Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression.

Author: Moeller S1, Lücke C2, Heinen C3, Bewernick BH4, Aydin M2, Lam AP2, Grömer TW5, Philipsen A2, Müller HHO2
1Universitätsklinik für Psychiatrie und Psychotherapie, Carl von Ossietzky Universität Oldenburg; Universitätsklinikum Bonn AöR, Klinik und Poliklinik für Psychiatrie;
2Universitätsklinikum Bonn AöR, Klinik und Poliklinik für Psychiatrie.
3Universitätsklinik für Neurochirurgie am Evangelischen Krankenhaus Oldenburg, Carl von Ossietzky Universität Oldenburg.
4Universitätsklinikum Bonn AöR, Klinik und Poliklinik für Psychiatrie; Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Abteilung für medizinische Psychologie, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn.
5Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen.
Conference/Journal: J Vis Exp.
Date published: 2019 Jan 7
Other: Issue ID: 143 , Special Notes: doi: 10.3791/58264. , Word Count: 174

Vagus nerve stimulation (VNS) is an approved neurostimulation therapy. The purpose of the method is to treat patients with therapy-resistant depression (TRD). VNS exhibits antidepressive and stabilizing effects. This method is particularly useful as a long-term treatment, in which up to two-thirds of patients respond. The vagus nerve stimulator is positioned on the left vagus nerve during a surgical procedure and is activated telemetrically by a wand connected to a handheld computerized device. The treating physician can perform various adjustments of the vagus nerve stimulator during in-office visits (e.g., by modifying stimulation intensity or stimulation frequency) to achieve maximum therapeutic effects with low side effects. Set-up of the device usually takes several months. Typical side effects include wound infection, temporary salivation, coughing, paralysis of the vocal cords, bradycardia, or even asystole. The patient can stop the VNS by placing a magnet over the generator. The current protocol describes delivery of the specific stimulation tool and methods for adjusting the tuning parameters to achieve the best remission rates in patients with TRD.

PMID: 30663639 DOI: 10.3791/58264