Noninvasive Transcutaneous Vagal Nerve Stimulation (tcVNS) for Neuromodulating the Conscious State

Inclusion Criteria: * Aged \> 18 years of age * Patients undergoing lumbar surgery for degenerative disc disease or spinal stenosis involving two or more levels * Mini-Mental State Examination (MMSE) score ≥ 15-accept mild * Ability to use a keyboard * Able to understand and communicate in English * Be able to consent independently * Women of child-bearing age must be comfortable confirming a negative pregnancy prior to participating in the study. * Must not be involved in any other research intervention study testing neurobehavioral functioning * Good internet connectivity and ability to use computer, smart phone or good telephone connectivity (follow up) Exclusion Criteria: * Age \< 18 years of age * History of vagotomy (cutting the vagus nerve) * History of bradycardia, heart block, prolonged QT syndrome, brugada syndrome, heart failure with ejection fraction less than 35% and/or New York Heart Association symptoms * MMSE \< 15 * History of seizure disorder or intracranial hemorrhage * Patients with carotid stenosis * Patients with aneurysms * Other neurological diagnoses or a diagnosis of severe psychiatric disorder (e.g., psychosis) or a reported childhood learning disability * Pregnancy, breastfeeding * Active addiction history * ECG adhesive allergy * Severe aphasia, preventing subject from understanding the protocol and giving written consent * Patients with an active implantable medical device, such as a pacemaker, hearing aid implant, or any implanted electronic device * Patients with metallic device such as a stent, bone plate or bone screw implanted at or near their neck * Patients with an active implantable medical device, such as a pacemaker, hearing aid implant, or any implanted electronic device * Patients with metallic device such as a stent, bone plate or bone screw implanted at or near their neck * Patients who are using another device at the same time (e.g., transcutaneous electrical nerve stimulation (TENS) Unit, muscle stimulator) or any portable electronic device (e.g., mobile phone).