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Physiology

The vagus neurometabolic interface and clinical disease

International Journal of Obesity volume 42, pages 1101–1111 (2018)Cite this article

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Abstract

The nervous system both monitors and modulates body metabolism to maintain homoeostasis. In disease states such as obesity and diabetes, the neurometabolic interface is dysfunctional and contributes to clinical illness. The vagus nerve, in particular, with both sensory and motor fibres, provides an anatomical substrate for this interface. Its sensory fibres contain receptors for important circulating metabolic mediators, including leptin and cholecystokinin, and provide real-time information about these mediators to the central nervous system. In turn, efferent fibres within the vagus nerve participate in a brain-gut axis to regulate metabolism. In this review, we describe these vagus nerve-mediated metabolic pathways and recent clinical trials of vagus nerve stimulation for the management of obesity. These early studies suggest that neuromodulation approaches that employ electricity to tune neurometabolic circuits may represent a new tool in the clinical armamentarium directed against obesity.

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Acknowledgements

We thank Miguel F. Herrera and Juan P. Pantoja for technical and methodological discussion regarding clinical aspects of gastric electrical stimulation, and Jesse Roth and Valentin Pavlov for critical reading of the manuscript.

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Authors and Affiliations

  1. Laboratory of Biomedical Sciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA

    Emily Battinelli Masi & Sergio Iván Valdés-Ferrer

  2. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA

    Emily Battinelli Masi

  3. Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Sergio Iván Valdés-Ferrer

  4. Department of Anesthesia and Pain Medicine, Hospital for Sick Children, and Department of Anesthesia, University of Toronto, Toronto, ON, Canada

    Benjamin Ethan Steinberg

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  1. Emily Battinelli Masi
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  2. Sergio Iván Valdés-Ferrer
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Correspondence to Benjamin Ethan Steinberg.

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Masi, E.B., Valdés-Ferrer, S.I. & Steinberg, B.E. The vagus neurometabolic interface and clinical disease. Int J Obes 42, 1101–1111 (2018). https://doi.org/10.1038/s41366-018-0086-1

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