Exploring Remyelination and Functional Recovery With Vagus Nerve Stimulation in MS: Cristin Welle, PhD

WATCH TIME: 4 minutes

"I think it's an exciting time for neuromodulation technologies broadly, as they have the potential to drive plasticity, functional recovery, and, at least in the case of vagus nerve stimulation, direct remyelination."

Neuromodulation, particularly vagus nerve stimulation (VNS), has emerged as a promising therapeutic approach for promoting myelin repair and restoring function in multiple sclerosis (MS). Recent studies have demonstrated that VNS may enhance remyelination by increasing the generation of myelinating oligodendrocytes. When paired with specific motor tasks, VNS facilitates the precise restoration of myelin sheaths on previously demyelinated axons, leading to significant improvements in motor function.¹

This topic was a key focus at the 2025 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, held February 27 to March 1, in West Palm Beach, Florida. The session, chaired by Eric Klawiter, MD, and Unsong Oh, MD, explored the interplay between different regions of the central nervous system (CNS), its compartments, and its connections with the peripheral nervous system (PNS).² Among the presentations, Cristin Welle, PhD, highlighted the potential of neuromodulation for myelin repair and functional recovery, alongside discussions on CNS structural disconnectivity, meningeal inflammation, and CNS autoimmunity. Collectively, these talks underscored the importance of regional connectivity in MS pathophysiology and emerging therapeutic strategies.

Expanding on this topic, Welle, a professor of neurosurgery and physiology at the University of Colorado School of Medicine, spoke with NeurologyLive^® at the Forum to discuss her research on VNS as a potential MS treatment. She emphasized that both implanted and noninvasive VNS have shown promise in animal models, enhancing remyelination and improving motor function after demyelinating injury. Additionally, she highlighted neuromodulation’s potential to work alongside disease-modifying therapies, its anti-inflammatory effects, and key research questions regarding optimal timing and rehabilitation pairing.

Click here for coverage of 2025 ACTRIMS Forum.

REFERENCES
1. Huang R, Carter ER, Hughes EG, Welle CG. Paired vagus nerve stimulation drives precise remyelination and motor recovery after myelin loss. Preprint. bioRxiv. 2024;2024.05.10.593609. Published 2024 May 12. doi:10.1101/2024.05.10.593609
2. Welle C. Neuromodulation for Myelin Repair and Restoration of Function. Presented at ACTRIMS Forum 2025; February 27 to March 1; West Palm Beach, Florida. S4.2