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Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
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Vagus Nerve Stimulation Modulates Inflammation in Treatment-Resistant Depression Patients: A Pilot Study.

Paul Lespérance1, Véronique Desbeaumes Jodoin1, David Drouin2

  • 1Department of Psychiatry, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC H2X 0C1, Canada.

International Journal of Molecular Sciences
|March 13, 2024
PubMed
Summary

Vagal neurostimulation (VNS) significantly improved depression and anxiety symptoms in patients with treatment-resistant depression. The therapy also modulated inflammatory biomarkers, suggesting a novel treatment pathway.

Keywords:
blood–brain barrierinflammationmajor depressionneuromodulation

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Area of Science:

  • Neuroscience
  • Immunology
  • Psychiatry

Background:

  • Vagal neurostimulation (VNS) is an established treatment for epilepsy and treatment-resistant depression.
  • VNS exhibits known neuropsychiatric effects and systemic anti-inflammatory activity.

Purpose of the Study:

  • To evaluate the long-term clinical efficacy of VNS in patients with refractory depression.
  • To investigate the impact of VNS on plasma inflammatory biomarkers.

Main Methods:

  • Six patients with treatment-resistant depression received VNS therapy.
  • Depression and anxiety symptoms were assessed using standardized rating scales.
  • Plasma samples were analyzed for 40 soluble molecules before and after long-term VNS therapy.

Main Results:

  • VNS therapy led to a 59.9% reduction in depression severity and an 87% response rate.
  • Significant reductions in anxiety symptoms were observed.
  • Specific inflammatory markers (IL-7, CXCL8, CCL2, CCL13, CCL17, CCL22, Flt-1, VEGFc) decreased, while bFGF increased post-VNS.

Conclusions:

  • VNS demonstrates significant long-term efficacy in treating refractory depression and anxiety.
  • VNS modulates specific inflammatory pathways, potentially via enhanced blood-brain barrier integrity and reduced inflammatory cell recruitment.
  • These findings suggest VNS as a promising therapeutic strategy targeting neuroinflammation in depression.