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Im Gegensatz zu gel\u00e4ufigeren Behandlungen wie EKT sind Kenntnisse \u00fcber VNS sowohl in der Allgemeinbev\u00f6lkerung als auch in Fachkreisen gering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methoden<\/jats:title>\n                    <jats:p>In diesem narrativen Review geben wir eine klinisch und wissenschaftlich fundierte \u00dcbersicht \u00fcber die VNS. Hypothesen zum Wirkmechanismus sowie die aktuelle Evidenzlage zur Wirksamkeit werden dargestellt. Das perioperative Management, das Nebenwirkungsprofil und die Nachbetreuung einschlie\u00dflich Dosistitration werden beschrieben. Ein Vergleich \u00fcber internationale Leitlinienempfehlungen zur VNS findet sich ebenfalls. Ferner formulieren wir Kriterien, die bei der Auswahl geeigneter Patienten hilfreich sind.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>Die elektrischen Impulse werden \u00fcber den N.\u00a0vagus afferent weitergeleitet und stimulieren \u00fcber verschiedene Wege ein neuromodulatorisches zerebrales Netzwerk. Viele Studien und Fallserien zeigten die Wirksamkeit von VNS als adjuvantes Verfahren bei TRD. Der Effekt tritt mit einer Latenz von 3 bis 12\u00a0Monaten ein und steigt m\u00f6glicherweise mit der Dauer der VNS. Unter der Beachtung der Stimulationsempfehlungen sind die Nebenwirkungen f\u00fcr die meisten Patienten tolerabel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Fazit<\/jats:title>\n                    <jats:p>Die VNS ist eine zugelassene, wirksame und gut vertr\u00e4gliche Langzeittherapie f\u00fcr chronische und therapieresistente Depressionen. Weitere Sham-kontrollierte Studien \u00fcber einen l\u00e4ngeren Beobachtungszeitraum sind zur Verbesserung der Evidenz w\u00fcnschenswert.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00115-022-01282-6","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T10:33:49Z","timestamp":1649154829000},"page":"921-930","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Vagusnervstimulation bei schwer zu behandelnden Depressionen","Vagus nerve stimulation for difficult to treat depression"],"prefix":"10.1007","volume":"93","author":[{"given":"C.","family":"Reif-Leonhard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Reif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. 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A.\u00a0Reif bezog Sprecher- und Beraterhonorare von Medice, Takeda, Janssen, SAGE. B.\u00a0T.\u00a0Baune bezog Sprecher- und Beraterhonorare von AstraZeneca, Bristol-Myers Squibb, Lundbeck, Pfizer, Servier Laboratories, Wyeth Pharmaceuticals, Takeda, Janssen, LivaNova PLC. E.\u00a0Kavakbasi bezog Sprecherhonorare von Janssen und LivaNova.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"F\u00fcr diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgef\u00fchrt. F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}