Cerebral blood flow changes during vagus nerve stimulation for depression

Positron emission tomography (PET oxygen-15 labeled water or PET [15O]H2O) was used to identify changes in regional cerebral blood flow (rCBF) in response to acute vagus nerve stimulation (VNS) in four subjects with treatment-resistant major depression (TRMD). Four 90-s PET [15O]H2O scans were performed on each subject in an off-on sequence (2 VNS de-activated; 2 VNS activated). PET images were aligned, normalized for global uptake, and resampled to standard atlas space. Statistical t-images were used to evaluate change. VNS-induced increases in rCBF were found in the bilateral orbitofrontal cortex, bilateral anterior cingulate cortex, and right superior and medial frontal cortex. Decreases were found in the bilateral temporal cortex and right parietal area. Regions of change were consistent with brain structures associated with depression and the afferent pathways of the vagus nerve.

[1]  R. Myers Quantification of brain function using PET , 1996 .

[2]  W. Maier,et al.  Changes in regional cerebral blood flow by therapeutic vagus nerve stimulation in depression: An exploratory approach , 2005, Psychiatry Research: Neuroimaging.

[3]  J. Mazziotta,et al.  Rapid Automated Algorithm for Aligning and Reslicing PET Images , 1992, Journal of computer assisted tomography.

[4]  H. Mayberg Positron emission tomography imaging in depression: a neural systems perspective. , 2003, Neuroimaging clinics of North America.

[5]  Vagus nerve stimulation , 2001 .

[6]  J. Talairach,et al.  Co-Planar Stereotaxic Atlas of the Human Brain: 3-Dimensional Proportional System: An Approach to Cerebral Imaging , 1988 .

[7]  T L Faber,et al.  Acute blood flow changes and efficacy of vagus nerve stimulation in partial epilepsy , 1999, Neurology.

[8]  D. Bohning,et al.  Feasibility of Vagus Nerve Stimulation–Synchronized Blood Oxygenation Level–Dependent Functional MRI , 2001, Investigative radiology.

[9]  T L Faber,et al.  Brain Blood Flow Alterations Induced by Therapeutic Vagus Nerve Stimulation in Partial Epilepsy: I. Acute Effects at High and Low Levels of Stimulation , 1998, Epilepsia.

[10]  C. Nahmias,et al.  Regional Cerebral Blood Flow in Man Manipulated by Direct Vagal Stimulation , 1992, Pacing and clinical electrophysiology : PACE.

[11]  Thomas R. Henry,et al.  Therapeutic mechanisms of vagus nerve stimulation , 2002, Neurology.

[12]  Z. Nahas,et al.  Vagus nerve stimulation (VNS) synchronized BOLD fMRI suggests that VNS in depressed adults has frequency/dose dependent effects. , 2002, Journal of psychiatric research.

[13]  H N Wagner,et al.  Paralimbic hypoperfusion in unipolar depression. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[14]  M. Raichle,et al.  A functional anatomical study of unipolar depression , 1992, The Journal of neuroscience : the official journal of the Society for Neuroscience.