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Beyond the Treatment of Epilepsy: New Applications of Vagus Nerve Stimulation in Psychiatry

Published online by Cambridge University Press:  07 November 2014

Markus Kosel  and
Thomas E. Schlaepfer
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Abstract

Vagus nerve stimulation (VNS) in humans generally refers to stimulation of the left vagus nerve at the cervical level. VNS is an established treatment largely devoid of severe side effects for medically refractory partial-onset seizures and has been used in more than 16,000 patients. Over the past 5 years, applications in other neuropsychiatric disorders have been investigated, with a special emphasis on depression. Recent data from an open-label, multi-center pilot study involving 60 patients suggest a potential clinical usefulness in the acute and maintenance treatment of drug-resistant depressive disorder. The perspective of VNS as a long-term treatment with the advantage of assured compliance makes it an interesting technique to potentially treat drug-resistant depression. However, definite therapeutic effects of clinical significance remain to be confirmed in large placebo-controlled trials. Results of clinical pilot studies involving patients suffering from obesity and Alzheimer's disease indicate that VNS might induce weight loss and improve cognition. Besides its clinical usefulness, VNS can be used as a research tool, allowing neuro-physiologic investigations of the parasympathetic system and its interactions with other parts of the central nervous system.

Type
Review Article
Information
CNS Spectrums , Volume 8 , Issue 7: Brain Stimulation Methods in the Treatment of Affective Disorders , July 2003 , pp. 515 - 521
Copyright
Copyright © Cambridge University Press 2003

