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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Sherry on April 4, 2000, at 8:26:36
Does anyone have any new info. on the studies that are being done with the implant for depression?
Posted by Scott L. Schofield on April 4, 2000, at 9:37:16
In reply to Vagus Nerve Stimulation, posted by Sherry on April 4, 2000, at 8:26:36
> Does anyone have any new info. on the studies that are being done with the implant for depression?
The results of VNS investigations seem to be more encouraging than those of rTMS.
http://www.pslgroup.com/dg/15131a.htm
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Vagus Nerve Stimulation Successful For DepressionDALLAS, TX -- December 16, 1999 - A nationwide clinical trial has shown Vagus Nerve Stimulation (VNS), an electrical stimulation therapy currently used to combat epilepsy, to be a promising new method for treating patients with severe treatment-resistant depression.
Results of the VNS pilot study showed that 40 percent of the treated patients displayed at least a 50 percent or greater improvement in their condition... Half the patients also had at least a 50-percent improvement on the Montgomery Asberg Depression Rating Scale. The condition of several patients improved so substantially that they were able to return to work or other normal activities. All the patients who responded to the treatment have continued to do well.
The Food and Drug Administration has approved an expanded, 94-patient trial of VNS at up to 15 medical centers to begin next year. Houston-based Cyberonics, which helped fund the research, developed the treatment and devices. The firm has said that the study may ultimately involve 200 patients at up to 20 medical centers. The NCP System used to deliver VNS is not currently approved for the treatment of depression.
"The vagus nerve carries information to many areas of the brain that control mood, sleep and other functions," Rush said. VNS treatment involves stimulating the left vagus nerve in the neck with a series of miniscule electrical pulses traveling through a small surgically implanted wire attached to a pulse generator in the chest. The pulse generator delivers stimulation to the vagus nerve in individualized therapeutic "doses."
Following surgery to implant the pulse generator in the upper chest and tunnel the wires into the neck, where they were wrapped around the left vagus nerve, patients received no electrical stimulation while they healed, a two-week period for most.
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3 : Biol Psychiatry 2000 Feb 15;47(4):287-95
Related Articles, BooksVagus nerve stimulation: a new tool for brain research and therapy.
George MS, Sackeim HA, Rush AJ, Marangell LB, Nahas Z, Husain MM, Lisanby S, Burt T, Goldman J, Ballenger JC
Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Biological psychiatry has a long history of using somatic therapies to treat neuropsychiatric illnesses and to understand brain function. These methods have included neurosurgery, electroconvulsive therapy, and, most recently, transcranial magnetic stimulation. Fourteen years ago researchers discovered that intermittent electrical stimulation of the vagus nerve produces inhibition of neural processes, which can alter brain electrical activity and terminate seizures in dogs. Since then, approximately 6000 people worldwide have received vagus nerve stimulation for treatment-resistant epilepsy. We review the neurobiology and anatomy of the vagus nerve and provide an overview of the vagus nerve stimulation technique. We also describe the safety and potential utility of vagus nerve stimulation as a neuroscience research tool and as a putative treatment for psychiatric conditions. Vagus nerve stimulation appears to be a promising new somatic intervention that may improve our understanding of brain function and has promise in the treatment of neuropsychiatric disorders.
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: Biol Psychiatry 2000 Feb 15;47(4):276-86
Related Articles, BooksVagus nerve stimulation (VNS) for treatment-resistant depressions: a multicenter study.
Rush AJ, George MS, Sackeim HA, Marangell LB, Husain MM, Giller C, Nahas Z, Haines S, Simpson RK Jr, Goodman R
Departments of Psychiatry and Neurosurgery, University of Texas Southwestern Medical Center, Dallas 75235-9086, USA.
BACKGROUND: Vagus Nerve Stimulation (VNS) delivered by the NeuroCybernetic Prosthesis (NCP) System was examined for its potential antidepressant effects. METHODS: Adult outpatients (n = 30) with nonpsychotic, treatment-resistant major depressive (n = 21) or bipolar I (n = 4) or II (n = 5; depressed phase) disorders who had failed at least two robust medication trials in the current major depressive episode (MDE) while on stable medication regimens completed a baseline period followed by NCP System implantation. A 2-week, single-blind recovery period (no stimulation) was followed by 10 weeks of VNS. RESULTS: In the current MDE (median length = 4.7 years), patients had not adequately responded to two (n = 9), three (n = 2), four (n = 6), or five or more (n = 13) robust antidepressant medication trials or electroconvulsive therapy (n = 17). Baseline 28-item Hamilton Depression Rating Scale (HDRS(28)) scores averaged 38.0. Response rates (> or =50% reduction in baseline scores) were 40% for both the HDRS(28) and the Clinical Global Impressions-Improvement index (score of 1 or 2) and 50% for the Montgomery-Asberg Depression Rating Scale. Symptomatic responses (accompanied by substantial functional improvement) have been largely sustained during long-term follow-up to date. CONCLUSIONS: These open trial results suggest that VNS has antidepressant effects in treatment-resistant depressions.
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Posted by Noa on April 4, 2000, at 12:22:41
In reply to Re: Vagus Nerve Stimulation, posted by Scott L. Schofield on April 4, 2000, at 9:37:16
One thing I have heard, from recent news coverage, and from a friend of a friend with epilepsy who has the vagus nerve stimulator, is that one problem to adapt to is the way it affects your voice. If you are talking when the pulse is emitted, it makes your vocal chords very shaky and interferes with voice production. Of course, it passes. But I imagine this would be a big adjustment for many people.
Posted by Sherry on April 4, 2000, at 13:12:09
In reply to Re: Vagus Nerve Stimulation, posted by Noa on April 4, 2000, at 12:22:41
Thanks for the website Scott. I found a lot of valuable info. there.
And Noa thank you. I have been really feeling hopeless today, and kind of grasping at straws for some shred of hope. The voice thingy would be the least of my concerns. If it would help me enjoy life again, I wouldn't care if it made me leap tall buildings in a single bound.> One thing I have heard, from recent news coverage, and from a friend of a friend with epilepsy who has the vagus nerve stimulator, is that one problem to adapt to is the way it affects your voice. If you are talking when the pulse is emitted, it makes your vocal chords very shaky and interferes with voice production. Of course, it passes. But I imagine this would be a big adjustment for many people.
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