Cerebral blood flow changes during vagus nerve stimulation for depression.
Positron emission tomography (PET oxygen-15 labeled water or PET [15O]H2O) was used to identify changes in regional cerebral blood flow (rCBF) in response to acute vagus nerve stimulation (VNS) in four subjects with treatment-resistant major depression (TRMD). Four 90-s PET [15O]H2O scans were performed on each subject in an off-on sequence (2 VNS de-activated; 2 VNS activated). PET images were aligned, normalized for global uptake, and resampled to standard atlas space. Statistical t-images were used to evaluate change. VNS-induced increases in rCBF were found in the bilateral orbitofrontal cortex, bilateral anterior cingulate cortex, and right superior and medial frontal cortex. Decreases were found in the bilateral temporal cortex and right parietal area. Regions of change were consistent with brain structures associated with depression and the afferent pathways of the vagus nerve.
Conway
Charles R
CR
Department of Psychiatry, Saint Louis University School of Medicine, 1221 South Grand Boulevard, St. Louis, MO 63104, USA. conwaycr@slu.edu
Sheline
Yvette I
YI
Chibnall
John T
JT
George
Mark S
MS
Fletcher
James W
JW
Mintun
Mark A
MA
D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000378:metabolism / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D003865:Major Depressive Disorder / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D004311:Double-Blind Method; D004558:Electric Stimulation / Q000295:instrumentation; D004567:Electrodes, Implanted; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000378:metabolism / Q000503:physiopathology; D007839:Functional Laterality / Q000502:physiology; D006179:Gyrus Cinguli / Q000098:blood supply / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D009475:Neurons, Afferent / Q000502:physiology; D010100:Oxygen / Q000378:metabolism; D010296:Parietal Lobe / Q000098:blood supply / Q000378:metabolism / Q000503:physiopathology; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000098:blood supply / Q000378:metabolism / Q000503:physiopathology; D013702:Temporal Lobe / Q000098:blood supply / Q000378:metabolism / Q000503:physiopathology; D035441:Thoracic Wall; D014630:Vagus Nerve / Q000502:physiology*
D010100:Oxygen