Vagus Nerve Stimulation for Treatment Resistant Depression at the University of Minnesota

Saturday, May 4, 2024

3:53 PM – 3:55 PM CT

Location: S405b

Presenting Author(s)

Janessa Engelmeyer, BA (she/her/hers)

Medical Student
University of Minnesota

Co-Author(s)

David Darrow, MD MPH (he/him/his)

Assistant Professor, Neurosurgery Department
University of Minnesota
Minneapolis, MN, US
TH

Tariq Hattab, MD

Post-Doctoral Associate
University of Minnesota, United States
AH

Alexander Herman, MD PhD

Assistant Professor, Department of Psychiatry
University of Minnesota, United States
ZN

Ziad Nahas, MD MSCR

Executive Vice Chair, Professor, Department of Psychiatry
University of Minnesota, United States
MP

Michael C. Park, MD PhD

Associate Professor, Department of Neurosurgery
University of Minnesota, United States
AW

Alik Widge, MD PhD

Associate Professor, Department of Psychiatry
University of Minnesota, United States
SW

Saydra Wilson, MD

Assistant Professor, Department of Psychiatry
University of Minnesota, United States

Disclosure(s):

Janessa Engelmeyer, BA: No financial relationships to disclose

David Darrow, MD MPH: No financial relationships to disclose

Introduction: Vagus Nerve Stimulators (VNS) received FDA approval for Treatment Resistant Depression (TRD) in 2005 but has only recently begun garnering attention due to promising long-term outcomes, prompting a CMS-funded multicenter trial. As a result, many insurance plans are beginning to cover VNS for TRD. We present our experience with VNS for TRD during this resurgence including early outcomes.

Methods: This is a retrospective study of TRD patients who underwent VNS procedures at the University of Minnesota Medical Center between January 1st 2018 and November 1st 2023. We included both patients who were implanted for the first time and patients with a previously implanted VNS who needed the battery replaced. Data was collected on patient suicide ideality and PHQ9 scores. Suicide ideality was recorded at time of VNS implant or battery replacement and at the most recent follow up. PHQ9 scores were recorded at time of implant or battery replacement and in the following intervals post operatively: 1, 6, 12, and 18 months, 2 years, and 3 years.

Results: A total of 53 patients with TRD received VNS procedures, 43 were new implants and 9 were battery replacements. Using Growth Curve Models (GCM) over a 3-year period, a significant linear decrease was observed in the PHQ9 scores over time (β = -0.13, t = -2.03, p = 0.045). In addition, VNS treatment significantly reduced suicidal ideation, with 31 out of 53 patients reporting ideation before VNS versus 12 after, including 2 patients who did not have ideation prior (McNemar chi-square with Yates' correction = 8.643, p = 0.003).

Conclusion : Our findings indicate that in patients with TRD, VNS treatment serves as a potentially efficacious intervention, as evidenced by a reduction in PHQ9 scores across a span of 3 years in addition to a reduction in suicidal ideation rates.