Cervical vagus nerve stimulation for treatment-resistant depression.
Therapeutic brain stimulation through left cervical VNS now has established safety and efficacy as a long-term adjunct treatment for medication-resistant epilepsy. There is considerable evidence from both animal and human studies that the vagus nerve carries afferent signals to limbic and higher cortical brain regions, providing a rationale for its possible role in the treatment of psychiatric disorders. Open-label studies in patients with treatment-resistant depression have produced promising results, especially when response rates at longer term (1 year and 2 years) follow-up time points are considered. Short-term (10 weeks) treatment with VNS failed to demonstrate statistical superiority over sham treatment in a recently completed double-blind study, so antidepressant efficacy has not yet been established. Longer term data on VNS in depressed patients as well as further information regarding the possible dose-response relation will help to determine the place of VNS in the armament of therapeutic modalities available for major depression.
Carpenter
Linda L
LL
Department of Psychiatry, Brown University Medical School, Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, USA. Linda_Carpenter_MD@Brown.edu
Friehs
Gerhard M
GM
Price
Lawrence H
LH
D000928:Antidepressive Agents / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D004351:Drug Resistance; D004558:Electric Stimulation / Q000295:instrumentation; D006801:Humans; D008279:Magnetic Resonance Imaging; D009333:Neck; D014630:Vagus Nerve / Q000502:physiology*
D000928:Antidepressive Agents