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. 2024 Sep 21;14(9):945.
doi: 10.3390/brainsci14090945.

Transcutaneous Auricular Vagus Nerve Stimulation Modulating the Brain Topological Architecture of Functional Network in Major Depressive Disorder: An fMRI Study

Zhi-Peng Guo  1 , Dan Liao  2 , Lei Chen  1 , Cong Wang  3 , Miao Qu  4 , Xue-Yu Lv  5 , Ji-Liang Fang  5 , Chun-Hong Liu  1
Affiliations

Transcutaneous Auricular Vagus Nerve Stimulation Modulating the Brain Topological Architecture of Functional Network in Major Depressive Disorder: An fMRI Study

Zhi-Peng Guo et al. Brain Sci. .

Abstract

Background: Transcutaneous auricular vagus nerve stimulation (taVNS) is effective in regulating mood and high-level cognition in patients with major depressive disorder (MDD). This study aimed to investigate the efficacy of taVNS treatment in patients with MDD and an altered brain topological organization of functional networks.

Methods: Nineteen patients with MDD were enrolled in this study. Patients with MDD underwent 4 weeks of taVNS treatments; resting-state functional magnetic resonance imaging (rs-fMRI) data of the patients were collected before and after taVNS treatment. The graph theory method and network-based statistics (NBS) analysis were used to detect abnormal topological organizations of functional networks in patients with MDD before and after taVNS treatment. A correlation analysis was performed to characterize the relationship between altered network properties and neuropsychological scores.

Results: After 4 weeks of taVNS treatment, patients with MDD had increased global efficiency and decreased characteristic path length (Lp). Additionally, patients with MDD exhibited increased nodal efficiency (NE) and degree centrality (DC) in the left angular gyrus. NBS results showed that patients with MDD exhibited reduced connectivity between default mode network (DMN)-frontoparietal network (FPN), DMN-cingulo-opercular network (CON), and FPN-CON. Furthermore, changes in Lp and DC were correlated with changes in Hamilton depression scores.

Conclusions: These findings demonstrated that taVNS may be an effective method for reducing the severity of depressive symptoms in patients with MDD, mainly through modulating the brain's topological organization. Our study may offer insights into the underlying neural mechanism of taVNS treatment in patients with MDD.

Keywords: default mode network; graph theory; major depression disorder; network-based statistics; transcutaneous auricular vagus nerve stimulation.

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Conflict of interest statement

Author Cong Wang was employed by the company Kerfun Medical (Suzhou) Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study workflow. (A) taVNS intervention and bold signal extraction. (B) Graph theory analysis. (C) Statistical analysis. Abbreviations: taVNS, transcutaneous auricular vagus nerve stimulation. * p < 0.05, *** p < 0.001.
Figure 2
Figure 2
Differences in global network topological properties of patients with MDD across the sparsity range (0.05–0.4). (A) Gamma in patients with MDD before and after taVNS treatment; (B) lambda in patients with MDD; (C) sigma in patients with MDD; (D) Lp in patients with MDD; (E) Eglob in patients with MDD; (F) Eloc in patients with MDD. Abbreviations: Lp, characteristic path length; MDD, major depressive disorder; Eglob, global efficiency; taVNS, transcutaneous auricular vagus nerve stimulation; Eloc, local efficiency.
Figure 3
Figure 3
Differences in global properties of patients with MDD before and after taVNS treatment based on AUC values. (A) Eglob in patients with MDD; (B) Lp in patients with MDD. Abbreviations: Eglob, global efficiency; taVNS, transcutaneous auricular vagus nerve stimulation; Lp, characteristic path length; MDD, major depressive disorder; AUC, area under the curve. *** p < 0.001.
Figure 4
Figure 4
Differences in nodal properties of patients with MDD before and after taVNS treatment based on the AUC values. (A) The left AG; (B) the DC of the left AG in patients with MDD; (C) the NE of the left AG in patients with MDD. Abbreviations: AG, angular gyrus; AUC, area under the curve; DC, degree centrality; taVNS, transcutaneous auricular vagus nerve stimulation; NE, nodal efficiency; MDD, major depressive disorder. * p < 0.05, *** p < 0.001.
Figure 5
Figure 5
Differences in network connectivity of patients with MDD before and after taVNS treatment. The blue lines indicate the decreased functional connections between the DMN and FPN, DMN and CON, and FPN and CON. Abbreviations: CON, cingulo-opercular network; CN, cerebellar network; DMN, default mode network; MDD, major depressive disorder; FPN, frontoparietal network; SMN, sensorimotor network; taVNS, transcutaneous auricular vagus nerve stimulation; VN, visual network.
Figure 6
Figure 6
Relationships between changes in global and nodal network properties and changes in HAMD scores of patients with MDD after taVNS treatment. (A) Change in Lp was positively associated with alternation in HAMD scores (r = 0.616, p = 0.005). (B) Changes in DC in the left AG were negatively associated with changes in HAMD scores (r = −0.703, p = 0.001). Abbreviations: AG, angular gyrus; DC, degree centrality; MDD, major depressive disorder; HAMD, 24-Hamilton Depression Rating Scale; Lp, characteristic path length; taVNS, transcutaneous auricular vagus nerve stimulation.
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