Vagus Nerve Stimulation Modulates Inflammation in Treatment-Resistant Depression Patients: A Pilot Study

Int J Mol Sci. 2024 Feb 26;25(5):2679. doi: 10.3390/ijms25052679.

ABSTRACT

Vagal neurostimulation (VNS) is used for the treatment of epilepsy and major medical-refractory depression. VNS has neuropsychiatric functions and systemic anti-inflammatory activity. The objective of this study is to measure the clinical efficacy and impact of VNS modulation in depressive patients. Six patients with refractory depression were enrolled. Depression symptoms were assessed with the Montgomery-Asberg Depression Rating, and anxiety symptoms with the Hamilton Anxiety Rating Scale. Plasmas were harvested prospectively before the implantation of VNS (baseline) and up to 4 years or more after continuous therapy. Forty soluble molecules were measured in the plasma by multiplex assays. Following VNS, the reduction in the mean depression severity score was 59.9% and the response rate was 87%. Anxiety levels were also greatly reduced. IL-7, CXCL8, CCL2, CCL13, CCL17, CCL22, Flt-1 and VEGFc levels were significantly lowered, whereas bFGF levels were increased (p values ranging from 0.004 to 0.02). This exploratory study is the first to focus on the long-term efficacy of VNS and its consequences on inflammatory biomarkers. VNS may modulate inflammation via an increase in blood-brain barrier integrity and a reduction in inflammatory cell recruitment. This opens the door to new pathways involved in the treatment of refractory depression.

PMID:38473935 | PMC:PMC10931975 | DOI:10.3390/ijms25052679

Cervical sympathetic schwannoma simulating a thyroid nodule

Med J Malaysia. 2002 Jun;57(2):218-20.

ABSTRACT

Schwannomas are rare tumours arising from peripheral nerve linings. A case of a schwannoma arising from cervical sympathetic chain is presented. The clinical presentation was that of a right solitary thyroid nodule. Intra-operatively, a 3 x 3 cm encapsulated lesion was seen arising posterior to the vagas nerve and attached to the cervical sympathetic trunk. The lesion was excised together with part of the nerve. Post-operatively, the patient developed Horner’s syndrome that persisted. Unitil 2000, less that 50 cased of cervical sympathetic schwannoma have been described in the Englidh literature. A brief description of the pathology, presentation, diagnosis and treatment of this condition is presented.

PMID:24326656