Cognition-enhancing effect of vagus nerve stimulation in patients with Alzheimer's disease: a pilot study.

Full Abstract

BACKGROUND:
Vagus nerve stimulation (VNS) is an established treatment method for therapy-refractory epilepsy and, in Europe, for treatment-resistant depression also. Clinical and experimental investigations have also shown positive effects of VNS on cognition in epilepsy and depression. The purpose of the present pilot study was to investigate the effect of VNS on cognition in patients with Alzheimer's disease.

METHOD:
All the included patients (N = 10) met the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria for the diagnosis of Alzheimer's disease. Before the implantation of the vagus stimulator (NeuroCybernetic Prosthesis), the patients underwent neuropsychological tests (e.g., Alzheimer's Disease Assessment Scale-cognitive subscale [ADAS-cog] and Mini-Mental State Examination [MMSE]), computerized tomography of the brain, medical/neurologic and psychological examinations (status evaluation), and lumbar puncture with investigation of the cerebrospinal fluid. The presence of depressive symptoms was rated using the Montgomery-Asberg Depression Rating Scale. The VNS was initiated 2 weeks after the implantation, and the patients were followed up with regular investigations and tests over 6 months. Response was defined as improvement or absence of impairment in ADAS-cog and MMSE scores after 3 and 6 months.

RESULTS:
After 3 months of treatment, 7 of 10 patients were responders according to the ADAS-cog (median improvement of 3.0 points), and 9 of 10 patients were responders according to the MMSE (median improvement of 1.5 points). After 6 months of treatment, 7 patients were responders on the ADAS-cog (median improvement of 2.5 points), and 7 patients were responders on the MMSE (median improvement of 2.5 points). VNS was well tolerated, and its side effects were mild and transient.

CONCLUSION:
The results of this open-label pilot study suggest a positive effect of VNS on cognition in patients with Alzheimer's disease. Further studies are warranted.

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Author information

Author/s: Sjögren, Magnus J C (MJ); Hellström, Per T O (PT); Jonsson, Michael A G (MA); Runnerstam, Magnus (M); Silander, Hans C-Son (HC); Ben-Menachem, Elinor (E);

Affiliation: Institute of Clinical Neuroscience, Göteborg University, Mölndal, Sweden. magnus.sjogren(-atsign-)medfak.gu.se

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: The Journal of clinical psychiatry (J Clin Psychiatry), published in United States. (Language: eng)

Reference: 2002-Nov; vol 63 (issue 11) : pp 972-80

Dates: Created 2002/11/26; Completed 2002/12/26; Revised 2006/11/15;

PMID: 12444809, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Affect - physiology
Aged
Alzheimer Disease - physiopathology; psychology; therapy
Cognition Disorders - physiopathology; therapy
Electric Stimulation Therapy - instrumentation
Electrodes, Implanted
Female
Follow-Up Studies
Humans

Male
Mental Processes - physiology
Mental Status Schedule - statistics & numerical data
Microcomputers
Neuropsychological Tests - statistics & numerical data
Pilot Projects
Psychometrics
Quality of Life - psychology
Software
Vagus Nerve - physiopathology

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