Vagus nerve stimulation and deep brain stimulation: implantable device-related neurostimulation for treatment-resistant mood disorders

Abstract

There has been a growth of interest in recent years in exploring the therapeutic potential of device-related neurostimulation techniques for individuals with treatment-resistant depression (TRD). The renaissance of interest in the role of neurostimulation for TRD has emerged from multiple factors. There is the recognition that more than one in three patients with major depressive disorder (MDD) remain symptomatic despite conventional pharmacological and psychotherapeutic interventions. Recurrent MDD is associated with an average decrease in life expectancy of seven years in women and over ten years in men. Furthermore, greater understanding of the neural correlates of antidepressant response and advances in technology have provided multiple means of modulating activity in key structures in the brain involved in mood regulation, which confer an opportunity to improve the outcomes of those with TRD. The purpose of this chapter is to review the data on the efficacy, safety, and mechanisms of action of vagus nerve stimulation (VNS) and deep brain stimulation (DBS), two invasive brain stimulation approaches for TRD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)