The procedure to place the device, which is usually performed under general anesthesia on an outpatient basis, takes about an hour. Two small incisions are required: one on the upper chest area for the pulse generator and one on the left neck for the thin, flexible wires that connect the pulse generator to the vagus nerve. The incisions heal in one to two weeks, and the scars fade over time. The neck scar is usually located within a natural crease of the neck and is therefore not very visible.

"The pulse generator, which is like a pacemaker, is implanted in the chest area and sends mild pulses to the brain via the vagus nerve in the neck. A thin, thread-like wire attached to the generator, runs under the skin to the left vagus nerve. The vagus nerve, one of the 12 cranial nerves, serves as the body's 'information highway' connecting the brain to many major organs," said Zajecka.

The device delivers very mild, intermittent, brief pulses to the left vagus nerve. The pulses are then transmitted via the nerve to the central nervous system, to specific areas in the central nervous system that control mood, motivation, sleep, appetite, and other symptoms that are relevant to depression. Several studies have shown that VNS Therapy may modulate neurotransmitters such as serotonin and norepinephrine thought to be involved in mood regulation, according to Zajecka.

VNS Therapy is approved by the Food and Drug Administration as a long-term adjunctive (add-on) treatment for patients 18 years of age and older who are experiencing a major depressive episode and have not had an adequate response to four or more antidepressant treatments. VNS Therapy was appro
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Contact: Mary Ann Schultz
mary_ann_schultz@rush.edu
312-942-7816
Rush University Medical Center
5-Sep-2005