title: Vagus nerve stimulation for treatment-resistant mood disorders: a long-term naturalistic study.
abstract: BACKGROUND
  Limited therapeutic options are available for patients with treatment-refractory major depression who do not respond to routinely available therapies. Vagus nerve stimulation showed adjunctive antidepressant effect in chronic treatment resistant depression, even though available studies rarely exceed 2-year follow up. We report a naturalistic 5-year follow up of five patients who received VNS implant for resistant depression (3 patients with major depressive disorder and 2 with bipolar disorder).
  
  
  METHODS
  Response was defined as a reduction of the 17-item HDRS total score ≥50% with respect to baseline, remission as a score ≤7.
  
  
  RESULTS
  Response and remission rates were both 40% (2/5) after 1 year, and 60% (3/5) at 5 years. Two patients withdrew from the study because of side effects or inefficacy of stimulation.
  
  
  CONCLUSIONS
  Our case series showed that long-term VNS may be effective in reducing severity of depression in a small but significant minority of patients, although two patients had stimulation terminated because of adverse effects and/or refusal to continue the study.
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, Mood and Anxiety Disorders Unit, University of Torino, via Cherasco 11, 10126, Turin, Italy. umberto.albert@unito.it.
authors.forename: Umberto
authors.initials: U
authors.lastname: Albert
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, Mood and Anxiety Disorders Unit, University of Torino, via Cherasco 11, 10126, Turin, Italy. giuseppe.maina@unito.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Maina
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, Mood and Anxiety Disorders Unit, University of Torino, via Cherasco 11, 10126, Turin, Italy. andrea_aguglia@yahoo.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Aguglia
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, Mood and Anxiety Disorders Unit, University of Torino, via Cherasco 11, 10126, Turin, Italy. alberto.vitalucci@unito.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Vitalucci
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, Mood and Anxiety Disorders Unit, University of Torino, via Cherasco 11, 10126, Turin, Italy. filippo.bogetto@unito.it.
authors.forename: Filippo
authors.initials: F
authors.lastname: Bogetto
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, Neurosurgery Unit, University of Torino, via Cherasco 11, 10126, Turin, Italy. chiara.fronda@unito.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Fronda
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, Neurosurgery Unit, University of Torino, via Cherasco 11, 10126, Turin, Italy. alessandro.ducati@unito.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ducati
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, Neurosurgery Unit, University of Torino, via Cherasco 11, 10126, Turin, Italy. michele.lanotte@unito.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Lanotte
mesh_terms: D000368:Aged; D001714:Bipolar Disorder / Q000628:therapy*; D003865:Major Depressive Disorder / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000628:therapy*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000379:methods*