Current and future perspectives on vagus nerve stimulation in treatment-resistant depression

Bernardo Dell'Osso, Giulia Camuri, Lucio Oldani, A. Carlo Altamura

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Treatment-resistant depression (TRD) is a leading cause of disability and therapeutic strategies used for this prevalent and impairing condition include pharmacological augmentation strategies and brain stimulation techniques. Vagus nerve stimulation (VNS) is a brain stimulation intervention that has shown to decrease seizure frequency in partial-onset seizure patients. Subsequent trials performed on treatment-resistant patients with major depression indicated that VNS may be an effective and safe treatment. VNS involves minor surgery in which an electrode pair is wrapped around the left vagus nerve in the neck and connected to a generator implanted in the chest wall subcutaneously. Several methodological approaches have been employed in order to better understand the mechanism of action of VNS and its effects on neurobiological circuits involved in mood regulation. Despite its invasive nature, the tolerability profile of VNS seems to be favourable given that, differently from other brain stimulation interventions (i.e., ECT, rTMS, tDCS), VNS is a continuous and chronic stimulation. Even though previous positive results from clinical trials have led VNS to be approved by the FDA and the EMEA for the use in TRD, researchers are now focusing their efforts in the identification of possible predictors of response to VNS. Further investigation of the effects of VNS in the long-term treatment (>2 years) of TRD is also required.

Original languageEnglish
Title of host publicationDeep Brain Stimulation: Applications, Complications and Side Effects
PublisherNova Science Publishers, Inc.
Pages177-188
Number of pages12
ISBN (Print)9781606928950
Publication statusPublished - 2009

Keywords

  • Brain stimulation
  • Treatment resistant depression (TRD)
  • Vagus nerve stimulation (VNS)

ASJC Scopus subject areas

  • Psychology(all)
  • Medicine(all)

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