DIY Transcutaneous Vagus Nerve Stimulator

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Introduction: DIY Transcutaneous Vagus Nerve Stimulator

Introduction

Transcutaneous Vagus Nerve Stimulation is a relatively new concept based on the more invasive implantable Vagus Nerve Stimulation devices. Originally, the implantable devices would require surgery to put a battery and nerve stimulator in your neck to treat epilepsy or severe depression.

Some suggested applications of Vagus Nerve Stimulation now include:
- Treatment of Anxiety, Depression
- Stimulation of the Migrating Motor Complex in the digestive system to help issues such as Irritable Bowel, Small Intestine Bacteria Overgrowth, Delayed Gastric emptying
- Reducing pain and inflammation in the body (maybe because of MMC improvements)
- dampening Tinnitus
- reduction of atrial fibrillation symptoms

Obviously do your own research on the potential benefits. While the implanted device does has some research favoring its use, the transcutaneous approach has less scientific studies. The main study as of December 2019 is the following, which uses a modified TENS device to stimulate the vagus nerve by attaching a clip to the tragus of the ear, which contains a branch of the vagus nerve.

https://www.aging-us.com/article/102074/text

The afib study is below, and it uses a device to treat tinnitus:
https://www.medpagetoday.com/meetingcoverage/hrs/7...

The device that afib study used is here:
https://www.parasym.co/parasym-device-transcutaneo...

Obviously, that device is a bit pricey, but we can replicate the device using cheaper options.

Disclaimers: transcutaneous vagus nerve stimulation's benefits haven't been validated by the FDA, and there's no promise of a cure of any condition. When using TENS units, please read the instructions and precautions.

Supplies

Here's what you need:

1) A TENS Unit that will let you set the frequency, pulse width, and intensity. This one, I like because it also has the microcurrent mode (think Alpha-Stim), but you can get anything in their InTENSity line that has the TENS mode.
TENSpros.com InTENSity Micro Combo unit

2) 2 pairs of ear clips
tenspros.com black ear clip electrodes

Note: you can order the ear clips with your TENS device and probably save 50%

3) A Dremel or Rotary device with a cut-off wheel attachment
Example of a Cut off wheel

4) Super Glue - any will do.

Step 1: Disassemble One of Two Ear Clips

You should have 4 one-sided ear clips to start with. We're going to make two double-sided ear clips out of them.

So, set aside the first two. We're just gonna take them apart and keep the side with the electrode on it. The flat side with no electrode can be discarded.

Step 2: Cut Off the Non-Electrode End of One Side of the Clip.

With the two remaining clips, we need to cut off the circular end of the non-electrode side of the clip. This is where the other electrode will go.

With a Dremel or tool of your choice, carefully remove just the circular part of the non-electrode side of two clips.

Step 3: Glue the Electrodes Together

You want to take one of the electrodes in step #1 and glue it to one of the electrodes from Step #2.

Line up the two electrodes as best you can so that they a) face each other and b) touch when closed.

You'll want to stick a pencil or some sort of brace in the middle of the clips to keep them open while the glue is drying. Super Glue works fine. Just make them look like the photos above.

Step 4: Insert the TENS Wires

The InTENsity Micro Combo unit has two wires from each channel. Put one red and one back wire on either side of the ear clip as pictured above.

Step 5: Clip to the Tragus of Your Ear and Turn on the Device

Clip the electrodes to your ears as shown. get them wet by rubbing water on the surfaces to improve conduction

On the TENS unit, set the unit to TENS
- N (Normal, constant current)
- Pulse Width 200 microseconds
- Frequency 30Hz
- Time 20 minutes

Use the up Arrows to turn the device on - you will feel a prickly sensation in your ears. Go as high as you can tolerate, then back down one notch and leave it there for the duration.

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33 Comments

Here is why this method is dangerous and should NOT be used, with most serious issues topping the list.

1. The Intensity MicoCombo IMC) offers 2 Modes:

(A) TENS (1 mA and above): This current level is way too strong for Vagus Nerve Stim (VNS).

(B) Micro-current (700 uA and below). This is the correct current range for VNS, but the IMC's Pulse-width control for Micro-current mode starts at 2 mS (milliseconds) which is way to wide (long) and will expose your skin and the vagus nerve to excess current.

