Changes in regional cerebral blood flow by therapeutic vagus nerve stimulation in depression: an exploratory approach.
Abnormalities in regional cerebral blood flow (rCBF) have been reported to characterize depressive episodes; they are at least partly reversed by antidepressant treatment. Treatment-specific as well as response-related changes in rCBF have been reported. We explored the changes in rCBF induced by vagus nerve stimulation (VNS), a recently proposed antidepressant strategy, by application of single photon emission-computed tomography with (99m)Tc-hexamethyl-propylene amine oxime in otherwise treatment-refractory patients. Both region-of-interest (ROI) and statistical parametric mapping (SPM) analytic approaches were used. Decreases of rCBF in the amygdala, left hippocampus, left subgenual cingulate cortex, left and right ventral anterior cingulum, right thalamus and brain stem were observed; the only increase of rCBF was found by SPM analysis in the middle frontal gyrus. This pattern shares features with changes of rCBF previously associated with the administration of selective serotonin reuptake inhibitors. Similarities to other brain-stimulation strategies in antidepressant treatment were less pronounced.
Zobel
Astrid
A
Department of Psychiatry, University of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. astrid.zobel@ukb.uni-bonn.de
Joe
Alexius
A
Freymann
Nikolaus
N
Clusmann
Hans
H
Schramm
Johannes
J
Reinhardt
Michael
M
Biersack
Hans-Jürgen
HJ
Maier
Wolfgang
W
Broich
Karl
K
D000328:Adult; D000679:Amygdala / Q000098:blood supply / Q000473:pathology; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D015283:Citalopram / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006179:Gyrus Cinguli / Q000098:blood supply / Q000473:pathology; D006624:Hippocampus / Q000098:blood supply / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use; D000078785:Mirtazapine; D010091:Oximes; D019275:Radiopharmaceuticals; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013788:Thalamus / Q000098:blood supply / Q000473:pathology; D015899:Tomography, Emission-Computed, Single-Photon; D004561:Transcutaneous Electric Nerve Stimulation / Q000295:instrumentation*; D014630:Vagus Nerve / Q000502:physiology*
D000929:Antidepressive Agents, Tricyclic; D015283:Citalopram; D008803:Mianserin; D000078785:Mirtazapine; D010091:Oximes; D019275:Radiopharmaceuticals; D017367:Selective Serotonin Reuptake Inhibitors; C068296:hexamethylpropyleneamine oxime