| Background Invasive vagus nerve stimulation has been approved for the treatment of treatment-resistant depression, and its therapeutic effect may be related to the anti-inflammatory effect of vagus nerve stimulation (VNS). The efficacy of non-invasive transcutaneous cervical vagus nerve stimulation (tcVNS) in treating major depressive disorder (MDD) and its impact on plasma inflammatory factors remain unclear. Objective To observe the improvement of depression, anxiety, and sleep in MDD patients after tcVNS treatment and its impact on plasma interleukin-6 (IL-6) and interleukin-10 (IL-10) levels, so as to provide a reference for the rehabilitation treatment of MDD patients. Methods From August 21, 2019 to April 17, 2024, 45 patients who met the diagnostic criteria for Major Depressive Disorder (MDD) in the Diagnostic and Statistical Manual of Mental Disorders (5th edition) were recruited at the outpatient clinic of the Department of Psychosomatic Medicine, First Affiliated Hospital of Air Force Military Medical University. They were divided into the study group (n=23) and the control group (n=22) by the method of random number table. Both groups received escitalopram treatment. On this basis, the study group received tcVNS stimulation once a day for 30 minutes for 4 weeks, and the control group automatically stopped the stimulation after 30 seconds of each stimulation. Before treatment and 4 weeks after treatment, the 17-item Hamilton Depression Rating Scale (HAMD-17) was used to assess depressive symptoms, and the anxiety/somatization factor and sleep disorder factor in HAMD-17 were used to assess patients' anxiety symptoms and sleep quality respectively.?The levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) were detected by enzyme-linked immunosorbent assay. Results The generalized estimation equation results showed that the time effects of the total HAMD-17 scores, anxiety/somatization factor scores, and sleep disorder factor scores in both groups were statistically significant (Wald χ2 = 315.226, 495.481, 82.420, all P < 0.01). After 4 weeks of treatment, comparisons of the total HAMD-17 scores and anxiety/somatization factor scores between the study group and the control group showed statistically significant differences (Wald χ2 = 4.967, 32.543, P < 0.05 or 0.01), while there was no statistically significant difference in the sleep disorder factor scores between the two groups (Wald χ2 = 0.819, P = 0.366). The time effect of IL-6 levels in both groups was statistically significant (Wald χ2 = 21.792, P < 0.01). The plasma IL-10 level in the study group was higher than that before treatment, with a statistically significant difference (Wald χ2 = 5.118, P = 0.024). After 4 weeks of treatment, comparisons of IL-6 and IL-10 levels between the study group and the control group showed no statistically significant differences (Wald χ2 = 0.363, 0.088, both P > 0.05). Conclusion Escitalopram combined with tcVNS is beneficial for improving depressive symptoms, anxiety/somatization symptoms, and sleep quality in patients with MDD. Additionally, it helps reduce plasma IL-6 levels and increase IL-10 levels. |