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References

REFERENCES

1.Penry, JK, Dean, JC. Prevention of intractable partial seizures by intermittent vagal stimulation in humans: Preliminary results. Epilepsia. 1990;31(suppl 2):S40–S43.CrossRefGoogle ScholarPubMed
2.Terry, R, Tarver, WB, Zabara, J. An implantable neurocybernetic prosthesis system. Epilepsia. 1990;31(suppl 2):S33–S37.CrossRefGoogle Scholar
3.Schachter, SC. Vagus nerve stimulation therapy summary—five years after FDA approval. Neurology. 2002;59(suppl 4):S15–S20.CrossRefGoogle ScholarPubMed
4.Privitera, MD, Welty, TE, Ficker, DM, et al.Vagus nerve stimulation for partial seizures. In: The Cochrane Library. Issue 3, 2002; Oxford.Google Scholar
5.The Vagus Nerve Stimulation Study Group. A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. Neurology. 1995;45:224–230.CrossRefGoogle Scholar
6.Handforth, A, DeGiorgio, CM, Schachter, SC, et al.Vagus nerve stimulation for partial-onset seizures: a randomized active-control trial. Neurology. 1998;51:48–55.CrossRefGoogle ScholarPubMed
7.DeGiorgio, CM, Schachter, SC, Handforth, A, et al.Prospective long-term study of vagus nerve stimulation for the treatment of refractory seizures. Epilepsia. 2000;41:1195–2000.CrossRefGoogle ScholarPubMed
8.Binks, AP, Paydarfar, D, Schachter, SC, et al.High strength stimulation of the vagus nerve in awake humans: a lack of cardiorespiratory effects. Respir Physiol. 2001;127:125–133.CrossRefGoogle ScholarPubMed
9.Schachter, SC. Vagus nerve stimulation: where are we? Curr Opin Neurol. 2002;15:201–206.CrossRefGoogle ScholarPubMed
10.Rush, AJ, George, MS, Sackeim, HA, et al.Vagus nerve stimulation for treatment-resistant depression: a multicenter study. Biol Psychiatry. 2000;47:276–286.CrossRefGoogle ScholarPubMed
11.Marangell, LB, Rush, AJ, George, MS, et al.Vagus nerve stimulation for major depressive episodes: one year outcomes. Biol Psychiatry. 2002;51:280–287.CrossRefGoogle ScholarPubMed
12.Physician's Manual: NeuroCybernetic Prothesis System NCP Pulse Generator Models 100 and 101. Houston, Tex: Cyberonics; 2001.Google Scholar
13.Henry, TR. Therapeutic mechanisms of vagus nerve stimulation. Neurology. 2002;59(suppl 4):S3–S14.CrossRefGoogle ScholarPubMed
14.Vonck, K, Van Laere, K, Dedeurwaerdere, S, et al.The mechanism of action of vagus nerve stimulation for refractory epilesy: the current status. J Clin Neurophysiol. 2001;18:394–401.CrossRefGoogle Scholar
15.George, MS, Sackeim, HA, Rush, AJ, et al.Vagus nerve stimulation: a new tool for brain research and therapy? Biol Psychiatry. 2000;47:287–295.CrossRefGoogle ScholarPubMed
16.Sitdikov, FG, Gil'mutdinova, RI, Minnakhmetov, RR, et al.Asymmetrical effects of vagus nerves on functional parameters of rat heart in postnatal ontogeny. Bull Exp Biol Med. 2000;130:620–623.CrossRefGoogle ScholarPubMed
17.Porges, SW. Orienting in a defensive world: mammalian modifications of our evolutionary heritage—a polyvagal theory. Psychophysiology. 1995;32:301–318.CrossRefGoogle Scholar
18.Krahl, SE, Senanyake, SS, Handforth, A. Destruction of peripheral C-fibers does not alter subsequent vagus nerve stimulation-induced seizure suppression on rats. Epilepsia. 2001;42:586–589.CrossRefGoogle Scholar
19.Zagon, A, Kemeny, AA. Slow hyperpolarization in cortical neurons: a possible mechanism behind vagus nerve stimulation therapy for refractory epilepsy. Epilepsia. 2000;41:1382–1389.CrossRefGoogle ScholarPubMed
20.Koo, B. EEG changes with vagus nerve stimulation. J Clin Neurophysiol. 2001;18:434–441.CrossRefGoogle ScholarPubMed
21.Lomarev, MP, Denslow, S, Nahas, Z, et al.Vagus nerve stimulation synchronized BOLD fMRI suggests that VNS in depressed adults has frequency/dose dependent effects. J Psychiatr Res. 2002;36:219–227.CrossRefGoogle ScholarPubMed
