Sept. 24, 2001 -- Gray Scott, of Florence, S.C., has been
treated for anxiety for nine years, from the time she was diagnosed with an
eating disorder at age 15. Since then, she has tried a variety of medications
and psychotherapy, with variable results.
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"When the symptoms are alleviated, it becomes
tolerable," she tells WebMD. "At their worst, I have felt very
Scott is not alone. Anxiety disorders -- including phobias,
panic attacks, obsessive-compulsive disorders, and posttraumatic stress
disorder -- affect more than 23 million Americans. Although treatment with a
combination of drugs and therapy is very often successful, some patients go
from drug to drug, and therapy to therapy, with no relief.
"Most people think of anxiety disorders as not terribly
devastating, and easily treatable with drugs," says psychiatrist Mark
George, MD, director of the brain stimulation laboratory at the Medical
University of South Carolina in Charleston. "But there is a substantial
core of people for whom drugs don't work and for whom there are no good
That may change, however, if a new surgical treatment called
vagus nerve stimulation, or VNS, proves successful.
On May 18, Scott became one of the first anxiety patients to
receive the experimental treatment. On that day, surgeons at the Medical
College of South Carolina implanted a device in her chest, similar to a heart
pacemaker, and wired it to electrically stimulate the vagus nerve in her
Named for the Latin word meaning "wandering," the vagus
nerve meanders from the colon, past the intestines, heart, and lungs, and comes
together at the diaphragm, where it runs as a thick cable past the esophagus
and into the brain.
George calls the nerve "an information superhighway to the
brain." Contrary to long-held wisdom, the traffic on that highway is mostly
going north -- from the body to the brain, not vice versa, he says.
"Most people have thought of it as the way the brain
controls the heart and the guts," George explains. "In fact, most of
the information is actually going in the other direction. The vagus nerve is
really the brain's way of interpreting what is happening in the heart and the
That suggests an intriguing theoretical reason why VNS might
work well for people with anxiety, he says.
"Emotions are not brain events, but the brain's
interpretation of bodily events," George says. "When you feel scared,
it's really your brain sensing that your heart rate is going up."
So by stimulating the vagus nerve, George and others hope to
influence the exchange of information between body and brain, and thereby
relieve the symptoms of anxiety.
Whether this works remains to be seen. Today, the device
implanted in Scott's chest activates every five minutes, stimulating her vagus
nerve with a small electrical current for a period of five seconds. When it
activates while she is talking, her voice suddenly becomes mildly hoarse.
"Some days I think it's helping, and some days I don't
know," she says. "At first I was expecting something instantaneous, but
it doesn't work that way. It can take months to see any results."