title: Transcutaneous Vagus Nerve Stimulation Modulates Default Mode Network in Major Depressive Disorder.
abstract: BACKGROUND
  Depression is the most common form of mental disorder in community and health care settings and current treatments are far from satisfactory. Vagus nerve stimulation (VNS) is a Food and Drug Administration approved somatic treatment for treatment-resistant depression. However, the involvement of surgery has limited VNS only to patients who have failed to respond to multiple treatment options. Transcutaneous VNS (tVNS) is a relatively new, noninvasive VNS method based on the rationale that there is afferent/efferent vagus nerve distribution on the surface of the ear. The safe and low-cost characteristics of tVNS have the potential to significantly expand the clinical application of VNS.
  
  
  METHODS
  In this study, we investigated how tVNS can modulate the default mode network (DMN) functional connectivity (FC) in mild or moderate major depressive disorder (MDD) patients. Forty-nine MDD patients were recruited and received tVNS or sham tVNS (stVNS) treatments.
  
  
  RESULTS
  Thirty-four patients completed the study and were included in data analysis. After 1 month of tVNS treatment, the 24-item Hamilton Depression Rating Scale score reduced significantly in the tVNS group as compared with the stVNS group. The FC between the DMN and anterior insula and parahippocampus decreased; the FC between the DMN and precuneus and orbital prefrontal cortex increased compared with stVNS. All these FC increases are also associated with 24-item Hamilton Depression Rating Scale reduction.
  
  
  CONCLUSIONS
  tVNS can significantly modulate the DMN FC of MDD patients; our results provide insights to elucidate the brain mechanism of tVNS treatment for MDD patients.
authors.affiliation: Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.; Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Jiliang
authors.initials: J
authors.lastname: Fang
authors.affiliation: Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.. Electronic address: rongpj@hotmail.com.
authors.forename: Peijing
authors.initials: P
authors.lastname: Rong
authors.affiliation: Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Hong
authors.affiliation: Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Yangyang
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Honghong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Guolei
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Chen
authors.affiliation: Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Shi
authors.affiliation: Huguosi Hospital, Beijing University of Chinese Medicine, Beijing.
authors.forename: Liping
authors.initials: L
authors.lastname: Wang
authors.affiliation: Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.; Hospital of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing.
authors.forename: Rupeng
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jiwon
authors.initials: J
authors.lastname: Hwang
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.; Acupuncture & Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu.
authors.forename: Zhengjie
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Tao
authors.affiliation: Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.; Hospital of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jian
authors.initials: J
authors.lastname: Kong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010296:Parietal Lobe / Q000503:physiopathology*; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D016037:Single-Blind Method; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000503:physiopathology*; D055536:Vagus Nerve Stimulation; D055815:Young Adult
keywords: Default mode network; Functional connectivity; Major depressive disorder; Transcutaneous vagus nerve stimulation; Vagus nerve stimulation; fMRI