22.Henry, TR, Votaw, JR, Pennell, PB, et al.Acute blood flow changes and efficacy of vagus nerve stimulation in partial epilepsy. Neurology. 1999;52:1166–1173.CrossRefGoogle ScholarPubMed
23.Narayanan, JT, Watts, R, Haddad, N, et al.Cerebral activation during vagus nerve stimulation: A functional MR study. Epilepsia. 2002;43:1509–1514.CrossRefGoogle ScholarPubMed
24.Van Laere, K, Vonck, K, Boon, P, et al.Perfusion SPECT changes after acute and chronic vagus nerve stimulation in relation to prestimulus condition and longterm clinical efficacy. J Nucl Med. 2002;43:733–744.Google ScholarPubMed
25.Murray, CJ, Lopez, AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997;349:1498–1504.CrossRefGoogle ScholarPubMed
26.Dunner, DL. Acute and maintenance treatment of chronic depression. J Clin Psychiatry. 2001;62(suppl 6):S10–S16.Google ScholarPubMed
27.Kellner, CH, Fink, M. The efficacy of ECT and ”treatment resistance.” J ECT. 2002;18:1–2.CrossRefGoogle ScholarPubMed
28.Sackeim, HA, Prudic, J, Devanand, DP, et al.A prospective, randomized, double-blind comparison of bilateral and right unilateral electroconvulsive therapy at different stimulus intensities. Arch Gen Psychiatry. 2000;57:425–434.CrossRefGoogle ScholarPubMed
29.Sackeim, HA, Haskett, RF, Mulsant, BH, et al.Continuation pharmacotherapy in the prevention of relapse following electroconvulsive therapy: a randomized controlled trial. JAMA. 2001;285:1299–1307.CrossRefGoogle ScholarPubMed
30.McCall, WV. Electroconvulsive therapy in the era of modern psychopharmacology. Int J Neuropsychopharmacol. 2001;4:315–324.CrossRefGoogle ScholarPubMed
31.Ben-Menachem, E. Vagus nerve stimulation, side effects, and long-term safety. J Clin Neurophysiol. 2001;18:415–418.CrossRefGoogle ScholarPubMed
32.Harden, CL. The comorbidity of depression and epilepsy. Neurology. 2002;59(suppl 4):S48–S55.Google ScholarPubMed
33.Harden, CL, Pulver, MC, Ravdin, LD, et al.A pilot study of mood in epilepsy patients treated with vagus nerve stimulation. Epilepsy Behav. 2000;1:93–99.CrossRefGoogle ScholarPubMed
34.Hoppe, C, Helmstaedter, C, Scherrmann, J, et al.Self-reported mood changes following 6 months of vagus nerve stimulation in epilepsy patients. Epilepsy Behav. 2001;2:225–342.Google ScholarPubMed
35.Rush, AJ, Linden, M, Zobel, A. Vagusstimulation. Eine neue Behaldlungsoption fur chronifizierte depressive Erkrankungen. Fortschr Neurol Psychiatr. 2002;70:297–302.CrossRefGoogle Scholar
36.Sackeim, HA, Rush, AJ, George, MS, et al.Vagus nerve stimulation for treatment-resistant depression: efficacy, side effects, and predictors of outcome. Neuropsychopharmacology. 2001;25:713–728.CrossRefGoogle ScholarPubMed
37.George, MS, Nahas, Z, Bohning, D, et al.Vagus nerve stimulation therapy: a research update. Neurology. 2002;59(suppl 4):S56–S61.CrossRefGoogle ScholarPubMed
38.Roslin, M, Kurian, M. Vagus nerve stimulation in the treatment of morbid obesity. In: Schachter, SC, Schmidt, D, eds. Vagus Nerve Stimulation. London, England: Martin Dunitz; 2002:113–121.Google Scholar
39.Sjogren, MJ, Hellstrom, PT, Jonsson, MA, et al.Cognition-enhancing effect of vagus nerve stimulation in patients with Alzheimer's disease: a pilot study. J Clin Psychiatry. 2002;63:972–980.CrossRefGoogle ScholarPubMed
40.Annegers, JF, Coan, SP, Hauser, WA, et al.Epilepsy, vagal nerve stimulation by the NCP system, mortality, and sudden, unexpected, unexplained death. Epilepsia. 1998;39:206–212.CrossRefGoogle ScholarPubMed
41.Annegers, JF, Coan, SP, Hauser, WA, et al.Epilepsy, vagal nerve stimulation by the NCP system, all-cause mortality, and sudden, unexpected, unexplained death. Epilepsia. 2000;41:549–453.CrossRefGoogle ScholarPubMed
42.Tatum, WO, Moore, DB, Stecker, MM, et al.Ventricular asystole during vagus nerve stimulation for humans. Neurology. 1999;52:1267–1269.CrossRefGoogle ScholarPubMed
