Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy
Objective: The effectiveness of vagus nerve stimulation (VNS) for residual seizures after corpus callosotomy (CC) has not yet been fully investigated. We hypothesized that seizure control would be improved by VNS after CC. The purpose of this study was to compare seizure frequency between patients w...
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MDPI AG
2021-10-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/11/11/1395 |
| _version_ | 1797510989827014656 |
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| author | Keisuke Hatano Ayataka Fujimoto Takamichi Yamamoto Hideo Enoki Tohru Okanishi |
| author_facet | Keisuke Hatano Ayataka Fujimoto Takamichi Yamamoto Hideo Enoki Tohru Okanishi |
| author_sort | Keisuke Hatano |
| collection | DOAJ |
| description | Objective: The effectiveness of vagus nerve stimulation (VNS) for residual seizures after corpus callosotomy (CC) has not yet been fully investigated. We hypothesized that seizure control would be improved by VNS after CC. The purpose of this study was to compare seizure frequency between patients with implantation of a VNS generator (post-VNS group) or without VNS (non-post-VNS group) following CC. Methods: We retrospectively reviewed patients who underwent CC between January 2009 and May 2019 in our institution. We evaluated proportions of ≥50% reduction in seizure frequency (responders) and seizure reduction rate 1 and 2 years after VNS. To investigate factors related to responders, uni- and multivariate logistic regression analyses were performed regarding age, number of anti-seizure medications (ASMs), addition of novel ASMs (levetiracetam, lacosamide or perampanel), and post-VNS or non-post-VNS status. Results: Thirteen post-VNS patients and 24 non-post-VNS patients were analyzed in this study. Responder rate at 1 year after VNS differed significantly between the post-VNS group (53.9%) and non-post-VNS group (12.5%, <i>p</i> = 0.017). Number of ASMs at the time of CC and post-VNS were significantly associated with responders in univariate analyses (odds ratio [OR] 0.34, 95% confidence interval [CI] 0.13–0.88, <i>p</i> = 0.025 and OR 8.2, 95%CI 1.6–41.6, <i>p</i> = 0.011, respectively), whereas age, sex, seizure frequency, and addition of novel ASMs were not. In multivariate analysis, the presence of VNS procedures after CC was the only factor favorably associated with responder status (OR 82.2, 95%CI 1.55–4355.7, <i>p</i> = 0.03). Conclusions: VNS therapy after CC may increase the proportion of responders independent of the addition of novel ASMs. |
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| language | English |
| last_indexed | 2024-03-10T05:40:00Z |
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| spelling | doaj.art-23fab148d47e4650ad5b76cf257c63662023-11-22T22:37:01ZengMDPI AGBrain Sciences2076-34252021-10-011111139510.3390/brainsci11111395Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant EpilepsyKeisuke Hatano0Ayataka Fujimoto1Takamichi Yamamoto2Hideo Enoki3Tohru Okanishi4Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu 430-8558, Shizuoka, JapanComprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu 430-8558, Shizuoka, JapanComprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu 430-8558, Shizuoka, JapanComprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu 430-8558, Shizuoka, JapanComprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu 430-8558, Shizuoka, JapanObjective: The effectiveness of vagus nerve stimulation (VNS) for residual seizures after corpus callosotomy (CC) has not yet been fully investigated. We hypothesized that seizure control would be improved by VNS after CC. The purpose of this study was to compare seizure frequency between patients with implantation of a VNS generator (post-VNS group) or without VNS (non-post-VNS group) following CC. Methods: We retrospectively reviewed patients who underwent CC between January 2009 and May 2019 in our institution. We evaluated proportions of ≥50% reduction in seizure frequency (responders) and seizure reduction rate 1 and 2 years after VNS. To investigate factors related to responders, uni- and multivariate logistic regression analyses were performed regarding age, number of anti-seizure medications (ASMs), addition of novel ASMs (levetiracetam, lacosamide or perampanel), and post-VNS or non-post-VNS status. Results: Thirteen post-VNS patients and 24 non-post-VNS patients were analyzed in this study. Responder rate at 1 year after VNS differed significantly between the post-VNS group (53.9%) and non-post-VNS group (12.5%, <i>p</i> = 0.017). Number of ASMs at the time of CC and post-VNS were significantly associated with responders in univariate analyses (odds ratio [OR] 0.34, 95% confidence interval [CI] 0.13–0.88, <i>p</i> = 0.025 and OR 8.2, 95%CI 1.6–41.6, <i>p</i> = 0.011, respectively), whereas age, sex, seizure frequency, and addition of novel ASMs were not. In multivariate analysis, the presence of VNS procedures after CC was the only factor favorably associated with responder status (OR 82.2, 95%CI 1.55–4355.7, <i>p</i> = 0.03). Conclusions: VNS therapy after CC may increase the proportion of responders independent of the addition of novel ASMs.https://www.mdpi.com/2076-3425/11/11/1395vagus nerve stimulation (VNS)corpus callosotomy (CC)drug-resistant epilepsy |
| spellingShingle | Keisuke Hatano Ayataka Fujimoto Takamichi Yamamoto Hideo Enoki Tohru Okanishi Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy Brain Sciences vagus nerve stimulation (VNS) corpus callosotomy (CC) drug-resistant epilepsy |
| title | Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy |
| title_full | Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy |
| title_fullStr | Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy |
| title_full_unstemmed | Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy |
| title_short | Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy |
| title_sort | effects of vagus nerve stimulation following corpus callosotomy for patients with drug resistant epilepsy |
| topic | vagus nerve stimulation (VNS) corpus callosotomy (CC) drug-resistant epilepsy |
| url | https://www.mdpi.com/2076-3425/11/11/1395 |
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