Early cortical biomarkers of longitudinal transcutaneous vagus nerve stimulation treatment success in depression.
Transcutaneous vagus nerve stimulation (tVNS), a non-invasive method of brain stimulation through the auricular branch of the vagus nerve, has shown promising results in treating major depressive disorder (MDD) in several pilot studies. However, the neural mechanism by which the effect on depression might be achieved has not been fully investigated, with only a few neuroimaging studies demonstrating tVNS-induced changes in the brains of healthy volunteers. Identifying specific neural pathways, which are influenced by tVNS compared with sham in depressed individuals, as well as determining neurobiomarkers of tVNS treatment success are needed to advance the application of tVNS for MDD. In order to address these questions, we measured fMRI brain activity of thirty-eight depressed patients assigned to undergo tVNS (n= 17) or sham (n= 21) treatment for 4 weeks, during the first stimulation session. The results showed significant fMRI signal increases in the left anterior insula, revealed by a direct comparison of tVNS and sham stimulation. Importantly, the insula activation level during the first stimulation session in the tVNS group was significantly associated with the clinical improvement at the end of the four-week treatment, as indicated by the Hamilton Depression Rating Scale (HAM-D) score. Our findings suggest that anterior insula fMRI activity could serve as a potential cortical biomarker and an early predictor of tVNS longitudinal treatment success.
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China; Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Jiliang
J
Fang
Massachusetts General Hospital/Harvard Medical School, Charlestown, MA 02219, USA.
Natalia
N
Egorova
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Peijing
P
Rong
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Jun
J
Liu
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Yang
Y
Hong
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Yangyang
Y
Fan
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Xiaoling
X
Wang
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Honghong
H
Wang
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Yutian
Y
Yu
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Yunyao
Y
Ma
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Chunhua
C
Xu
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Shaoyuan
S
Li
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Jingjun
J
Zhao
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Man
M
Luo
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Bing
B
Zhu
Massachusetts General Hospital/Harvard Medical School, Charlestown, MA 02219, USA.
Jian
J
Kong
D000328:Adult; D000704:Analysis of Variance; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000097:blood; D011569:Psychiatric Status Rating Scales; D016037:Single-Blind Method; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000379:methods*
D010100:Oxygen
Functional magnetic resonance imaging (fMRI); Major depressive disorder (MDD); Transcutaneous vagus nerve stimulation tVNS