tVNS® activates the body’s natural communication pathway between the body and brain, supporting mood regulation, stress processing, pain perception, inflammatory balance, and neuroplasticity through gentle, repeated stimulation.
The abbreviation tVNS stands for transcutaneous vagus nerve stimulation. Transcutaneous means “through the skin.” What is electrically stimulated through the skin is a branch of the vagus nerve in the auricle (the outer ear). tVNS is therefore a non-invasive treatment that can be applied mobile at home.
The vagus nerve is an important nerve that influences many bodily functions – including mood, stress processing, sleep, heart rate, and pain perception. With tVNS, the vagus nerve is stimulated at a specific spot on the ear, the so-called cymba conchae, using gentle electrical impulses.
Transcutaneous vagus nerve stimulation thus uses a natural communication pathway between the body’s core and the brain: the vagus nerve. This nerve contains fibers that can relay sensory information from the organs to the brain, as well as fibers that can transmit signals in the opposite direction from the brain to the organs.
Through the gentle electrical stimulation, signaling pathways are activated that have an influence on various messengers (neurotransmitters), the regulation of the autonomic nervous system, and the brain’s adaptability (neuroplasticity).
Neurotransmitters are chemical messengers that nerve cells use to communicate with one another. Activation of the vagus nerve can indirectly influence the release of several important neurotransmitters:
This plays a central role in:
tVNS activates brain areas such as the dorsal raphe nucleus, which contains serotonergic neurons. As a result, more serotonin can be released and exert its effect, similar to some antidepressants – though triggered via the activation of the body’s own signaling pathways rather than by medications introduced into the body.
This influences:
Via connections to the so-called locus coeruleus, a region of the brainstem, tVNS can stabilize
norepinephrine regulation. This can help dampen excessive stress responses without causing wakefulness or nervousness.
The vagus nerve is the main nerve of the parasympathetic nervous system. Activating it, therefore, also results in an activation of the parasympathetic nervous system via the neurotransmitter acetylcholine.
These two neuro-transmitters regulate the balance between:
Studies suggest that tVNS can shift this balance toward greater neuronal stability – important in cases of anxiety, pain, and overexcitation.
These explanations are, of course, greatly simplified. The different messengers have a great many different mechanisms of action throughout the body and can trigger an opposite effect at other organs and receptors.
The vagus nerve is a central component of the so-called parasympathetic nervous system – the body’s “rest and regeneration system.”
The release of stress hormones (e.g., cortisol) can decrease, and heart rate variability can increase (meaning greater adaptability and, thereby, improved stress regulation).
The body’s anti-inflammatory action can be activated (this is referred to as the cholinergic anti-inflammatory pathway).
This is especially relevant because chronic stress and low-grade (“silent”) inflammation play a role in many neurological and psychiatric conditions.
A particularly exciting aspect of tVNS is its possible influence on neuroplasticity.
Neuroplasticity describes the brain’s ability to:
In conditions such as depression or chronic pain, unfavorable neuronal loops are often active (e.g. negative appraisal of one’s own environment, pain memory, overexcitation).
Through repeated activation of certain brain networks, tVNS can:
Put simply: tVNS makes it easier to learn more stress-resistant responses and thereby overwrites old behavioral patterns.
This is why it does not work immediately like a painkiller, but instead develops its effects over time and through repetition.
Transcutaneous vagus nerve stimulation can:
It therefore does not suppress symptoms, but rather regulates, as support for the unconsciously controlled nervous system.
Using tVNS is very simple. With delivery, you receive everything you need for the application, including a detailed description and an instructional video. For any questions, our customer support is, of course, always available. And here is how you use tVNS:
tVNS acts on the body’s central control system: the vagus nerve. Among other things, this influences stress responses, mood, pain processing, and inflammatory processes. As a complementary therapy, tVNS can:
Especially in chronic conditions where multiple factors interact, such a holistic approach can be useful.
Invasive vagus nerve stimulation (iVNS) requires the surgical implantation of a stimulator. Transcutaneous vagus nerve stimulation (tVNS) follows the same basic principle, but without a surgical procedure. This results in several important advantages.
There is one spot on the human body where the vagus nerve lies particularly close beneath the skin. This spot is located in the upper region of the auricle and is called the cymba conchae. In this small depression, exclusively branches of the vagus nerve run beneath the skin, meaning there is 100% innervation by the vagus nerve. Due to the superficial position of the vagus nerve in the cymba conchae, this area is particularly well suited for non-invasive stimulation of the vagus nerve – entirely without surgery. With tVNS, afferent branches of the vagus nerve are addressed in the cymba conchae – that is, nerve fibers of the vagus nerve that relay information from the body to the brain. This explains why the stimulation can have strong effects on central processes in the brain. Evolutionarily, the vagus nerve originates from the nervous systems of phylogenetically ancient vertebrates. Already in early fish and amphibians, there were:
Over the course of evolution, these structures were repurposed, relocated, and specialized. The auricular branch of the vagus nerve is a relic of these ancient connections.
The tVNS® E is currently the only transcutaneous, non-invasive vagus nerve stimulation device approved in Europe under the new Medical Device Regulation (MDR EU 2017/745). The tVNS® E is explicitly approved for the indications epilepsy (more information can be found here), chronic migraine (more information can be found here), depression (more information can be found here) and Prader-Willi syndrome.
Epilepsie: Reduzierung der Anfallshäufigkeit während der tVNS im Vergleich zur Phase vor der Intervention um mindestens 25 %, nach einer Behandlungsdauer von 20 Wochen. (Bauer et al. 2016)
Depression: Reduzierung des Depressionsspezifischen HAMD-Scores um mindestens 2-3 Punkte bei erwachsenen Patient:innen bei gleichzeitiger Anwendung mit psychopharmakologischen und psychotherapeutischen Behandlungen nach einer Behandlungsdauer von 9 Wochen. (Melis et al. 2020: Evensen et al. 2022)
Chronische Migräne: Reduzierung der Häufigkeit von Migränetagen um 50 % nach einer Behandlungsdauer von 12 Wochen. (Straube et al. 2015)
Prader-Willi-Syndrom: Reduzierung der durchschnittlichen Anzahl von Wutausbrüchen pro Tag im Vergleich zur durchschnittlichen Anzahl von Ausbrüchen pro Tag in einer Phase vor der Intervention um mindestens 50 % nach einer Behandlungsdauer von 12 Monaten. (Manning et al. 2019)
