# Non-invasive Vagal Nerve Stimulation to improve functional outcomes in Veterans with Alcohol Use Disorder

> **NIH VA IK1** · VA SAN DIEGO HEALTHCARE SYSTEM · 2023 · —

## Abstract

Alcohol use disorder (AUD) is a serious mental health disorder that affects more than 40% of US military
Veterans, presenting a major burden to this population and to the VA Healthcare System. Relapse rates of AUD
are extremely high; over half of Veterans who complete treatment relapse within 6 months, highlighting the need
for improved treatments or differing treatment targets. Chronic, heavy drinking leads to an imbalance in
homeostasis resulting in psychological and physical distress during periods of abstinence, and the urge to drink
to relieve these symptoms to restore homeostasis. Noninvasive vagal nerve stimulation (nVNS) is a low-risk form
of neuromodulation that has been shown to alleviate anxiety and chronic pain, and to reduce drug and alcohol
relapse in animal models. We hypothesize that nVNS attenuates distress-related craving in AUD in humans by
modifying the autonomic nervous system and changing the perception of inner bodily sensations of physiological
and affective distress. We also hypothesize that nVNS improves functional outcomes and quality of life in
Veterans with AUD.
The proposed research will utilize the infrastructure of an ongoing VA-funded study by adding a small subsample
of Veterans who meet for a diagnosis of AUD (with at least one functional disability due to alcohol use, current
alcohol craving, and current heavy drinking). Subjects will be randomly assigned to receive nVNS or sham
stimulation prior to performing a well-validated functional Magnetic Resonance Imaging task designed to assess
neural correlates of physical distress (via a heat stimulus). Subjects will then self-administer nVNS/sham at home
twice a day for 7 days and return for a follow-up visit, during which all study components will be repeated.
Behavioral assessments of functional disability, quality of life, psychological and physiological distress, and
craving will be administered at baseline, after stimulation, and at follow-up.
The aim of the proposed study is to establish feasibility and acceptability of applying nVNS as a rehabilitative
treatment for AUD. In addition, the study will evaluate the preliminary effectiveness of nVNS in improving
functional outcomes and quality of life, in reducing distress and craving, and in altering neural activation patterns
in brain regions involved in the perception and awareness of distress and pain. The proposed work has the
potential to lead to innovative, low-risk treatment options with high promise to significantly improve the care and
lives of Veterans as there is a need for alternative treatments for AUD. As such, this novel AUD treatment could
be particularly beneficial for Veterans who do not tolerate pharmacotherapy, and who have access or cognitive
limitations or stigma concerns that act as barriers to psychotherapy. The immediate career goal for this CDA-1
award is to provide the applicant with the clinical research experience and the pilot data necessary for a
competitive CDA-2 grant application...

## Key facts

- **NIH application ID:** 10613308
- **Project number:** 5IK1RX003629-02
- **Recipient organization:** VA SAN DIEGO HEALTHCARE SYSTEM
- **Principal Investigator:** Ruth Klaming
- **Activity code:** IK1 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2023
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2022-05-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10613308

## Citation

> US National Institutes of Health, RePORTER application 10613308, Non-invasive Vagal Nerve Stimulation to improve functional outcomes in Veterans with Alcohol Use Disorder (5IK1RX003629-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10613308. Licensed CC0.

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