La neurostimolazione vagale in Neurologia e Psichiatria

Introduction

Recent progress in biotechnology and neuroimaging has enlarged the possibilities for applying neurostimulation procedures to treat common neuropsychiatric conditions and chronic pain disorders. These conditions are refractory to pharmacological and other conventional treatments, to variable degrees, and are associated with a heavy social and economic burden. Refinements in neuroanatomical targeting have enlarged the clinical indications for these neurostimulation treatments, and increased the need to identify robust patient selection criteria. Neurostimulation is a relatively low invasivity procedure, and may be safer than conventional treatments, mainly because it is fully reversible, but also because it is highly flexible, offering a wide range of modulation (amplitude, duration, frequency) and stimulation (unipolar/bipolar, continuous/cycling, unilateral/bilateral) modes. There are various types of neurostimulation technique which promise great therapeutic potential now extending from Neurology to Psychiatry that is still only partly explored. The present paper reviews the clinical applications of these techniques, presenting main results and discussing limitations, with particular regard to newest applications of vagal nerve stimulation.