Vagus Nerve Stimulation (VNS)
Vagus nerve stimulation is a brain stimulation approach that has been available since 2005 for treatment-resistant depression. VNS is indicated for use as an adjunctive long-term treatment of chronic or recurrent depression for patients 18 years of age or older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments.
Psychiatric Intervention psychiatrists will consider VNS as one of the possible treatments that may be appropriate for patients with treatment-resistant depression. Unfortunately, most health insurance companies do not cover VNS. However, if the decision is still made to pursue VNS, a referral will be made to a neurosurgical consultant for consultation and surgical implantation. The Psychiatric Intervention team of psychiatrists can then monitor the treatment during subsequent office visits.
Transcranial Direct Current Stimulation (tDCS)
Transcranial direct current stimulation (tDCS), is a non-invasive, painless brain stimulation treatment that uses direct electrical currents to stimulate specific parts of the brain. A constant, low intensity current is passed through two electrodes placed over the head which modulates neuronal activity.
Many studies suggest that tDCS is a valuable tool for the treatment of neuropsychiatric conditions such as depression, anxiety, Parkinson's disease, and chronic pain. Research has also demonstrated cognitive improvement in some patients undergoing tDCS.
The results of research studies on tDCS up to now have been very variable. This is probably due to the fact that the electrical stimulus cannot currently be precisely targeted to the area of the brain of interest for the specific disorder being treated.
Dr. Goodman is actively involved in research on tDCS, and is on the Board of Directors of Aaken-Insight, a start-up company with a proprietary procedure involving specialized brain imaging that allows for very precise targeting of desired areas of the brain. Once this technique is perfected, we plan to offer this service to our patients as we begin to disseminate this technique to other research groups and physicians.