Vagus Nerve Stimulation as an Adjunctive Therapy for Post-Traumatic Stress Disorder: Literature Review

Abstract

Introduction: Post-Traumatic Stress Disorder (PTSD) is a chronic psychiatric condition characterized by impaired emotional regulation, persistent hyperarousal, and deficits in fear extinction. Although exposure-based psychotherapy remains the first-line treatment, high failure and dropout rates persist, particularly in treatment-resistant cases. Vagus Nerve Stimulation (VNS) has emerged as a neuromodulatory approach with the potential to enhance the neurobiological mechanisms underlying fear extinction.

Method: This literature review was conducted through systematic searches of Google Scholar, PubMed, ScienceDirect, and Frontiers databases using keywords related to VNS, PTSD, neuromodulation, and the autonomic nervous system. English-language articles published between 2017 and 2025 were narratively reviewed..

Discussion: The reviewed literature demonstrates that both invasive and non-invasive VNS consistently enhance neural plasticity, stabilize autonomic nervous system function, and modulate key brain circuits involved in emotional regulation and fear extinction. Preclinical and clinical studies indicate that VNS paired with exposure therapy reduces core PTSD symptoms, attenuates hyperarousal, improves cognitive function, and suppresses stress-induced inflammatory responses.

Conclusion: Vagus Nerve Stimulation represents a promising adjunctive therapy for PTSD, particularly in patients who are refractory to conventional treatments. This approach supports a shift toward precision, neurobiologically informed psychiatry, although further large-scale studies are required to standardize stimulation protocols and confirm long-term efficacy.