Vagus nerve stimulation…25 years later! What do we know about the effects on cognition?

Vonck, Kristl; Raedt, Robrecht; Naulaerts, Joke; Vogelaere, Frederick De; Thiery, Evert; Roost, Dirk Van; Aldenkamp, Bert; Miatton, Marijke; Boon, Paul

doi:10.1016/j.neubiorev.2014.05.005

Cited by 157 publications

(122 citation statements)

References 68 publications

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“…However, a recent review21 suggested, ‘short-term VNS studies show a positive effect on memory consolidation, enhancing recognition and recall performance; though there is no compelling evidence for improvement in patients’ subjective evaluation of their memory and cognitive functioning after treatment with long-term VNS’.…”

Section: Comparative Review Resultsmentioning

confidence: 99%

“…Moreover, treatment with CRS was not associated with cognitive decline when tested through 2 years and in fact there were small but significant beneficial treatment effects on naming in patients with neocortical onsets and modest improvements in verbal learning for patients with seizure onsets in mesial temporal structures 22. VNS too has demonstrated short-term improvements in cognition 21. However, consistent long-term improvements have not been demonstrated.…”

Section: Discussionmentioning

confidence: 97%

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Comparing neurostimulation technologies in refractory focal-onset epilepsy

Gooneratne

Green

Dugan

et al. 2016

J Neurol Neurosurg Psychiatry

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For patients with pharmacoresistant focal epilepsy in whom surgical resection of the epileptogenic focus fails or was not feasible in the first place, there were few therapeutic options. Increasingly, neurostimulation provides an alternative treatment strategy for these patients. Vagal nerve stimulation (VNS) is well established. Deep brain stimulation (DBS) and cortical responsive stimulation (CRS) are newer neurostimulation therapies with recently published long-term efficacy and safety data. In this literature review, we introduce these therapies to a non-specialist audience. Furthermore, we compare and contrast long-term (5-year) outcomes of newer neurostimulation techniques with the more established VNS. A search to identify all studies reporting long-term efficacy (>5 years) of VNS, CRS and DBS in patients with refractory focal/partial epilepsy was conducted using PubMed and Cochrane databases. The outcomes compared were responder rate, percentage seizure frequency reduction, seizure freedom, adverse events, neuropsychological outcome and quality of life. We identified 1 study for DBS, 1 study for CRS and 4 studies for VNS. All neurostimulation technologies showed long-term efficacy, with progressively better seizure control over time. Sustained improvement in quality of life measures was demonstrated in all modalities. Intracranial neurostimulation had a greater side effect profile compared with extracranial stimulation, though all forms of stimulation are safe. Methodological differences between the studies mean that direct comparisons are not straightforward. We have synthesised the findings of this review into a pragmatic decision tree, to guide the further management of the individual patient with pharmacoresistant focal-onset epilepsy.

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Section: Comparative Review Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Comparing neurostimulation technologies in refractory focal-onset epilepsy

Gooneratne

Green

Dugan

et al. 2016

J Neurol Neurosurg Psychiatry

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“…This is a new noninvasive method to stimulate the vagus nerve, presented for the first time by Ventureyra (2000; see also Vonck et al, 2014). tVNS stimulates the afferent auricular branch of the vagus nerve located medial of the tragus at the entry of the acoustic meatus (Kreuzer et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous Vagus Nerve Stimulation Enhances Post-error Slowing

Sellaro

Leusden

Tona

et al. 2015

Journal of Cognitive Neuroscience

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People tend to slow down after they commit an error, a phenomenon known as post-error slowing (PES). It has been proposed that slowing after negative feedback or unforeseen errors is linked to the activity of the locus coeruleus-norepinephrine (LC-NE) system, but there is little direct evidence for this hypothesis. Here, we assessed the causal role of the noradrenergic system in modulating PES by applying transcutaneous vagus nerve stimulation (tVNS), a new noninvasive and safe method to stimulate the vagus nerve and to increase NE concentrations in the brain. A single-blind, sham-controlled, between-group design was used to assess the effect of tVNS in healthy young volunteers (n = 40) during two cognitive tasks designed to measure PES. Results showed increased PES during active tVNS, as compared with sham stimulation. This effect was of similar magnitude for the two tasks. These findings provide evidence for an important role of the noradrenergic system in PES.

