Feinstein Institutes releases comprehensive vagus nerve atlas from 30 donors, advancing bioelectronic medicine device design

Researchers at the Feinstein Institutes for Medical Research, the research arm of Northwell Health in Manhasset, New York, have released the first population-scale, fiber-resolution atlas of the human vagus nerve, creating a publicly available anatomical resource intended to support the design of more selective bioelectronic medicine devices. The dataset, generated under the NIH-funded Reconstructing Vagal Anatomy (REVA) project and published on July 27, 2026, maps approximately 200,000 individual nerve fibers across 60 vagus nerves from 30 human donors and is now available through the SPARC Science data-sharing platform.

The vagus nerve has become a major target for neuromodulation therapies in epilepsy, depression, inflammatory diseases, and heart failure, yet device development has relied on limited knowledge of how functionally distinct nerve fibers are organized. Current stimulation systems typically activate the nerve broadly, increasing the risk of off-target effects on cardiac or respiratory fibers when the therapeutic objective is modulation of immune or gastrointestinal pathways. By characterizing the spatial organization of individual fascicles across multiple donors rather than a single specimen, the REVA atlas provides a reference for designing electrodes capable of selectively stimulating specific fiber populations.

The three-year project combined high-resolution microCT imaging, immunohistochemistry, and ultrasound to reconstruct individual nerve fibers with submicron resolution. Bilateral vagus nerves were collected from 30 human donors, allowing researchers to compare left- and right-sided anatomy and capture inter-individual variability that has previously limited translation of anatomical observations into device design.

Stavros Zanos, MD, PhD, Associate Professor at the Institute of Bioelectronic Medicine and co-leader of the REVA project, described the resource as "the most detailed anatomical reconstruction of the human vagus nerve to date," adding that it would enable the development of "more precise, effective and safe neuromodulation therapies and devices."

The atlas has immediate relevance for companies developing vagus nerve stimulation technologies. Rather than stimulating the entire nerve trunk, future devices could use the anatomical map to target fascicles associated with specific organs or physiological pathways, potentially improving efficacy while reducing unintended activation of neighboring cardiac or pulmonary fibers. The resource may also support development of closed-loop neuromodulation systems and non-invasive approaches such as focused ultrasound, where accurate anatomical targeting is essential.

The release follows growing clinical validation of bioelectronic medicine. In July 2025, the US FDA cleared the first vagus nerve stimulation device for rheumatoid arthritis, establishing proof of concept for treating inflammatory disease through activation of the inflammatory reflex. Companies including SetPoint Medical, Galvani Bioelectronics, and LivaNova are developing or marketing vagus nerve stimulation platforms across neurological and inflammatory indications, although none has previously had access to a population-scale anatomical atlas of the human vagus nerve.

The REVA atlas is intended as a foundational research resource rather than evidence of clinical benefit. While it does not demonstrate that anatomy-guided stimulation improves patient outcomes, it provides the structural framework needed to develop and evaluate the next generation of precision neuromodulation devices. The dataset is publicly available through the NIH-supported SPARC Science platform, reflecting the programme's goal of accelerating peripheral nervous system research through open data sharing.

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