2. The conductive Silicone clamp electrodes are not designed to be used per "Instructables."
The relatively large mass of carbon-infused silicone inside the electrodes will require using higher current levels which could damage and overstimulate the nerve.

3. Combining these two electrodes will alter the spring clamp and cause it to exert more clamp-pressure on the tragus. Clamp pain will result.

4. Clamp-spring actuated electrode should not be used on the tragus, as the compressive force will damage skin tissue.

Just because it is possible do something does not mean it is a good idea, or safe.


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imnotarobot
imnotarobot

Reply 6 months ago

100% agree. Question: what then is the correct Pulse-width?

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mark.erzen
mark.erzen

Reply 2 years ago

Dr. Jonathan Honeycutt(NeuropsychologistPHD https://coolstim.com/),

I invite you to read the following:
https://www.aging-us.com/article/102074/text


Specifically, "tVNS was performed using a TENS machine (V-TENS Plus, Body Clock Health Care Ltd, United Kingdom in studies 1 and 2 and EMS7500 Roscoe Medical in study 3) with customised auricular electrode clips attached on the inner and outer surface of the tragus of the ear (Auricular Clips, Body Clock Health Care Ltd, UK). Participants wore the electrode clips throughout all three recordings (baseline, stimulation, recovery). tVNS was applied continuously for 15 minutes with a pulse width of 200 µs and pulse frequency of 30 Hz. Amplitude was adjusted to the level of sensory threshold (usually 2-4 mA) until the participants reported a ‘pin-prick’ or ‘tingling’ sensation. The stimulus was then turned down until the stimulus was borderline perceptible and comfortable."


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H1psman
H1psman

Reply 2 years ago

mark.erzen, shame PHDs are trying to make money off of this, glad I read your reply. Thou becouse of the way comment section is designed here, I almost missed the "reply" section of this comment. I would suggest adding your reply to Dr. Jonathan Honeycutt criticism as a separate comment, so that others won't miss it.

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mark.erzen
mark.erzen

Reply 2 years ago

There's a number of companies that make these devices. Insurance won't cover it, so you pay out of pocket. Just trying to make this available to those who can't drop $600 on something like this.

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marian100170
marian100170

Question 2 years ago

Hello,
Please, should it be used on both ears or on just one?
Thanks!

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mark.erzen
mark.erzen

Answer 2 years ago

I do both ears

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imnotarobot
imnotarobot

Reply 6 months ago

Unless you're ok with potentially messing with your heart rhythm, keep all VNS activities on the left only.

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marian100170
marian100170

Reply 2 years ago

Thanks, I feel that only the left ear has no effect. Instead, I feel the immediate effect on both ears. I assembled exactly the components described by you and for me this taVNS has better results than tDCS. Thanks for sharing!

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dexterfortune
dexterfortune

9 months ago on Step 5

Interesting to see this is finally making it's way out into the world. I came across this in a research paper in 2014 and have been using it with my clients ever since.
So, firstly modifying the ear clip is unnecessary and does not add anything to the outcome.
The position of the ear clips is critical, one should be attached to the Tragus (the flappy bit over the hole). The other can be attached anywhere but the ear lobe is usual.
It does not matter which polarity is placed where.
This should only be used on the left ear. The right branch of the Vagus is linked primarily to the heart, whereas the left attaches to all primary organs affected by the fight or flight response.
Pulse width can be thought of as a comfort setting, use whatever feels right for you. The pulse rate should be kept low. Most research uses 30Hz because that's what they use when implanting the device and can separate the afferent and efferent nerves. However, because with this technique, the signal travels up to the brain as well as down to the organs it should be viewed a form of Cranial Electro Stimulation. Which makes 30Hz a bad choice. Based on my own research with Neurofeedback I use a lower setting of 12Hz. One note of caution 150HZ has been linked to causing permanent damage to the nerve so stay well away from it. The intensity (volume) should be kept low, a light tickle is all that is needed. Sessions should be kept to 15mins max to avoid exhausting the synapse. Two or three times daily is fine.

