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J Clin Psychiatry ; 67(8): 1171-8, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16965193

ABSTRACT

BACKGROUND: Cognitive-enhancing effects of vagus nerve stimulation (VNS) have been reported during 6 months of treatment in a pilot study of patients with Alzheimer's disease (AD). Data through 1 year of VNS (collected from June 2000 to September 2003) are now reported. METHOD: All patients (N = 17) met the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for probable AD. Responder rates for the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Mini-Mental State Examination (MMSE) were measured as improvement or absence of decline from baseline. Global change, depressive symptoms, and quality of life were also assessed. Cerebrospinal fluid (CSF) levels for total tau, tau phosphorylated at Thr181 (phosphotau), and Abeta42 were measured by standardized enzyme-linked immunosorbent assay (ELISA). RESULTS: VNS was well tolerated. After 1 year, 7 (41.2%) of 17 patients and 12 (70.6%) of 17 patients improved or did not decline from baseline on the ADAS-cog and MMSE, respectively. Twelve of 17 patients were rated as having no change or some improvement from baseline on the Clinician Interview-Based Impression of Change (CIBIC+). No significant decline in mood, behavior, or quality of life occurred during 1 year of treatment. The median change in CSF tau at 1 year was a reduction of 4.8% (p = .057), with a 5.0% increase in phosphotau (p = .040; N = 14). CONCLUSION: The results of this study support long-term tolerability of VNS among patients with AD and warrant further investigation.


Subject(s)
Alzheimer Disease/therapy , Cognition Disorders/therapy , Electric Stimulation Therapy/methods , Vagus Nerve/physiology , Aged , Aged, 80 and over , Alzheimer Disease/cerebrospinal fluid , Alzheimer Disease/diagnosis , Amyloid beta-Peptides/cerebrospinal fluid , Biomarkers/cerebrospinal fluid , Cholinesterase Inhibitors/therapeutic use , Cognition Disorders/cerebrospinal fluid , Cognition Disorders/diagnosis , Combined Modality Therapy , Depression/cerebrospinal fluid , Depression/diagnosis , Depression/psychology , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Membrane Proteins/cerebrospinal fluid , Middle Aged , Pilot Projects , Psychiatric Status Rating Scales/statistics & numerical data , Quality of Life , Taurine/analogs & derivatives , Taurine/cerebrospinal fluid , Treatment Outcome
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