The effects of vagus nerve stimulation on cognitive performance in patients with treatment-resistant depression
by
Sackeim HA, Keilp JG, Rush AJ, George MS, Marangell LB, Dormer JS,
Burt T, Lisanby SH, Husain M, Cullum CM, Oliver N, Zboyan H
Department of Biological Psychiatry,
New York State Psychiatric Institute,
New York 10032, USA. has1@columbia.edu
Neuropsychiatry Neuropsychol Behav Neurol 2001 Jan; 14(1):53-62


ABSTRACT

BACKGROUND: Chronic vagus nerve stimulation (VNS) is effective in the management of treatment-resistant epilepsy. Open-trial evidence suggests that VNS has clinically significant antidepressant effects in some individuals who experience treatment-resistant major depressive episodes. However, limited information regarding the effects of VNS on neurocognitive performance exists. OBJECTIVE: The primary aim of this study was to determine whether VNS leads to neurocognitive deterioration. METHOD: A neuropsychological battery was administered to 27 patients with treatment-resistant depression before and after 10 weeks of VNS. Thirteen neurocognitive tests sampled the domains of motor speed, psychomotor function, language, attention, memory, and executive function. RESULTS: No evidence of deterioration in any neurocognitive measure was detected. Relative to baseline, improvement in motor speed (finger tapping), psychomotor function (digit-symbol test), language (verbal fluency), and executive functions (logical reasoning, working memory, response inhibition, or impulsiveness) was found. For some measures, improved neurocognitive performance correlated with the extent of reduction in depressive symptoms, but VNS output current was not related to changes in cognitive performance. CONCLUSIONS: Vagus nerve stimulation in treatment-resistant depression may result in enhanced neurocognitive function, primarily among patients who show clinical improvement. Controlled investigation is needed to rule out the contribution of practice effects.
rTMS
TCAs
SSRIs
RIMAs
Bupropion
Amineptine
Reboxetine
Nefazodone
Mirtazapine
Venlafaxine
Tranylcypromine
Vagus nerve stimulation
Vagus nerve and cytokines


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