Systematic review and meta-analysis of vagus nerve stimulation in the treatment of depression: variable results based on study designs
Abstract
PURPOSE: To determine the efficacy of vagus nerve stimulation (VNS) for treatment of depression. METHODS: We conducted a systematic review and meta-analysis of analytical studies. Efficacy was evaluated according to severity of illness and percentage of responders. RESULTS: We identified 687 references. Of these, 14 met the selection criteria and were included in the review. The meta-analysis of efficacy for uncontrolled studies showed a significant reduction in scores at the Hamilton Depression Rating Scale endpoint, and the percentage of responders was 31.8% ([23.2% to 41.8%], P<0.001). However, the randomised control trial which covered a sample of 235 patients with depression, reported no statistically significant differences between the active intervention and placebo groups (OR=1.61 [95%CI 0.72 to 3.62]; P=0.25). To study the cause of this heterogeneity, a meta-regression was performed. The adjusted coefficient of determination (R2(Adj)) was 0.84, which implies that an 84% variation in effect size across the studies was explained by baseline severity of depression (P<0.0001). CONCLUSION: Currently, insufficient data are available to describe VNS as effective in the treatment of depression. In addition, it cannot be ruled out that the positive results observed in the uncontrolled studies might have been mainly due to a placebo effect.
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Previous meta-analyses mainly focused on assessing the effectiveness of vagus nerve stimulation via surgical implantation for managing major depressive disorder.
“The previous meta-analyses mainly focused on assessing the effectiveness of vagus nerve stimulation via surgical implantation for managing major depressive disorder.[25–27]”
From Transcutaneous auricular vagus nerve stimulation in treating major depressive disorder: A systematic review and meta-analysis (2018) · cites this paper as [25]
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- Authors
- Martin, J. L. R., & Martín-Sánchez, E.
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-04
- Volume
- 27
- Issue
- 3
- Pages
- 147-155
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- OpenAlex
- W2100055265
- Cited by
- 102
- References
- 51
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 7 · 2019: 9 · 2018: 9 · 2017: 8 · 2016: 13 · 2015: 12 · 2014: 9 · 2013: 10 · 2012: 9
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- ABACUS. Repositorio de Producción Científica (Universidad Europea) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- vagus nerve stimulation, depression, treatment efficacy, placebo effect, baseline depression severity, uncontrolled studies, randomized controlled trials, meta-regression, Hamilton Depression Rating Scale
- MeSH terms
- Depressive Disorder, Humans, Research Design, Severity of Illness Index, Randomized Controlled Trials as Topic, Treatment Outcome, Vagus Nerve Stimulation
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