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With a variety of different devices on the market, it’s important to do the proper research and make the choice that’s right for you. Most importantly, you need to be sure that the intervention you’re looking at has been scientifically proven to target the vagus nerve. 

Here are a few of the key factors to consider when making a decision:

• Consult with your health care professional
  Before starting any new medical intervention, it’s always a good idea to consult with a medical professional first. For vagus nerve stimulation, choose a neurologist or specialist who is familiar with VNS devices, so they can correctly advise you on if it will help your specific symptoms.
• Compatibility with your symptoms
  VNS devices are designed to improve specific symptoms, including depressive states, chronic tiredness, gastrointestinal issues, and brain fog. Make sure that vagus nerve stimulation has been studied and evaluated for its effectiveness for your specific health needs. VNS devices also have different stimulation locations, such as the neck and ear. Sensate, which is not a VNS device, claims to stimulate it through the chest. However, Nurosym’s AVNT approach and Gammacore’s approach both have scientific evidence of precise targeting and safety. Other approaches at any location are at best playing the piano out of tune and at worst actively dangerous.
• Safety & Wearable Device Status
  Many devices claim to be VNS devices and be safe, but it’s important to evaluate the scientific research done on each device to understand its safety profile. Sensate and Pulsetto say that they activate the vagus nerve, but they don’t have any scientific evidence to confirm it. Different methods of vagus nerve stimulation are associated with different side effects too, so it’s good to understand all the risks before you buy. Devices that have obtained certified Wearable Device status are key––this certification requires rigorous quality testing and safety studies to ensure that they don’t harm the nervous system
• Effectiveness & Research
  Be sure to look for devices backed by scientific research and ideally, placebo-controlled studies. A reputable device will have published research to back up its claims. Randomised placebo-controlled testing ensures that a device’s effects are not based on placebo, giving confidence in the device’s actual therapeutic benefits. Similarly, peer-reviewed studies reduce the risk of biased results and prove the credibility of the device tested.

  Many devices quote generic VNS research but they haven’t conducted any safety and efficacy studies on their device. Just because a device emits an electrical current where the vagus nerve is located, doesn’t guarantee that it activates the vagus nerve or impacts it positively. Most research on vagus nerve stimulation was done with invasive methods, not portable devices. So a handheld device that references invasive VNS research is falsely representing the data to sell their product.

• Stimulation vs Modulation
  It’s also important to be aware that some devices, like Pulsetto or GammaCore, provide high-intensity stimulation which may increase the chance of side effects and may harm people with chronic symptoms whose nervous systems are already dysregulated. Nurosym with 45 energy levels offers precise control of modulation to provide the same benefits with fewer risks.

• Price
  The device you choose must fit in your budget. Some devices have a subscription model that requires ongoing payments over time. Others like Nurosym and Sensate are one-time purchases. Because the benefits of using VNS require consistent use, the more they are used, the better the outcomes. Therefore, when considering getting a device, think long term how the costs of long term use would stack up. Taking Nurosym as an example, the cost of the device averages out to approximately 2 EUR per day over a year, and after that there are no more payments. Meanwhile, GammaCore is preloaded with 3 months of sessions. After that, you’ll need to purchase more sessions to continue using it. Pulsetto offers a paid app subscription, so long term costs of use might add up.

Testing Protocol

Since these devices are NOT created equal, it’s essential to carefully evaluate their features, effectiveness, and user experience before making a decision. So we set out to compare four of the most popular devices that people purchase for vagus nerve stimulation – Pulsetto, Sensate, Gammacore, and Nurosym. However, it’s important to note that unlike Nurosym and GammaCore, Pulsetto and Sensate are not certified VNS devices. 

For an accurate comparison, we had each device evaluated by a team of PhDs and medical health care professionals. I used each device for one month, with a one-month break after each to avoid any carryover effects. I started with Sensate, then Pulsetto, Nurosym, and finally, GammaCore.

Here are the results and rankings: