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

Zobel, Astrid; Joe, Alexius; Freymann, Nikolaus; Clusmann, Hans; Schramm, Johannes; Reinhardt, Michael; Biersack, Hans-Jürgen; Maier, Wolfgang; Broich, Karl

doi:10.1016/j.pscychresns.2005.02.010

« Previous Next »Psychiatry Research: Neuroimaging
Volume 139, Issue 3 , Pages 165-179, 30 August 2005

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

Astrid Zobel
- Department of Psychiatry, University of Bonn, Sigmund-Freud-Straβe 25, 53105 Bonn, Germany
- Corresponding author. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Sigmund-Freud-Straβe 25, 53105 Bonn, Germany. Tel.: +49 228 2 87 5717; fax: +49 228 2 87 4760.
Alexius Joe
- Department of Nuclear Medicine, University of Bonn, Bonn, Germany
Nikolaus Freymann
- Department of Psychiatry, University of Bonn, Sigmund-Freud-Straβe 25, 53105 Bonn, Germany
Hans Clusmann
- Department of Neurosurgery, University of Bonn, Bonn, Germany
Johannes Schramm
- Department of Neurosurgery, University of Bonn, Bonn, Germany
Michael Reinhardt
- Department of Nuclear Medicine, University of Bonn, Bonn, Germany
Hans-Jürgen Biersack
- Department of Nuclear Medicine, University of Bonn, Bonn, Germany
Wolfgang Maier
- Department of Psychiatry, University of Bonn, Sigmund-Freud-Straβe 25, 53105 Bonn, Germany
Karl Broich
- Department of Psychiatry, University of Bonn, Sigmund-Freud-Straβe 25, 53105 Bonn, Germany

Received 8 December 2003; received in revised form 16 November 2004; accepted 28 February 2005.

Abstract

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.

Keywords: Vagus nerve stimulation, Treatment-resistant depression, HMPAO-SPECT