Feinstein Institutes Maps the Body’s Vagus Nerve System

Northwell Health’s Feinstein Institutes for Medical Research has released the world’s first comprehensive human vagus nerve anatomical map, an achievement experts claim could change scientists’ understanding of the autonomic nervous system and accelerate development of bioelectronic medicine and neuromodulation therapies. The first dataset release, meticulously collected over three years from 30 human donors encompassing 60 vagus nerves, is currently widely available to the global scientific community through SPARC science.

The vagus nerve is the longest cranial nerve and a critical “information superhighway,” consisting of two main bundles (one on the left side of the neck and the other on the right side of the neck) containing more than 200,000 individual nerve fibers stretching from the brainstem to all major organs. It manages automatic functions such as heart rate, breathing, and digestion, and serves as the body’s “on/off switch” for immune response and inflammation. To better understand each vagal fiber function, this new dataset resource offers a 3D view into the intricate anatomy of the human vagus nerve, using advanced techniques such as microCT imaging, immunohistochemistry, and ultrasound. By mapping the organization of fascicles and fibers, researchers can gain critical insights into the way the vagus nerve communicates with various organs and influences human health and disease.

“This dataset represents a major step forward in bioelectronic medicine, offering the most detailed anatomical reconstruction of the human vagus nerve to date,” said Stavros Zanos, M.D., Ph.D., associate professor in the Institute of Bioelectronic Medicine at the Feinstein Institutes and co-leader of the project. “For the first time, we can visualize the vagus nerve’s complex architecture that will allow us to design more precise, effective, and safe neuromodulation therapies and devices. We are proud to be the first in the world to make such a resource available.”

This accomplishment marks a significant milestone that began with a $6.7 million National Institutes of Health (NIH) grant awarded to the Feinstein Institutes in October 2022 for its Reconstructing Vagal Anatomy (REVA) project, part of the NIH Common Fund’s SPARC program. The delivery of this world-first map was supported by Peter J. Pappas, Jr., whose donation provided crucial philanthropic support towards the project’s goals.

“Decoding the vagus nerve’s intricate language is an important advance for science and medicine,” stated Kevin J. Tracey, M.D., president/CEO of the Feinstein Institutes, Karches Family Distinguished Chair in Medical Research, and author of the book, “The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes.” “This knowledge will further empower researchers to re-engineer human biology and unlock novel therapies for future patients.”

The Feinstein Institutes for Medical Research is the global scientific leader in bioelectronic medicine and vagus nerve stimulation, where medical researchers use modern technology to develop new device-based therapies to treat disease and injury. Built on decades of research, the field of bioelectronic medicine integrates insights from neuroscience, molecular medicine, and biomedical engineering, and researchers at the Feinstein Institutes leverage the connection between the brain and the immune system to develop bioelectronic medicine interventions.

The discovery that initiated the field of bioelectronic medicine—called the “inflammatory reflex”—occurred more than 30 years ago by Dr. Tracey. This discovery emerged from studies on vagus nerve signaling and showed that both the brain and body communicate to regulate inflammation and, if uncontrolled, inflammation could lead to disease. New knowledge then sparked extensive research and clinical trials and led to the first U.S. Food and Drug Administration-approved vagus nerve stimulation device in July 2025 to treat rheumatoid arthritis, and Northwell Health was the first in the United States to implant the newly approved treatment in patients in August 2025.

Today, engineers, computer scientists, immunologists, neuroscientists, and clinicians develop cutting-edge medicine, including neuroimmune modulation, miniature implants for stimulating and recording the vagus nerve, noninvasive ultrasound neuromodulation to suppress inflammation, and brain-computer interfaces to overcome nervous system injuries. These collaborative efforts converge to create personalized, precise treatments that hold promise in treating acute and chronic diseases, often with fewer side effects compared to current therapies.

These treatments can potentially enhance or replace existing treatments across numerous conditions such as arthritis, heart disease, inflammatory bowel diseases, diabetes, cancer, and autoimmune disorders. By producing bioelectronic medicine knowledge, disease and injury could one day be treated by the body’s nerves without costly and potentially harmful pharmaceuticals.

The Feinstein Institutes for Medical Research is the home of the research institutes of Northwell Health, the largest health care provider and private employer in New York State. Encompassing 50-plus research labs, 3,000 clinical research studies, and 5,000 researchers and staff, the Feinstein Institutes raise the standard of medical innovation through its six institutes of behavioral science, bioelectronic medicine, cancer, health system science, molecular medicine, and translational research. The Institutes bills itself as the global scientific leader in bioelectronic medicine—a field of science that could potentially revolutionize medicine. The Feinstein Institutes publishes two open-access, international peer-reviewed journals, Molecular Medicine and Bioelectronic Medicine.