Academic Journal
A pilot study of vagus nerve stimulation (VNS) for treatment-resistant anxiety disorders
| العنوان: | A pilot study of vagus nerve stimulation (VNS) for treatment-resistant anxiety disorders |
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| المؤلفون: | Mark S. George, MD, Herbert E. Ward, Jr., MD, Philip T. Ninan, MD, Mark Pollack, MD, Ziad Nahas, MD, Berry Anderson, RN, Samet Kose, MD, Robert H. Howland, MD, Wayne K. Goodman, MD, James C. Ballenger, MD |
| المصدر: | Brain Stimulation, Vol 1, Iss 2, Pp 112-121 (2008) |
| بيانات النشر: | Elsevier |
| سنة النشر: | 2008 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | vagus nerve stimulation (VNS), anxiety disorder, obsessive compulsive disorder, panic disorder, posttraumatic stress disorder, clinical trial, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571 |
| الوصف: | Background: Vagus nerve stimulation (VNS) is an effective anticonvulsant device and has shown antidepressant effects in chronic treatment resistant depression. Because the vagus nerve sends information to brain regions important in anxiety regulation (locus coeruleus, orbitofrontal cortex, insula, hippocampus and amygdala), this pathway might be involved in perceiving or manifesting various somatic and cognitive symptoms that characterize anxiety disorders. On the basis of this reasoning and reports of anxiolytic effects of VNS in patients treated for epilepsy and depression, we organized an open-label pilot acute trial of adjunctive VNS on top of stable medications, followed by long-term follow-up, to assess the safety and potential efficacy of VNS for patients with treatment resistant anxiety disorders. Methods: Eleven adult outpatients with treatment resistant obsessive-compulsive disorder (OCD), panic disorder (PD), or posttraumatic stress disorder (PTSD) were recruited. Patients had failed several medication trials as well as cognitive behavioral therapy (CBT). All patients were rated with the Hamilton Anxiety Scale (HAM-A) and the clinical global impressions improvement scale (CGI-I). Patients with OCD were also rated with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Patients were maintained on their current psychotropic medications at fixed doses during the acute 12-week phase. Changes in medications and VNS stimulus parameters were allowed during the long-term follow-up. Response was defined as a 50% or greater improvement on the HAM-A for all patients and a 25% or greater improvement on the Y-BOCS for patients with OCD. Results: Eleven patients were recruited. Seven patients had a primary diagnosis of OCD, two had PTSD, and one had PD. One OCD patient changed their mind and was never implanted. One patient with OCD withdrew consent before the end of the acute phase, so long-term results were available for nine patients. Three patients were acute responders, based on the HAM-A, and there was some ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1935-861X |
| Relation: | http://www.sciencedirect.com/science/article/pii/S1935861X0800003X; https://doaj.org/toc/1935-861X; https://doaj.org/article/1233e4a2eec041ab92724666f50aa939 |
| DOI: | 10.1016/j.brs.2008.02.001 |
| الاتاحة: | https://doi.org/10.1016/j.brs.2008.02.001 https://doaj.org/article/1233e4a2eec041ab92724666f50aa939 |
| رقم الانضمام: | edsbas.25AF4073 |
| قاعدة البيانات: | BASE |
| تدمد: | 1935861X |
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| DOI: | 10.1016/j.brs.2008.02.001 |