Changes in regional cerebral blood flow by therapeutic vagus nerve stimulation in depression: An exploratory approach

• Published in: Psychiatry research 2005-08, Vol.139 (3), p.165-179
• Main Authors: Zobel, Astrid, Joe, Alexius, Freymann, Nikolaus, Clusmann, Hans, Schramm, Johannes, Reinhardt, Michael, Biersack, Hans-Jürgen, Maier, Wolfgang, Broich, Karl
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Amygdala - blood supply; Amygdala - pathology; Antidepressive Agents, Tricyclic - therapeutic use; Biological and medical sciences; Brain - blood supply; Brain - pathology; Cerebrovascular Circulation - physiology; Citalopram - therapeutic use; Combined Modality Therapy; Depression; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - psychology; Depressive Disorder, Major - therapy; Female; Functional Laterality - physiology; Gyrus Cinguli - blood supply; Gyrus Cinguli - pathology; Hippocampus - blood supply; Hippocampus - pathology; HMPAO-SPECT; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Mianserin - analogs & derivatives; Mianserin - therapeutic use; Mood disorders; Oximes; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Radiopharmaceuticals; Serotonin Uptake Inhibitors - therapeutic use; Thalamus - blood supply; Thalamus - pathology; Tomography, Emission-Computed, Single-Photon; Transcutaneous Electric Nerve Stimulation - instrumentation; Treatment-resistant depression; Vagus Nerve - physiology; Vagus nerve stimulation
• ISSN: 0925-4927; 0165-1781; 1872-7506
• DOI: 10.1016/j.pscychresns.2005.02.010

Abnormalities in regional cerebral blood flow (rCBF) have been reported to characterize depressive episodes; they are at least partly reversed by antidepressant treatment. Treatment-specific as well as response-related changes in rCBF have been reported. We explored the changes in rCBF induced by vagus nerve stimulation (VNS), a recently proposed antidepressant strategy, by application of single photon emission-computed tomography with 99mTc–hexamethyl-propylene amine oxime in otherwise treatment-refractory patients. Both region-of-interest (ROI) and statistical parametric mapping (SPM) analytic approaches were used. Decreases of rCBF in the amygdala, left hippocampus, left subgenual cingulate cortex, left and right ventral anterior cingulum, right thalamus and brain stem were observed; the only increase of rCBF was found by SPM analysis in the middle frontal gyrus. This pattern shares features with changes of rCBF previously associated with the administration of selective serotonin reuptake inhibitors. Similarities to other brain-stimulation strategies in antidepressant treatment were less pronounced.