Conway Charles R, Xiong Willa
Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St Louis, MO 63110, USA.
Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St Louis, MO 63110, USA.
Psychiatr Clin North Am. 2018 Sep;41(3):395-407. doi: 10.1016/j.psc.2018.04.005. Epub 2018 Jul 17.
Stimulation of the left cervical vagus nerve, or vagus nerve stimulation (VNS), brings about an antidepressant response in a subset of treatment-resistant depression (TRD) patients. How this occurs is poorly understood; however, knowledge of the neuroanatomic vagal pathways, in conjunction with functional brain imaging studies, suggests several brain regions associated with mood regulation are critical: brainstem nuclei (locus coeruleus, dorsal raphe, and ventral tegmental area), thalamus, and insular and prefrontal cortex. Furthermore, animal studies suggest that VNS enhances neuroplasticity and changes in neuronal firing patterns. Continued study to better understand the mechanism of action of VNS in TRD is warranted.
刺激左侧颈迷走神经，即迷走神经刺激（VNS），可在一部分难治性抑郁症（TRD）患者中引发抗抑郁反应。其发生机制尚不清楚；然而，结合功能性脑成像研究，对迷走神经的神经解剖通路的了解表明，几个与情绪调节相关的脑区至关重要：脑干核团（蓝斑、中缝背核和腹侧被盖区）、丘脑以及岛叶和前额叶皮质。此外，动物研究表明，VNS可增强神经可塑性并改变神经元放电模式。有必要继续开展研究，以更好地理解VNS在TRD中的作用机制。