43.Agnew, WF, McCreery, DB. Considerations for safety with chronically implanted nerve electrodes. Epilepsia. 1900;31(suppl 2):S27–S32.Google Scholar
44.Tubbs, RS, Patwardhan, R, Palmer, CA, et al.Histological appearance of a chronically stimulated vagus nerve in a pediatric patient. Pediatr Neurosurg. 2001;35:99–102.CrossRefGoogle ScholarPubMed
45.Charous, SJ, Kempster, G, Manders, E, et al.The effect of vagal nerve stimulation on voice. Laryngoscope. 2001;111:2028–2031.CrossRefGoogle ScholarPubMed
46.DeGiorgio, CM, Thompson, J, Lewis, P, et al.Vaguss nerve stimulation: analysis of device parameters in 154 patients during the long-term XE5 Study. Epilepsia. 2001;42:1017–1020.CrossRefGoogle ScholarPubMed
47.Lewis, ME, Al-Khaladi, AH, Bonser, RS, et al.Vagus nerve stimulation decreases left ventricular contractility in vivo in the human and pig heart. J Physiol. 2001;534:547–552.CrossRefGoogle ScholarPubMed
48.Frei, MG, Osorio, I. Left vagus nerve stimulation with the neurocybernetic prosthesis has complex effects on heart rate and on its variability in humans. Epilepsia. 2001;42:1007–1016.CrossRefGoogle ScholarPubMed
49.Banzett, RB, Guz, A, Paydarfar, D, et al.Cardiorespiratory variables and sensation during stimulation of the left vagus in patients with epilepsy. Epilepsy Res. 1999;35:1–11.CrossRefGoogle ScholarPubMed
50.Sanossian, N, Haut, S. Chronic diarrhea associated with vagal nerve stimulation. Neurology. 2002;58:330.CrossRefGoogle ScholarPubMed
51.Kim, W, Clancy, RR, Liu, GT. Homer syndrome associated with implantation of a vagus nerve stimulator. Am J Ophthalmol. 2001;131:383–384.CrossRefGoogle Scholar
52.Leijten, FS, Van Rijen, PC. Stimulation of the phrenic nerve as a complication of vagus nerve pacing in a patient with epilepsy. Neurology. 1998;51:1224–1225.CrossRefGoogle Scholar
53.Iriarte, J, Artieda, J, Alegre, M, et al.Spam of the sternocleidomastoid muscle induced by vagal nerve stimulation. Neurology. 2001;57:2319–2320.CrossRefGoogle Scholar
54.Malow, BA, Edwards, J, Merzec, M, et al.Effects of vagus nerve stimulation on respiration during sleep. Neurology. 2000;55:1450–1454.CrossRefGoogle ScholarPubMed
55.Lundgren, J, Ekberg, O, Olsson, R. Aspiration: a potential complication to vagus nerve stimulation. Epilepsia. 1998;39:998–1000.CrossRefGoogle ScholarPubMed
56.Schallert, G, Foster, J, Lindquist, N, et al.Chronic stimulation of the left vagal nerve in children: effect on swallowing. Epilepsia. 1998;39:1113–1114.CrossRefGoogle ScholarPubMed
57.Heck, C, Helmers, SL, DeGiorgio, CM. Vagus nerve stimulation therapy, epilepsy and device parameters: scientific basis and recommendations for use. Neurology. 2002;59(suppl 4):S31–S37.CrossRefGoogle ScholarPubMed
58.Sackeim, HA, Keilp, JG, Rush, AJ, et al.The effects of vagus nerve stimulation on cognitive performance in patients with treatment-resistant depression. Neuropsychiatry Neuropsychol Behav Neurol. 2001;14:53–62.Google ScholarPubMed
59.Clark, KB, Naritoku, DK, Smith, DC, et al.Enhanced recognition memory following vagus nerve stimulation in human subjects. Nat Neurosci. 1999;2:94–98.CrossRefGoogle ScholarPubMed
60.Helmstaedter, C, Hoppe, C, Elger, CE. Memory alterations during acute high-intensity vagus nerve stimulation. Epilepsy Res. 2001;47:37–42.CrossRefGoogle ScholarPubMed
61.Koo, B, Ham, SD, Sood, S, et al.Human vagus nerve electrophysiology: a guide to vagus nerve stimulation parameters. J Clin Neurophysiol. 2001;18:429–433.CrossRefGoogle ScholarPubMed
62.Boon, P, D'Havé, M, Van Walleghem, P, et al.Direct medical costs of refractory epilepsy incurred by three different treatment modalities: a prospective assessment. Epilepsia. 2002;43:96–102.CrossRefGoogle ScholarPubMed