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imnotarobot
imnotarobot

Reply 6 months ago

Thanks for the insightful comment Dex. I'm trying anything to get more than 2-4 hours of sleep a night. TENS / VNS is my next hope (I have a unit on order now) and your short comment stood out as some of the most knowledgeable I've yet to find. My main concern is that I don't turn myself into a zombie--at least no more so than a lack of sleep has done, so one thing I'm really interested in is current levels. Contrary to the seemingly popular opinion that for VNS with a TENS, the 'current' (if that's actually the correct term) should be jacked-up as much as you can stand, I've read that an 'imperceptible' level is best. It sounds like your advice has been learned from experience (and I've already pasted your above comment into my own VNS 'notebook' for reference) but can you provide anything further data, specs, or links to some valid information on the subject?
Thanks again,

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RIAAN
RIAAN

9 months ago

HI WHAT DOES THIS VNS COST ?

THANKS RIAAN

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GWestmorland
GWestmorland

Question 1 year ago on Introduction

V interesting and helpful.
How critical are the precision of the Pulse Width and Pulse Rate settings?
I have an old Tens machine (Everyway N603) that has no display and just very small rotary controls for these settings.
So I can set Pulse Width to about halfway between 180 and 220, as 200 isn't marked.
Pulse Rate setting is much harder as it is a logarithmic scale, and the nearest markings are 20 and 70 Hz.
Am I safe to use this, and guess the correct control position the best I can?

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elliot358
elliot358

1 year ago

I used kitchen scissors to cut off the circular end on one clip and a little kitchen knife to open up the hinge in the other clip and to cut off bits of plastic that (rightly or wrongly) I thought might get in the way of the gluing. You don't need fancy equipment to make this.

Does anyone know if this essentially re-creates the (very expensive) Parasym device? Here's a link to their quick start guide: https://files8.webydo.com/92/9224583/UploadedFiles/B4104A87-D5D8-0E0B-53F1-E81981E2B14F.pdf

They recommend the settings shown below (please click on the added image to see it properly).

The intensity/pulse amplitude goes up in 1mA steps, with the maximum being 36mA. The instructions on how to get to the right intensity seem similar to me.

One difference appears to be that the waveform is bi-phase square pulse (rather than mono-phase square pulse), which presumably explains why it doesn't matter which way round the Parasym clip goes on the ear.

Finally, I have seen plenty of references in academic papers to using a SINGLE clip on the LEFT ear only, so for now at least I have only made one double clip from a set of two clips. How do we know if a single clip on the right ear or clips on both ears is safe?

Thanks.

SnipImage.JPG
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drdux
drdux

Reply 1 year ago

The Salustim is the predecessor of the Parasym. It's output was a symmetric, biphasic rectangular waveform. Which Is EXACTLY what a TENS device outputs. The Salustim had a fixed pulse rate of 25 Hz and fixed pulse width of 250 μs. Both of which are within the range of any adjustable TENS device. So basically, the Salustim IS a fixed output TENS device.

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bornbranded29
bornbranded29

1 year ago

Hi. Thanks for doing this project. I bought the Intensity Micro Combo. Do you have some settings for the microcurrent, if one is interested in using it like the alpha stim?

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mark.erzen
mark.erzen

Reply 1 year ago

You want it in “M” mode with a pulse width as high as it’ll go and a pulse rate between 0.5 and 100HZ

Usually alpha stim starts you out at 100hz, then you drop to 1 or .5hz

Their pulse width varies between .25, .5, .75, and 1s. Best we can do here is the M mode at 200ms, but it will vary the pw from there.

383670B2-62A9-4F02-BC8A-44C35DC91B77.jpeg
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gioconda80
gioconda80

Reply 1 year ago

Thanks for this info Mark! I also want to know If you place the cable in just one channel or in both? I also want to mimic the alpha stim :)

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bornbranded29
bornbranded29

Reply 1 year ago

Thanks so much. I appreciate all the info. I've been using it with success under M1, but now I see M is the correct setting. Does that make any difference? Also, I set up the electrodes for Vagus Nerve Stimulation. Is saline necessary or just regular water? Also, could you explain why the anode and cathode need to be on each side of the tragus?

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cgeidenb
cgeidenb

1 year ago

Youtube video shows how to attach both clips of a single pair to the left ear. How does altering the clips in this way add anything? Seems like one can do the stimulation without requiring alteration of two pairs. Agree with other comment that just because you can doesnt mean you should.