Early cortical biomarkers of longitudinal transcutaneous vagus nerve stimulation treatment success in depression.
Early cortical biomarkers of longitudinal transcutaneous vagus nerve stimulation treatment success in depression.
复制标题
纵向穿迷走神经刺激治疗抑郁症的早期皮质生物标志物。
DOI：
10.1016/j.nicl.2016.12.016
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Kong J
中科院分区：
文献类型：
--
作者：
Fang J;Egorova N;Rong P;Liu J;Hong Y;Fan Y;Wang X;Wang H;Yu Y;Ma Y;Xu C;Li S;Zhao J;Luo M;Zhu B;Kong J
经皮迷走神经刺激（tVNS）是一种通过迷走神经耳分支进行脑刺激的非侵入性方法，在几项初步研究中显示出治疗重度抑郁症（MDD）的良好结果。然而，对抑郁症的影响可能实现的神经机制尚未得到充分研究，只有少数神经影像学研究证明了tVNS诱导的健康志愿者大脑变化。识别特定的神经通路，这是受tVNS与假相比，在抑郁症患者，以及确定tVNS治疗成功的神经生物标志物，需要推进tVNS的MDD的应用。为了解决这些问题，我们测量了38名抑郁症患者的fMRI脑活动，这些患者被分配接受tVNS（n = 17）或假手术（n = 21）治疗4周，在第一次刺激期间。结果显示，tVNS和假刺激的直接比较显示，左前额叶的fMRI信号显著增加。重要的是，tVNS组中第一次刺激期间的ESTA激活水平与四周治疗结束时的临床改善显著相关，如汉密尔顿抑郁评定量表（HAM-D）评分所示。我们的研究结果表明，前额叶fMRI活动可以作为一个潜在的皮质生物标志物和tVNS纵向治疗成功的早期预测。经皮迷走神经刺激（tVNS）用于治疗抑郁症（75）。在tVNS过程中观察到左前额叶显著的fMRI激活（81）。首次治疗期间的胰岛活化与临床改善相关（85）。
Transcutaneous vagus nerve stimulation (tVNS), a non-invasive method of brain stimulation through the auricular branch of the vagus nerve, has shown promising results in treating major depressive disorder (MDD) in several pilot studies. However, the neural mechanism by which the effect on depression might be achieved has not been fully investigated, with only a few neuroimaging studies demonstrating tVNS-induced changes in the brains of healthy volunteers. Identifying specific neural pathways, which are influenced by tVNS compared with sham in depressed individuals, as well as determining neurobiomarkers of tVNS treatment success are needed to advance the application of tVNS for MDD. In order to address these questions, we measured fMRI brain activity of thirty-eight depressed patients assigned to undergo tVNS (n = 17) or sham (n = 21) treatment for 4 weeks, during the first stimulation session. The results showed significant fMRI signal increases in the left anterior insula, revealed by a direct comparison of tVNS and sham stimulation. Importantly, the insula activation level during the first stimulation session in the tVNS group was significantly associated with the clinical improvement at the end of the four-week treatment, as indicated by the Hamilton Depression Rating Scale (HAM-D) score. Our findings suggest that anterior insula fMRI activity could serve as a potential cortical biomarker and an early predictor of tVNS longitudinal treatment success. Transcutaneous vagus nerve stimulation (tVNS) was used to treat depression (75). Significant fMRI activation in the left anterior insula was observed during tVNS (81). Insula activation during the first treatment was associated with clinical improvement (85).