Vagus nerve stimulation is associated with mood improvements in epilepsy patients

Elger, Gerda; Hoppe, Christian; Falkai, Peter; Rush, A. John; Elger, Christian E.

doi:10.1016/s0920-1211(00)00181-9

Cited by 295 publications

(148 citation statements)

References 21 publications

Supporting

Mentioning

126

Contrasting

Unclassified

Order By: Relevance

“…Prospective studies using standard depression rating scales confirmed that VNS is associated with statistically significant mood improvements [37,38]. Today, VNS is used as a safe and effective therapy for treatment-resistant depression [39,40].…”

Section: Discussionmentioning

confidence: 97%

The P3 Event-Related Potential is a Biomarker for the Efficacy of Vagus Nerve Stimulation in Patients with Epilepsy

et al. 2014

View full text Add to dashboard Cite

Currently, the mechanism of action of vagus nerve stimulation (VNS) is not fully understood, and it is unclear which factors determine a patient's response to treatment. Recent preclinical experiments indicate that activation of the locus coeruleus noradrenergic system is critical for the antiepileptic effect of VNS. This study aims to evaluate the effect of VNS on noradrenergic signaling in the human brain through a noninvasive marker of locus coeruleus noradrenergic activity: the P3 component of the event-related potential. We investigated whether VNS differentially modulates the P3 component in VNS responders versus VNS nonresponders. For this purpose, we recruited 20 patients with refractory epilepsy who had been treated with VNS for at least 18 months. Patients were divided into 2 groups with regard to their reduction in mean monthly seizure frequency: 10 responders (>50 %) and 10 nonresponders (≤50 %). Two stimulation conditions were compared: VNS OFF and VNS ON. In each condition, the P3 component was measured during an auditory oddball paradigm. VNS induced a significant increase of the P3 amplitude at the parietal midline electrode, in VNS responders only. In addition, logistic regression analysis showed that the increase of P3 amplitude can be used as a noninvasive indicator for VNS responders. These results support the hypothesis that activation of the locus coeruleus noradrenergic system is associated with the antiepileptic effect of VNS. Modulation of the P3 amplitude should be further investigated as a noninvasive biomarker for the therapeutic efficacy of VNS in patients with refractory epilepsy.

show abstract

Section: Discussionmentioning

confidence: 97%

The P3 Event-Related Potential is a Biomarker for the Efficacy of Vagus Nerve Stimulation in Patients with Epilepsy

et al. 2014

View full text Add to dashboard Cite

show abstract

“…In addition, several studies reported a time-dependent improvement of the quality of life and mood among the patients treated with VNS (Ben-Menachem, 2002;Cramer, 2001;Elger et al, 2000;Harden et al, 2000 for a review) and recent investigations have suggested a potential effect of VNS in the treatment of depression (Kosel and Schlaepfer, 2003). Given that the modulation of gamma bands plays a role in linking different brain areas involved in object representation as well as in unifying coherent percepts and in focusing the top-down flow of attentional mechanisms (Bertrand and Tallon-Baudry, 2000) it could be suggested that, perhaps independently by the antiepileptic mechanism, these effects might contribute to the improvement of the quality of life in epileptic subjects as well as in depressed patients.…”

Section: Discussionmentioning

confidence: 99%

Increase in 20–50Hz (gamma frequencies) power spectrum and synchronization after chronic vagal nerve stimulation

Marrosu¹,

Santoni²,

Puligheddu³

et al. 2005

Clinical Neurophysiology

View full text Add to dashboard Cite

Objective: Though vagus nerve stimulation (VNS) is an important option in pharmacoresistant epilepsy, its mechanism of action remains unclear. The observation that VNS desynchronised the EEG activity in animals suggested that this mechanism could be involved in VNS antiepileptic effects in humans. Indeed VNS decreases spiking bursts, whereas its effects on the EEG background remain uncertain. The objective of the present study is to investigate how VNS affects local and inter regional syncronization in different frequencies in pharmacoresistent partial epilepsy. Methods: Digital recordings acquired in 11 epileptic subjects 1 year and 1 week before VNS surgery were compared with that obtained 1 month and 1 year after VNS activation. Power spectrum and synchronization were then analyzed and compared with an epileptic group of 10 patients treated with AEDs only and with 9 non-epileptic patients. Results: VNS decreases the synchronization of theta frequencies (P!0.01), whereas it increases gamma power spectrum and synchronization (!0.001 and 0.01, respectively). Conclusions: The reduction of theta frequencies and the increase in power spectrum and synchronization of gamma bands can be related to VNS anticonvulsant mechanism. In addition, gamma modulation could also play a seizure-independent role in improving attentional performances. Significance: These results suggest that some antiepileptic mechanisms affected by VNS can be modulated by or be the reflection of EEG changes. q

show abstract

“…This procedure has been studied in patients with treatment-resistant epilepsy and has been demonstrated to be effective in reducing seizure frequency (Ben-Menachem et al 1994 ; The Vagus Nerve Stimulation Study Group, 1995 ;Handforth et al 1998 ;Morris & Mueller, 1999 ;Uthman, 2000 ;Ben-Menachem, 2001 ;Schachter, 2002). Significant and clinically meaningful antidepressant effects of VNS in epilepsy patients have been described, independent of reduction of seizure frequency (Elger et al 2000 ;Harden et al 2000 ;Helmstaedter et al 2001). …”

Section: Introductionmentioning

confidence: 99%

Vagus nerve stimulation for depression: efficacy and safety in a European study

et al. 2008

View full text Add to dashboard Cite

Background. Vagus nerve stimulation (VNS) therapy is associated with a decrease in seizure frequency in partial-onset seizure patients. Initial trials suggest that it may be an effective treatment, with few side-effects, for intractable depression.Method. An open, uncontrolled European multi-centre study (D03) of VNS therapy was conducted, in addition to stable pharmacotherapy, in 74 patients with treatment-resistant depression (TRD). Treatment remained unchanged for the first 3 months ; in the subsequent 9 months, medications and VNS dosing parameters were altered as indicated clinically.Results. The baseline 28-item Hamilton Depression Rating Scale (HAMD-28) score averaged 34. After 3 months of VNS, response rates (o50 % reduction in baseline scores) reached 37 % and remission rates (HAMD-28 score <10) 17 %. Response rates increased to 53 % after 1 year of VNS, and remission rates reached 33 %. Response was defined as sustained if no relapse occurred during the first year of VNS after response onset ; 44 % of patients met these criteria. Median time to response was 9 months. Most frequent side-effects were voice alteration (63 % at 3 months of stimulation) and coughing (23 %).Conclusions. VNS therapy was effective in reducing severity of depression ; efficacy increased over time. Efficacy ratings were in the same range as those previously reported from a USA study using a similar protocol ; at 12 months, reduction of symptom severity was significantly higher in the European sample. This might be explained by a small but significant difference in the baseline HAMD-28 score and the lower number of treatments in the current episode in the European study.

show abstract

Vagus nerve stimulation is associated with mood improvements in epilepsy patients

Cited by 295 publications

References 21 publications

The P3 Event-Related Potential is a Biomarker for the Efficacy of Vagus Nerve Stimulation in Patients with Epilepsy

The P3 Event-Related Potential is a Biomarker for the Efficacy of Vagus Nerve Stimulation in Patients with Epilepsy

Increase in 20–50Hz (gamma frequencies) power spectrum and synchronization after chronic vagal nerve stimulation

Vagus nerve stimulation for depression: efficacy and safety in a European study

Contact Info

Product

Resources

About