Kamath Markad V, Thomson Mary S, Gaitonde Sneha, Upton Adrian
Departments of Medicine, Health Sciences Centre, McMaster University, Hamilton, Ontario, Canada.
J Long Term Eff Med Implants. 2010;20(3):251-67.
Vagal nerve stimulation (VNS) is a non-pharmacologic therapeutic intervention approved in adults and children with neuropsychiatric disorders. Studies conducted over the past 20 years have demonstrated that VNS results in immediate and longer-term changes in brain regions implicated in neuropsychiatric disorders, such as the thalamus, cerebellum, orbitofrontal cortex, limbic system, hypothalamus, and medulla with vagus innervations. This review summarizes the effects of longer-term implanted VNS and how the incorporation of this non-pharmacologic therapeutic management in the treatment regime can be beneficial to address the needs of patients who are unable to tolerate medications and/or undergo surgery and do not respond to pharmacologic therapies. We also highlight the therapeutic efficacy of longer-term implanted VNS, safety, tolerability, patient acceptance, adherence, and adverse events, if any, in adults and children in this modality of treatment.
迷走神经刺激（VNS）是一种已被批准用于患有神经精神疾病的成人和儿童的非药物治疗干预措施。过去20年进行的研究表明，VNS会导致与神经精神疾病相关的脑区立即和长期发生变化，如丘脑、小脑、眶额皮质、边缘系统、下丘脑以及有迷走神经支配的延髓。本综述总结了长期植入VNS的效果，以及在治疗方案中纳入这种非药物治疗管理如何有利于满足那些无法耐受药物治疗和/或接受手术且对药物治疗无反应的患者的需求。我们还强调了长期植入VNS在这种治疗方式中对成人和儿童的治疗效果、安全性、耐受性、患者接受度、依从性以及不良事件（如有）。
