Repeated Electrical Vestibular Nerve Stimulation Reduces Anxiety in People With Moderate-to-Severe Anxiety: A Randomized, Sham-Controlled Trial: The Modius Anxiety Study

Neuromodulation. 2026 Jun;29(4):626-636. doi: 10.1016/j.neurom.2025.11.008. Epub 2026 Feb 5.

Abstract

Background: Generalized anxiety disorder (GAD) affects approximately 4% of the global population. Current treatment methods, for example, pharmacology and psychotherapy, are insufficient owing to side effects and a lack of efficacy and accessibility, highlighting the need for better therapeutic options. Studies have identified electrical vestibular nerve stimulation (VeNS) as a potential novel treatment method.

Objectives/hypothesis: Participants using a VeNS device will show superior improvement in GAD (GAD-7) score after 28 days of use to those receiving sham stimulation. Secondary outcomes were change in Insomnia Severity Index (ISI) and the 36-Item Short Form Health Survey (SF-36) scores (eight components).

Materials and methods: In this double-blind, randomized, sham-controlled study, N = 87 participants with a GAD-7 score ≥10 were allocated a VeNS or sham device (1:1 ratio). Participants were asked to complete daily 30-minute stimulation sessions at home for 28 days. Data were statistically analyzed using an intention-to-treat approach.

Results: The change in GAD-7 score from baseline to day 28 in those who presented at baseline with a GAD-7 score ≥5 was not statistically significant between the sham and treatment groups (3.90 ± 4.09 and 4.95 ± 4.32, sham and treatment groups, respectively; p = 0.269). Subgroup analysis of participants with moderate/severe GAD (GAD-7 score ≥10) showed a significantly greater improvement in GAD-7 score in the treatment group than in the sham group (intention to treat p = 0.045). There was no significant difference between intervention groups in improvement in either ISI score or SF-36 components in the moderate/severe anxiety group (GAD-7 score ≥10).

Conclusions: VeNS is a low-risk, noninvasive therapy that has the potential to alleviate the symptoms of moderate-to-severe GAD.

Clinical trial registration: The Clinicaltrials.gov registration number for the study is NCT05907967.

Keywords: Anxiety; GAD-7; ISI; RCT; SF-36; neurostimulation; vestibular stimulation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anxiety* / therapy
  • Double-Blind Method
  • Electric Stimulation Therapy* / methods
  • Female
  • Generalized Anxiety Disorder* / therapy
  • Humans
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Treatment Outcome
  • Vestibular Nerve* / physiology

Associated data

  • ClinicalTrials.gov/NCT05907967