Objectives

Vagus nerve stimulation (VNS) is reemerging as an exciting form of brain stimulation, due in part to the development of its noninvasive counterpart transcutaneous auricular VNS. As the field grows, it is important to understand where VNS emerged from, including its history and the studies that were conducted over the past four decades. Here, we offer a comprehensive review of the history of VNS in the treatment of major depression.

Materials and Methods

Using PubMed, we reviewed the history of VNS and aggregated the literature into a narrative review of four key VNS epochs: 1) early invention and development of VNS, 2) path to Food and Drug Administration (FDA) approval for depression, 3) refinement of VNS treatment parameters, and 4) neuroimaging of VNS.

Results

VNS was described in the literature in the early 1900s; however, gained traction in the 1980s as Zabara and colleagues developed an implantable neurocybernetic prosthesis to treat epilepsy. As epilepsy trials proceed in the 1990s, promising mood effects emerged and were studied, ultimately leading to the approval of VNS for depression in 2005. Since then, there have been advances in understanding the mechanism of action. Imaging techniques like functional magnetic resonance imaging and positron emission tomography further aid in understanding direct brain effects of VNS.

Conclusions

The mood effects of VNS were discovered from clinical trials investigating the use of VNS for reducing seizures in epileptic patients. Since then, VNS has gone on to be FDA approved for depression. The field of VNS is growing, and as noninvasive VNS quickly advances, it is important to consider a historical perspective to develop future brain stimulation therapies.

中文翻译：

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抑郁症迷走神经刺激的综合评价

目标

迷走神经刺激 (VNS) 作为一种令人兴奋的脑刺激形式重新出现，部分原因是其非侵入性对应的经皮耳廓 VNS 的发展。随着该领域的发展，了解 VNS 的起源非常重要，包括它的历史和过去四年进行的研究。在这里，我们全面回顾了 VNS 治疗重度抑郁症的历史。

材料和方法

使用 PubMed，我们回顾了 VNS 的历史，并将文献汇总成对四个关键 VNS 时代的叙述性回顾：1) VNS 的早期发明和发展，2) 食品和药物管理局 (FDA) 批准抑郁症的途径，3) 改进VNS 治疗参数和 4) VNS 的神经影像学。

结果

VNS 在 1900 年代早期的文献中有所描述；然而，在 1980 年代，随着 Zabara 及其同事开发了一种用于治疗癫痫的可植入神经控制假体，它获得了关注。随着 1990 年代癫痫试验的进行，出现并研究了有希望的情绪效应，最终导致 2005 年批准 VNS 治疗抑郁症。从那时起，在了解作用机制方面取得了进展。功能磁共振成像和正电子发射断层扫描等成像技术进一步有助于理解 VNS 对大脑的直接影响。

结论

VNS 的情绪影响是从调查使用 VNS 减少癫痫患者癫痫发作的临床试验中发现的。从那时起，VNS 继续被 FDA 批准用于治疗抑郁症。VNS 领域正在发展，随着无创 VNS 的快速发展，考虑历史视角来开发未来的脑刺激疗法非常重要。