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“…Cardiac vagal tone is also associated with both adaptive top-down and bottom-up modulation of emotional processing, which is implicated in depression (Park et al, 2013). From both animal and human neurochemical and neuroimaging studies as well as from studies using vagus nerve stimulation (VNS) – a therapeutic brain stimulation technique sending electrical impulses to the left cervical vagus nerve, which is approved as an adjunct long-term treatment for chronic or recurrent depression – there is considerable evidence that the vagus nerve and its stimulation influence limbic and higher cortical brain regions implicated in mood disorders (Park et al, 2007; Vonck et al, 2014). RSA-biofeedback and breathing training has also been shown to increase vagal modulation and to reduce depressive symptoms (Siepmann et al, 2008; Patron et al, 2012).…”

Section: Proposed Therapeutic Training Strategies Based On Current Scmentioning

confidence: 99%

The development of an RDoC-based treatment program for adolescent depression: â€œTraining for Awareness, Resilience, and Actionâ€ (TARA)

Blom

Duncan

et al. 2014

Front. Hum. Neurosci.

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Major depressive disorder (MDD) is one of the current leading causes of disability worldwide. Adolescence is a vulnerable period for the onset of depression, with MDD affecting 8–20% of all youth. Traditional treatment methods have not been sufficiently effective to slow the increasing prevalence of adolescent depression. We therefore propose a new model for the treatment of adolescent depression – Training for Awareness, Resilience, and Action (TARA) – that is based on current understanding of developmental and depression neurobiology. The TARA model is aligned with the Research Domain Criteria (RDoC) of the National Institute of Mental Health. In this article, we first address the relevance of RDoC to adolescent depression. Second, we identify the major RDoC domains of function involved in adolescent depression and organize them in a way that gives priority to domains thought to be driving the psychopathology. Third, we select therapeutic training strategies for TARA based on current scientific evidence of efficacy for the prioritized domains of function in a manner that maximizes time, resources, and feasibility. The TARA model takes into consideration the developmental limitation in top-down cognitive control in adolescence and promotes bottom-up strategies such as vagal afference to decrease limbic hyperactivation and its secondary effects. The program has been informed by mindfulness-based therapy and yoga, as well as modern psychotherapeutic techniques. The treatment program is semi-manualized, progressive, and applied in a module-based approach designed for a group setting that is to be conducted one session per week for 12 weeks. We hope that this work may form the basis for a novel and more effective treatment strategy for adolescent depression, as well as broaden the discussion on how to address this challenge.

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Vagus nerve stimulation…25 years later! What do we know about the effects on cognition?

Cited by 157 publications

References 68 publications

Comparing neurostimulation technologies in refractory focal-onset epilepsy

Comparing neurostimulation technologies in refractory focal-onset epilepsy

Transcutaneous Vagus Nerve Stimulation Enhances Post-error Slowing

The development of an RDoC-based treatment program for adolescent depression: â€œTraining for Awareness, Resilience, and Actionâ€ (TARA)

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Vagus nerve stimulation…25 years later! What do we know about the effects on cognition?

Cited by 157 publications

References 68 publications

Comparing neurostimulation technologies in refractory focal-onset epilepsy

Comparing neurostimulation technologies in refractory focal-onset epilepsy

Transcutaneous Vagus Nerve Stimulation Enhances Post-error Slowing

The development of an RDoC-based treatment program for adolescent depression: â€œTraining for Awareness, Resilience, and Actionâ€ (TARA)

Contact Info

Product

Resources

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The development of an RDoC-based treatment program for adolescent depression: â€œTraining for Awareness, Resilience, and Actionâ€ (TARA)