Transcutaneous vagus nerve stimulation modulates default mode network in major depressive disorder

Jiliang Fang, Peijing Rong, Yang Hong, Yangyang Fan, Jun Liu, Honghong Wang, Guolei Zhang, Xiaoyan Chen, Shan Shi, Liping Wang, Rupeng Liu, Jiwon Hwang, Zhengjie Li, Jing Tao, Yang Wang, Bing Zhu, Jian Kong

Research output: Contribution to journalArticle

69 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)266-273
Number of pages8
JournalBiological Psychiatry
Volume79
Issue number4
DOIs
StatePublished - Feb 15 2016
Externally publishedYes

Fingerprint

Vagus Nerve Stimulation
Transcutaneous Electric Nerve Stimulation
Major Depressive Disorder
Depression
Prefrontal Cortex
Therapeutics
Treatment-Resistant Depressive Disorder
Community Health Services
Parietal Lobe
Vagus Nerve
United States Food and Drug Administration
Mental Disorders
Ear
Costs and Cost Analysis
Brain

Keywords

  • Default mode network
  • fMRI
  • Functional connectivity
  • Major depressive disorder
  • Transcutaneous vagus nerve stimulation
  • Vagus nerve stimulation

ASJC Scopus subject areas

  • Biological Psychiatry

Cite this

Transcutaneous vagus nerve stimulation modulates default mode network in major depressive disorder. / Fang, Jiliang; Rong, Peijing; Hong, Yang; Fan, Yangyang; Liu, Jun; Wang, Honghong; Zhang, Guolei; Chen, Xiaoyan; Shi, Shan; Wang, Liping; Liu, Rupeng; Hwang, Jiwon; Li, Zhengjie; Tao, Jing; Wang, Yang; Zhu, Bing; Kong, Jian.

In: Biological Psychiatry, Vol. 79, No. 4, 15.02.2016, p. 266-273.

Research output: Contribution to journalArticle

Fang, J, Rong, P, Hong, Y, Fan, Y, Liu, J, Wang, H, Zhang, G, Chen, X, Shi, S, Wang, L, Liu, R, Hwang, J, Li, Z, Tao, J, Wang, Y, Zhu, B & Kong, J 2016, 'Transcutaneous vagus nerve stimulation modulates default mode network in major depressive disorder', Biological Psychiatry, vol. 79, no. 4, pp. 266-273. https://doi.org/10.1016/j.biopsych.2015.03.025
Fang, Jiliang ; Rong, Peijing ; Hong, Yang ; Fan, Yangyang ; Liu, Jun ; Wang, Honghong ; Zhang, Guolei ; Chen, Xiaoyan ; Shi, Shan ; Wang, Liping ; Liu, Rupeng ; Hwang, Jiwon ; Li, Zhengjie ; Tao, Jing ; Wang, Yang ; Zhu, Bing ; Kong, Jian. / Transcutaneous vagus nerve stimulation modulates default mode network in major depressive disorder. In: Biological Psychiatry. 2016 ; Vol. 79, No. 4. pp. 266-273.
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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.",
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AU - Zhang, Guolei

AU - Chen, Xiaoyan

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AU - Zhu, Bing

AU - Kong, Jian

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