuals.