精神医学63巻12号

2021年12月発行

特集 うつ病のニューロモデュレーション治療の新展開

うつ病への迷走神経刺激(VNS)療法

著者： 渡邊さつき¹ 松尾幸治¹

所属機関： ¹埼玉医科大学医学部精神医学

ページ範囲：P.1817 - P.1823

抄録　迷走神経刺激(vagus nerve stimulation：VNS)は，左頸部の迷走神経にコイル状の刺激電極を巻き付け，定期的な電気刺激を行う治療法である。VNSが最初に適応されたのはてんかんであった。やがて，てんかん患者の抑うつ症状に効果があることが報告されるようになり，諸外国では難治性うつ病へと適応が広がった。米国の5年間の長期追跡調査では，うつ病の寛解率はVNS追加群で43.4%，従来治療群で25.7%と，VNSを行った群で有意に高いことが示された。最近，非侵襲的な経皮的VNSについても研究が始められており，今後の発展が期待される。VNSがうつ病に効果を示すメカニズムについては，モノアミン仮説や神経可塑性仮説などがあるが，いまだに明らかにはなっていない。

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