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Transcutaneous vagus nerve stimulation (tVNS) is a promising therapeutic option for major depressive disorder (MDD) in adults. Alternative third-line treatments for MDD in adolescents are scarce. Here we aimed to assess the effects of acute tVNS on emotion recognition in adolescents with MDD.
Adolescents (14–17 years) with MDD (n = 33) and non-depressed controls (n = 30) received tVNS or sham-stimulation in a cross-sectional, case–control, within-subject cross-randomized controlled trial, while performing different tasks assessing emotion recognition. Correct responses, response times, and errors of omission and commission on three different computerized emotion recognition tasks were assessed as main outcomes. Simultaneous recordings of electrocardiography and electro dermal activity, as well as sampling of saliva for the determination of α-amylase, were used to quantify the effects on autonomic nervous system function.
tVNS had no effect on the recognition of gradually or static expressed emotions but altered response inhibition on the emotional Go/NoGo-task. Specifically, tVNS increased the likelihood of omitting a response toward sad target-stimuli in adolescents with MDD, while decreasing errors (independent of the target emotion) in controls. Effects of acute tVNS on autonomic nervous system function were found in non-depressed controls only.
Acute tVNS alters the recognition of briefly presented facial expressions of negative valence in adolescents with MDD while generally increasing emotion recognition in controls. tVNS seems to specifically alter early visual processing of stimuli of negative emotional valence in MDD. These findings suggest a potential therapeutic benefit of tVNS in adolescent MDD that requires further evaluation within clinical trials.
Cardiac vagal tone, indexed by heart rate variability (HRV), is a proxy
for the functional integrity of feedback mechanisms integrating central
and peripheral physiology.
To quantify differences in HRV in individuals with schizophrenia compared
with healthy controls.
Databases were systematically searched for studies eligible for
inclusion. Random effect meta-analyses of standardised mean differences
were calculated for vagal activity indicated by high-frequency HRV and
the root mean square of successive R–R interval differences (RMSSD).
Thirty-four studies were included. Significant main effects were found
for high-frequency HRV (P = 0.0008; Hedges'
g =–0.98, 95% CI −1.56 to −0.41, k =
29) and RMSSD (P<0.0001; g =–0.91,
95% CI −1.19 to −0.62, k = 24), indicating lower vagal
activity in individuals with schizophrenia than in healthy controls.
Considerable heterogeneity was evident but effects were robust in
subsequent sensitivity analyses.
Given the association between low HRV, threat processing, emotion
regulation and executive functioning, reduced vagal tone may be an
endophenotype for the development of psychotic symptoms.
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