Molecular Classification
Other (Peripheral sensory nerve; cranial nerve branch)
Other Names
Arnold's nerve, Alderman's nerve, mastoid branch of vagus nerve
Disease Roles
Neuromodulation target in depressionEpilepsy/seizure disordersTinnitus

Auricular branch of vagus nerve Overview

The **auricular branch of the vagus nerve** is a small peripheral sensory branch arising from the superior ganglion of the vagus nerve. It is also known as **Arnold’s nerve** or **Alderman’s nerve**. This branch supplies general somatic afferent innervation to parts of the external ear—specifically, portions of the external auditory canal, tragus, tympanic membrane, and auricle. The superficial course through auricular tissues makes it accessible for non-invasive electrical stimulation. Clinically, this anatomical feature has been leveraged in transcutaneous or percutaneous auricular vagus nerve stimulation (**aVNS**, tVNS), which is being investigated as a therapeutic approach for conditions such as epilepsy/seizures, depression, tinnitus, atrial fibrillation and other cardiovascular diseases, diabetes management support, stroke rehabilitation and endotoxemia. Stimulation can elicit physiological responses including cough reflexes ("Arnold Reflex") or rarely syncope due to strong parasympathetic activation. There are no known direct drug interactions with this target; rather it serves as an anatomical substrate for device-based neuromodulation therapies. No specific molecular biomarkers are used clinically for patient selection or monitoring efficacy at present. The term "auricular branch of vagus nerve" is anatomically correct and refers specifically to this distinct peripheral nervous structure.

Mechanism of Action

Electrical stimulation modulates neural activity via afferent fibers projecting to central autonomic and sensory nuclei

Biological Functions

Sensory innervation to the skin of the external ear canal, tragus, tympanic membrane, and auricle
Afferent limb for somatosensory signals from the ear to the brainstem (nucleus tractus solitarius)

Disease Associations

Neuromodulation target in depression
Epilepsy/seizure disorders
Tinnitus
Cardiovascular disease (e.g., atrial fibrillation)
Diabetes
Stroke recovery
Endotoxemia

Safety Considerations

  • Syncope or cough reflex upon stimulation due to vagal activation ("Arnold Reflex")