Transcutaneous Nerve Stimulation for Depression

This is a study that looks at using a device similar to the one I’ve been experimenting with in the clinic used for clinical depression. In this study, they show a decrease in depression and also fMRI changes in comparison to the sham treatment. Remember that there was a nice study from Japan that used indwelling needles and also showed a decrease in depression and an increase in HRV. They kindly sent me a reprint, here.TVNS and fmri

Biol Psychiatry. 2016 Feb 15;79(4):266-73. doi: 10.1016/j.biopsych.2015.03.025. Epub 2015 Apr 2.
Transcutaneous Vagus Nerve Stimulation Modulates Default Mode Network in Major Depressive Disorder.
Fang J1, Rong P2, Hong Y3, Fan Y3, Liu J3, Wang H3, Zhang G3, Chen X4, Shi S3, Wang L5, Liu R6, Hwang J4, Li Z7, Tao J8, Wang Y9, Zhu B6, Kong J4.
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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.