A 5-Year Observational Study of Patients With Treatment-Resistant Depression Treated With Vagus Nerve Stimulation or Treatment as Usual: Comparison of Response, Remission, and Suicidality

Aaronson, Scott T.; Sears, Peter; Ruvuna, Francis; Bunker, Mark; Conway, Charles R.; Dougherty, Darin D.; Reimherr, Frederick W.; Schwartz, Thomas L.; Zajecka, John

doi:10.1176/appi.ajp.2017.16010034

Cited by 271 publications

(235 citation statements)

References 22 publications

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“…Vagus Nerve Stimulation (VNS) has been shown to be efficacious for the long-term management of patients with treatment-resistant depression (Carreno & Frazer, 2017;Johnson & Wilson, 2018;Rush et al, 2000). A recent 5-year observational study of patients with treatment-resistant depression treated with VNS or treatment as usual has provided additional evidence that adjunctive VNS has enhanced antidepressant effects compared with treatment as usual (Aaronson et al, 2017;Rush et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

A pilot study on high amplitude low frequency–music impulse stimulation as an add‐on treatment for depression

et al. 2019

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Objective High Amplitude Low Frequency–Music Impulse Stimulation (HALF‐MIS) is a form of Vagus Nerve Stimulation (VNS). The aim of the study was to determine the feasibility, efficacy, and potential side effects of HALF‐MIS, used as an add‐on treatment for depression. Methods This is an open randomized controlled pilot study. Patients with depressive disorder were randomly allocated to either a HALF‐MIS group with eight add‐on HALF‐MIS sessions (over a period of 3–4 weeks) or a control group which received treatment as usual. Seated in a specially designed chair() embedded with a transducer, their central nervous system was stimulated through the abdomen, () using music and vibration. Hamilton rating was performed. Side effects were registered. Results Eighteen patients were randomized to the add‐on treatment and 20 patients to the control group. Both groups show in Hamilton Depression Rating Scale (HDRS)‐17 and in HDRS‐6, although the HALF‐MIS group had a greater decline of symptoms. This was a significant difference in intergroup analysis (p = .011, CI 95% for the HALF‐MIS group 3.0588–8.5327 and CI 95% for the control group 0.2384–3.0). The (HDRS)‐6 difference was also significant (p = .020, CI 95% for the HALF‐MIS group 1.5911–5.0487 and for the control group −0.297 to 1.7058). No side effects were observed. Conclusions High Amplitude Low Frequency–Music Impulse Stimulation treatment seems to give beneficial effect as an add‐on treatment for depression. HALF‐MIS appears to be a safe and effective add‐on treatment for depression.

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Section: Discussionmentioning

confidence: 99%

A pilot study on high amplitude low frequency–music impulse stimulation as an add‐on treatment for depression

et al. 2019

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“…It is effective in patients with treatment‐resistant depression (TRD). Treatment‐resistant depression is an American FDA‐approved indication for VNS …”

Section: Applicationmentioning

confidence: 99%

“…Treatment-resistant depression is an American FDA-approved indication for VNS. 43 The overall effect of VNS on cognition is unclear, and many studies focus on memory. There is an evidence that VNS treatment can acutely improve memory in a short time, but there seems to be no significant improvement within the long-term treatment.…”

Section: Appli C Ati Onmentioning

confidence: 99%

Research progress of vagus nerve stimulation in the treatment of epilepsy

Fan

Shan

et al. 2019

CNS Neurosci Ther

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The International League Against Epilepsy (ILAE) defined drug‐resistant epilepsy (DRE) that epilepsy seizure symptoms cannot be controlled with two well‐tolerated and appropriately chosen antiepileptic drugs, whether they are given as monotherapy or in combination. According to the WHO reports, there is about 30%‐40% of epilepsy patients belong to DRE. These patients need some treatments other than drugs, such as epilepsy surgery, and neuromodulation treatment. Traditional surgical approaches may be limited by the patient's clinical status, pathological tissue location, or overall prognosis. Thus, neuromodulation is an alternative choice to control their symptoms. Vagus nerve stimulation (VNS) is one of the neuromodulation methods clinically, which have been approved by the Food and Drug Administration (FDA). In this review, we systematically describe the clinical application, clinical effects, possible antiepileptic mechanisms, and future research directions of VNS for epilepsy.

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“…Therefore, most third party payers do not currently reimburse for the procedure. Recent data from a 5-year, prospective, open-label, nonrandomized, observational registry study of VNS involving 795 patients showed significantly higher response (67.6% for VNS compared to 40.9% for treatment as usual) and remission (43.3% for VNS compared to 25.7% for treatment as usual) 3 . This may help change the reimbursement landscape.…”

Section: Neurotherapeutic Interventionsmentioning

confidence: 99%

Neurotherapeutic Interventions for Psychiatric Illness

Dougherty

Widge

2017

Harv Rev Psychiatry

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Many patients with mental illness do not respond to common evidence-based treatments such as psychopharmacology and psychotherapy. We increasingly understand these illnesses as disorders of brain circuits, suggesting that otherwise treatment-refractory patients might be helped by direct intervention in those circuits. Non-invasive techniques for circuit intervention include electro-convulsive therapy (ECT) and transcranial magnetic stimulation (TMS). Circuits can also be targeted more directly and focally through neurosurgical intervention, including through vagus nerve stimulation (VNS), ablative neurosurgery (cingulotomy and capsulotomy), cortical brain stimulation (EpCS), or deep brain stimulation (DBS). Each of these approaches has evidence supporting its use in a major psychiatric disorder, although many have yet to demonstrate a strong clinical signal in a randomized controlled trial. New technologies that may aid in that demonstration include non-invasive techniques that can focus energy more precisely in the deep brain and invasive devices that respond in real time to changes in brain activity (closed-loop stimulation). In this article, we review the modalities and evidence base for these neurotherapeutics, with an emphasis on their clinical readiness and relative advantages.

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A 5-Year Observational Study of Patients With Treatment-Resistant Depression Treated With Vagus Nerve Stimulation or Treatment as Usual: Comparison of Response, Remission, and Suicidality

Abstract: This registry represents the longest and largest naturalistic study of efficacy outcomes in treatment-resistant depression, and it provides additional evidence that adjunctive VNS has enhanced antidepressant effects compared with treatment as usual in this severely ill patient population.

Cited by 271 publications

References 22 publications

A pilot study on high amplitude low frequency–music impulse stimulation as an add‐on treatment for depression

A pilot study on high amplitude low frequency–music impulse stimulation as an add‐on treatment for depression

Research progress of vagus nerve stimulation in the treatment of epilepsy

Neurotherapeutic Interventions for Psychiatric Illness

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