Chronic Vagus Nerve Stimulation for Treatment-resistant Depression Decreases Resting Ventromedial Prefrontal Glucose Metabolism

Overview

Journal Neuroimage

Specialty Radiology

Date 2008 Jul 4

PMID 18595737

Citations 31

Authors

Jose V Pardo

Sohail A Sheikh

Graeme C Schwindt

Joel T Lee

Michael A Kuskowski

Christa Surerus

Scott M Lewis

Faruk S Abuzzahab

David E Adson

Barry R Rittberg

Affiliations

Soon will be listed here.

Abstract

Vagus nerve stimulation (VNS) is used as an adjunctive therapy for treatment-resistant depression (TRD). Its mechanism of action is not fully understood. Longitudinal measurement of changes in brain metabolism associated with VNS can provide insights into this new treatment modality. Eight severely depressed outpatients who were highly treatment-resistant underwent electrical stimulation of the left vagus nerve for approximately one year. The main outcome measures were resting regional brain glucose uptake measured with positron emission tomography (PET) and the 24-item Hamilton Depression Scale. The most significant and extensive change over one year of chronic VNS localized to the ventromedial prefrontal cortex extending from the subgenual cingulate to the frontal pole. This region continued to decline in metabolism even toward the end of the study. Clinically, this cohort showed a trend for improvement. No correlations surfaced between change in glucose uptake and depression scores. However, the sample size was small; none remitted; and the range of depression scores was limited. Chronic VNS as adjunctive therapy in patients with severe TRD produces protracted and robust declines in resting brain activity within the ventromedial prefrontal cortex, a network with dense connectivity to the amygdala and structures monitoring the internal milieu.

Citing Articles

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