Do they need to have intractable hiccups first?

Pretty interesting!

So basically it's a vibrator on the neck part of the vagus nerve that is controlled by an app ?

Not dismissing the device, but I'm wondering why a massage can't do the job ? It could even be done by the patient if explained how to.

It very interesting because vagus nerve theory has been seen as unproven and is often cast upon with doubt as we don’t understand the underlying mechanism - a lot of PTSD treatments are along those lines.

I think they just don’t work universally/don’t understand the myriad pathways of presentation and are bad at predicting them - IE PTSD is a set of symptoms but we try to see it as a set of causes). There’s a big problem with “evidence based” because many fall into the cracks.

An implant is quite a thing though - looking at the wiki for VNS it seems to be seen as effective for a whole array of things, but without understanding why.

No relation. For those looking to try VNS, check out the TruVaga device: https://www.truvaga.com/product/truvaga-plus/

In my experience, vipassana meditation also stimulates the vagus nerve and includes a kind of exposure therapy when practiced properly. It seems much safer than surgery. Also, the meditation skill can be useful later in life, helping one to be more resilient against adversity.