Abstract
Vagus nerve stimulation (VNS) is an established treatment for selected patients with medically refractory seizures. Recent studies suggest that VNS could be potentially useful in the treatment of resistant depressive disorder. Although a surgical procedure is required in order to implant the VNS device, the possibility of a long-term benefit largely free of severe side effects could give VNS a privileged place in the management of resistant depression. In addition, VNS appears to affect pain perception in depressed adults; a possible role of VNS in the treatment of severe refractory headache, intractable chronic migraine and cluster headache has also been suggested. VNS is currently investigated in clinical studies, as a potential treatment for essential tremor, cognitive deficits in Alzheimer’s disease, anxiety disorders, and bulimia. Finally, other studies explore the potential use of VNS in the treatment of resistant obesity, addictions, sleep disorders, narcolepsy, coma and memory and learning deficits.
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References
Amar AP, Levy ML, McComb JG, Apuzzo MLJ (2001) Vagus nerve stimulation for control of intractable seizures in childhood. Pediatr Neurosurg 34: 218–223
American Psychiatric Association Task Force on ECT (2001) The practice of electroconvulsive therapy, 2nd edn. American Psychiatric Publishing, Washington
Ben-Menachem E (2001) Vagus nerve stimulation, side effects, and long-term safety. Clin Neurophysiol 18: 415–418
Borckard JJ, Kozel FA, Anderson B, Walker A, George MS (2005) Pain Res Manag 10: 9–14
Cechetto DF (1987) Central representation of visceral function. Fed Proc 46: 17–23
Cyberonics Inc. (2005) Depression Physician’s Manual. Houston, Texas
DeGiorgio CM, Thompson J, Lewis P, Arrambide S, Naritoku D, Handforth A, Labar D, Mullin P, Heck C; VNS U.S. Study Group (2000) Prospective long-term study of vagus nerve stimulation for the treatment of refractory seizures. Epilepsia 41: 1195–1200
Dunner DL (2001) Acute and maintenance treatment of chronic depression. J Clin Psychiatry 62Suppl 6: 10–16
Elger H, Hoppe C, Falkai P, Rush AJ, Elger CE (2000) Vagus nerve stimulation in association with mood improvements in epilepsy patients. Epilepsy Res 42: 203–210
George MS, Nahas Z, Bohning DE, Lomarev M, Denslow S, Osenbach R, Ballenger JC (2000) Vagus nerve stimulation: a new form of therapeutic brain stimulation. CNS Spectrums 5: 2–11
George M, Sackeim HA, Marangell LB, Husain MM, Nahas Z, Lisanby SH, Ballenger JC, Rush AJ (2000) Vagus nerve stimulation: a potential therapy for resistant depression? Psychiatr Clin North Am 23: 757–783
George M, Sackeim HA, Rush AJ, Marangell LB, Nahas Z, Husain MM, Lisanby S, Burt T, Goldman J, Ballenger JC (2000) Vagus nerve stimulation: a new tool for brain research and therapy. Biol Psychiatry 47: 287–295
Handforth A, Ondo WG, Tatter S (2003) Vagus nerve stimulation for essential tremor: a pilot efficacy and safety trial. Neurology 61: 1401–1405
Hornig G, Murphy JV, Schallert G, Tilton C (1997) Left vagus nerve stimulation in children with refractory epilepsy. South Med J 90: 484–488
Hosain S, Nikalov B, Harden C, Li M, Fraser R, Labar D (2000) Vagus nerve stimulation treatment for Lennox-Gestaut syndrome. J Child Neurol 15: 509–512
Kellner CH, Fink M (2002) The efficacy of ECT and “treatment resistance.” J ECT 18: 1–2
Kirse DJ, Werle AH, Murphy JV, Eyen TP, Bruegger DE, Hornig GW, Torkelson RD (2002) Vagus nerve stimulator implantation in children. Arch Otolaryngol Head Neck Surg 128: 1263–1230
Koo B (2001) EEG changes with vagus nerve stimulation. J Clin Neurophysiol 18: 434–441
Labar D, Murphy J, Tecoma E (1999) Vagus nerve stimulation for medication-resistant generalized epilepsy. VNS Study Group E-04. Neurology 52: 1510–1512
Luders HO, Comair YG (2001) Epilepsy surgery, 2nd edn. Lippincott Williams & Wilkins, New York, NY
Marangell LB, Rush AJ, George MS, Sackeim HA, Johnson CR, Husain MM, Nahas Z, Lisanby SH (2002) Vagus nerve stimulation (VNS) for major depressive episodes: one year outcomes. Biol Psychiatry 51: 280–287
Mauskop A (2005) Vagus nerve stimulation relieves chronic refractory migraine and cluster headaches. Cephalgia 25: 82–86
