Jiliang Fang1, Peijing Rong2, Yang Hong3, Yangyang Fan3, Jun Liu3, Honghong Wang3, Guolei Zhang3, Xiaoyan Chen4, Shan Shi3, Liping Wang5, Rupeng Liu6, Jiwon Hwang4, Zhengjie Li7, Jing Tao8, Yang Wang9, Bing Zhu6, Jian Kong4. 1. Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.; Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China. 2. Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.. Electronic address: rongpj@hotmail.com. 3. Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China. 4. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 5. Huguosi Hospital, Beijing University of Chinese Medicine, Beijing. 6. Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.; Hospital of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing. 7. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.; Acupuncture & Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu. 8. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China. 9. Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Abstract
BACKGROUND: Depression is the most common form of mental disorder in community and health care settings and current treatments are far from satisfactory. Vagus nerve stimulation (VNS) is a Food and Drug Administration approved somatic treatment for treatment-resistant depression. However, the involvement of surgery has limited VNS only to patients who have failed to respond to multiple treatment options. Transcutaneous VNS (tVNS) is a relatively new, noninvasive VNS method based on the rationale that there is afferent/efferent vagus nerve distribution on the surface of the ear. The safe and low-cost characteristics of tVNS have the potential to significantly expand the clinical application of VNS. METHODS: In this study, we investigated how tVNS can modulate the default mode network (DMN) functional connectivity (FC) in mild or moderate major depressive disorder (MDD) patients. Forty-nine MDD patients were recruited and received tVNS or sham tVNS (stVNS) treatments. RESULTS: Thirty-four patients completed the study and were included in data analysis. After 1 month of tVNS treatment, the 24-item Hamilton Depression Rating Scale score reduced significantly in the tVNS group as compared with the stVNS group. The FC between the DMN and anterior insula and parahippocampus decreased; the FC between the DMN and precuneus and orbital prefrontal cortex increased compared with stVNS. All these FC increases are also associated with 24-item Hamilton Depression Rating Scale reduction. CONCLUSIONS: tVNS can significantly modulate the DMN FC of MDD patients; our results provide insights to elucidate the brain mechanism of tVNS treatment for MDD patients.
BACKGROUND:Depression is the most common form of mental disorder in community and health care settings and current treatments are far from satisfactory. Vagus nerve stimulation (VNS) is a Food and Drug Administration approved somatic treatment for treatment-resistant depression. However, the involvement of surgery has limited VNS only to patients who have failed to respond to multiple treatment options. Transcutaneous VNS (tVNS) is a relatively new, noninvasive VNS method based on the rationale that there is afferent/efferent vagus nerve distribution on the surface of the ear. The safe and low-cost characteristics of tVNS have the potential to significantly expand the clinical application of VNS. METHODS: In this study, we investigated how tVNS can modulate the default mode network (DMN) functional connectivity (FC) in mild or moderate major depressive disorder (MDD) patients. Forty-nine MDDpatients were recruited and received tVNS or sham tVNS (stVNS) treatments. RESULTS: Thirty-four patients completed the study and were included in data analysis. After 1 month of tVNS treatment, the 24-item Hamilton Depression Rating Scale score reduced significantly in the tVNS group as compared with the stVNS group. The FC between the DMN and anterior insula and parahippocampus decreased; the FC between the DMN and precuneus and orbital prefrontal cortex increased compared with stVNS. All these FC increases are also associated with 24-item Hamilton Depression Rating Scale reduction. CONCLUSIONS:tVNS can significantly modulate the DMN FC of MDDpatients; our results provide insights to elucidate the brain mechanism of tVNS treatment for MDDpatients.
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