Mechanisms and state of the art of vagus nerve stimulation.
Vagus nerve stimulation (VNS) is an established treatment of medically refractory partial-onset seizures. Recent data from an open-label multicenter pilot study also suggest a potential clinical usefulness in the acute and maintenance treatment of drug-resistant depressive disorder. Despite the fact that surgery is needed to implant the stimulating device, the option of long-term use largely devoid of severe side effects would give this treatment modality a privileged place in the management of drug-resistant depression. However, definite therapeutic effects of clinical significance remain to be confirmed in large, placebo-controlled trials. Besides the potential clinical usefulness, VNS can be used as a research tool in epilepsy patients implanted for clinical reasons, allowing neurophysiologic investigations of the parasympathetic system and its interactions with other parts of the central nervous system.
Kosel
Markus
M
Department of Psychiatry, University Hospital, Bern, Switzerland.
Schlaepfer
Thomas E
TE
D001921:Brain / Q000503:physiopathology; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods*; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D009434:Neural Pathways / Q000503:physiopathology; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000503:physiopathology*