A pilot study of brain correlates of long-term treatment with transcutaneous vagal nerve stimulation in posttraumatic stress disorder.

OBJECTIVE

Posttraumatic Stress Disorder (PTSD) is a highly prevalent condition, and current treatments have limitations. Vagal Nerve Stimulation (VNS) is a new approach that potentially has promise for PTSD. Understanding the neurobiology of treatment response is important for developing new treatments. The purpose of this study was to assess neural correlations of long-term transcutaneous cervical VNS (tcVNS) in patients with PTSD.

METHODS

Patients with PTSD underwent randomization to active tcVNS (N = 6) or sham stimulation (N = 5) twice daily for three months. High-Resolution Positron Emission Tomography scanning with radiolabeled water was used to measure brain blood flow measurements before and after treatment during exposure to personalized traumatic scripts paired with active or sham stimulation.

RESULTS

Three months of active tcVNS resulted in activation in response to traumatic scripts in the sham stimulation group not seen in the tcVNS group in brain areas mediating the fear response, including posterior cingulate, thalamus, temporal and parietal cortex, and parahippocampal gyrus, with an increase in medial prefrontal cortex with tcVNS, in patients with PTSD.

CONCLUSION

TcVNS affects brain areas mediating fear and emotion which may underlie a therapeutic effect for PTSD.