A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder

Background: Major depression is the fourth leading cause of disability worldwide and poses a socioeconomic burden worldwide. Transcutaneous vagus nerve stimulation (tVNS) is a promising noninvasive clinical device that may reduce the severity of major depression. However, the neural mechanism underl...

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Main Authors: Yiheng Tu, Jiliang Fang, Jin Cao, Zengjian Wang, Joel Park, Kristen Jorgenson, Courtney Lang, Jun Liu, Guolei Zhang, Yanping Zhao, Bing Zhu, Peijing Rong, Jian Kong
Format: Article
Language:English
Published: Elsevier 2018-05-01
Series:Brain Stimulation
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1935861X18300342
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spelling doaj-0a19b432206a41febd97f3041d8b99582021-03-19T07:11:37ZengElsevierBrain Stimulation1935-861X2018-05-01113501508A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorderYiheng Tu0Jiliang Fang1Jin Cao2Zengjian Wang3Joel Park4Kristen Jorgenson5Courtney Lang6Jun Liu7Guolei Zhang8Yanping Zhao9Bing Zhu10Peijing Rong11Jian Kong12Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USAGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaDepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA; School of Acupuncture Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USADepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USADepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USADepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USAGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaInstitution of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, ChinaInstitution of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China; Corresponding author. Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, No 16. Dongzhimen Nan Xiao Street, Dongcheng District, Beijing 100700, China.Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA; Corresponding author. Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Building 120, 2nd Ave, Suite 101C, Charlestown, MA 02129, USA.Background: Major depression is the fourth leading cause of disability worldwide and poses a socioeconomic burden worldwide. Transcutaneous vagus nerve stimulation (tVNS) is a promising noninvasive clinical device that may reduce the severity of major depression. However, the neural mechanism underlying continuous tVNS has not yet been elucidated. Objective: We aimed to explore the effect of hypothalamic subregion functional connectivity (FC) changes during continuous tVNS treatment on major depressive disorder (MDD) patients and to identify the potential biomarkers for treatment outcomes. Methods: Forty-one mild to moderate MDD patients were recruited and received either real or sham tVNS treatment for 4 weeks. We used a seed-to-whole brain approach to estimate the FC changes of hypothalamic subregions and their surrounding control areas during continuous tVNS treatment and explored their association with clinical outcome changes after 4 weeks of treatment. Results: Of the thirty-six patients that completed the study, those in the tVNS group had significantly lower scores on the 24-item Hamilton Depression (HAM-D) Rating Scale compared to the sham tVNS group after 4 weeks of treatment. The FC between the bilateral medial hypothalamus (MH) and rostral anterior cingulate cortex (rACC) was significantly decreased during tVNS but not during sham tVNS. The strength of this FC was significantly correlated with HAM-D improvements after 4 weeks of tVNS. Conclusion: The FC between the bilateral MH and rACC may serve as a potential biomarker for the tVNS state and predict treatment responses. Our results provide insights into the neural modulation mechanisms of continuous tVNS and reveal a potential therapeutic target for MDD patients.http://www.sciencedirect.com/science/article/pii/S1935861X18300342Major depressive disorderHypothalamusRostral anterior cingulate cortexFunctional connectivityBiomarkerTranscutaneous vagus nerve stimulation
collection DOAJ
language English
format Article
sources DOAJ
author Yiheng Tu
Jiliang Fang
Jin Cao
Zengjian Wang
Joel Park
Kristen Jorgenson
Courtney Lang
Jun Liu
Guolei Zhang
Yanping Zhao
Bing Zhu
Peijing Rong
Jian Kong
spellingShingle Yiheng Tu
Jiliang Fang
Jin Cao
Zengjian Wang
Joel Park
Kristen Jorgenson
Courtney Lang
Jun Liu
Guolei Zhang
Yanping Zhao
Bing Zhu
Peijing Rong
Jian Kong
A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder
Brain Stimulation
Major depressive disorder
Hypothalamus
Rostral anterior cingulate cortex
Functional connectivity
Biomarker
Transcutaneous vagus nerve stimulation
author_facet Yiheng Tu
Jiliang Fang
Jin Cao
Zengjian Wang
Joel Park
Kristen Jorgenson
Courtney Lang
Jun Liu
Guolei Zhang
Yanping Zhao
Bing Zhu
Peijing Rong
Jian Kong
author_sort Yiheng Tu
title A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder
title_short A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder
title_full A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder
title_fullStr A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder
title_full_unstemmed A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder
title_sort distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder
publisher Elsevier
series Brain Stimulation
issn 1935-861X
publishDate 2018-05-01
description Background: Major depression is the fourth leading cause of disability worldwide and poses a socioeconomic burden worldwide. Transcutaneous vagus nerve stimulation (tVNS) is a promising noninvasive clinical device that may reduce the severity of major depression. However, the neural mechanism underlying continuous tVNS has not yet been elucidated. Objective: We aimed to explore the effect of hypothalamic subregion functional connectivity (FC) changes during continuous tVNS treatment on major depressive disorder (MDD) patients and to identify the potential biomarkers for treatment outcomes. Methods: Forty-one mild to moderate MDD patients were recruited and received either real or sham tVNS treatment for 4 weeks. We used a seed-to-whole brain approach to estimate the FC changes of hypothalamic subregions and their surrounding control areas during continuous tVNS treatment and explored their association with clinical outcome changes after 4 weeks of treatment. Results: Of the thirty-six patients that completed the study, those in the tVNS group had significantly lower scores on the 24-item Hamilton Depression (HAM-D) Rating Scale compared to the sham tVNS group after 4 weeks of treatment. The FC between the bilateral medial hypothalamus (MH) and rostral anterior cingulate cortex (rACC) was significantly decreased during tVNS but not during sham tVNS. The strength of this FC was significantly correlated with HAM-D improvements after 4 weeks of tVNS. Conclusion: The FC between the bilateral MH and rACC may serve as a potential biomarker for the tVNS state and predict treatment responses. Our results provide insights into the neural modulation mechanisms of continuous tVNS and reveal a potential therapeutic target for MDD patients.
topic Major depressive disorder
Hypothalamus
Rostral anterior cingulate cortex
Functional connectivity
Biomarker
Transcutaneous vagus nerve stimulation
url http://www.sciencedirect.com/science/article/pii/S1935861X18300342
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