McCall WV(2001) Electro convulsive therapy in the era of modern psychopharmacology. Int J Neuropsychopharmacol 4: 315–324
Morris GL 3rd, Mueller WM (1999) Long-term treatment with vagus nerve stimulation in patients with refractory epilepsy. Vagus Stimulation Study Group E101–105. Neurology 53: 1727–1735
Murphy JV (1999) Left vagal nerve stimulation in children with medically refractory epilepsy. J Pediatr 134: 563–567
Murray CJL, Lopez AD (1997) Global mortality, disability, and the contribution of risk factors: global burden of disease study. Lancet 349:1436–1442
Nahas Z, Marangell LB, Husain MM, Rush AJ, Sackeim HA, Lisanby SH, Martinez JM, George MS (2005) Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes. J Clin Psychiatry 66: 1097–1104
Patwardhan RV, Stong B, Bebin EM, Mathisen J, Grabb PA (2000) Efficacy of vagal nerve stimulation in children with medically refractory epilepsy. Neurosurgery 47: 1353–1358
Porges SW (1999) Orienting in a defensive world: mammalian modifications of our evolutionary heritage: a polyvagal theory. Psychophysiology 32: 301–318
Ramsay RE, Uthman BM, Augustinsson LE, Upton AR, Naritoku D, Willis J, Treig T, Barolat G, Wernicke JF (1994) Vagus nerve stimulation for treatment of partial seizures: 2. Safety, side effects, and tolerability. Epilepsia 35: 627–636
Renfroe JB, Wheless JW (2002) Earlier use of adjunctive vagus nerve stimulation therapy for refractory epilepsy. Neurology 59Suppl 4: S26–S30
Ricardo JA, Koh ET (1978) Anatomical evidence of direct projections from the nucleus of the solitary tract to the hypothalamus, amygdala and other forebrain structures in the rat. Brain Res 153: 1–26
Rush AJ, George MS, Sackeim HA, Marangell LB, Husain MM, Giller C, Nahas Z, Haines S, Simpson RK Jr, Goodman R (2000) Vagus nerve stimulation (VNS) for treatment-resistant depression: a multicenter study. Biol Psychiatry 47: 276–286
Rutecki P (1990) Anatomical, physiological, and theoretical basis for the antiepileptic effect of vagus nerve stimulation. Epilepsia 31Suppl 2: S1–S6
Sackeim HA, Haskett RF, Mulsant BH, Thase ME, Mann JJ, Pettinati HM, Greenberg RM, Crowe RR, Cooper TB, Prudic J (2001) Continuation pharmacotherapy in the prevention of relapse following electroconvulsive therapy: a randomized controlled trial. JAMA 285: 1299–1307
Sackeim HA, Rush AJ, George MS, Marangell LB, Husain MM, Nahas Z, Johnson CR, Seidman S, Giller C, Haines S, Simpson RK Jr, Goodman RR (2001) Vagus nerve stimulation (VNS) for treatment-resistant depression: efficacy, side effects, and predictors of outcome. Neuropsychopharmacology 25: 713–728
Sackeim HA, Prudic J, Devanand DP, Nobler MS, Lisanby SH, Peyser S, Fitzsimons L, Moody BJ, Clark J (2000) A prospective, randomized, double-blind comparison of bilateral and right unilateral electroconvulsive therapy at different stimulus intensities. Arch Gen Psychiatry 57: 425–434
Schachter SC (2002) Vagus nerve stimulation: where are we? Curr Opin Neurol 15: 201–206
Sitdikov FG, Gil’mutdinova RI, Minnakhmetov RR, Zefirov TL (2000) Effects of vagus nerves on functional parameters of rat heart in postnatal ontogeny. Bull Exp Biol Med 130: 620–623
Sjogren MJ, Hellstrom PT, Jonsson MA, Runnerstam M, Silander HC, Ben-Menachem E (2002) Cognition-enhancing effect of vagus nerve stimulation in patients with Alzheimer’s disease: a pilot study. J Clin Psychiatry 63: 972–980
TEC Assessment (1998) Chronic vagus nerve stimulation for the treatment of seizures
Vonck K, Van Laere K, Dedeurwaerdere S, Caemaert J, De Reuck J, Boon P (2001) The mechanism of action of vagus nerve stimulation for refractory epilepsy: the current status. J Clin Neurophysiol 18:394–401
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Ansari, S., Chaudhri, K., Al Moutaery, K. (2007). Vagus nerve stimulation: indications and limitations. In: Sakas, D.E., Simpson, B.A. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/2. Springer, Vienna. https://doi.org/10.1007/978-3-211-33081-4_31
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DOI: https://doi.org/10.1007/978-3-211-33081-4_31
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