Vagus nerve stimulation for refractory posttraumatic epilepsy: Efficacy and predictors of seizure outcome
BackgroundTraumatic brain injury (TBI) has been recognized as an important and common cause of epilepsy since antiquity. Posttraumatic epilepsy (PTE) is usually associated with drug resistance and poor surgical outcomes, thereby increasing the burden of the illness on patients and their families. Va...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.954509/full |
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| author | Mengyi Guo Mengyi Guo Jing Wang Chongyang Tang Chongyang Tang Jiahui Deng Jing Zhang Jing Zhang Zhonghua Xiong Zhonghua Xiong Siqi Liu Siqi Liu Yuguang Guan Yuguang Guan Jian Zhou Jian Zhou Feng Zhai Feng Zhai Guoming Luan Guoming Luan Tianfu Li Tianfu Li |
| author_facet | Mengyi Guo Mengyi Guo Jing Wang Chongyang Tang Chongyang Tang Jiahui Deng Jing Zhang Jing Zhang Zhonghua Xiong Zhonghua Xiong Siqi Liu Siqi Liu Yuguang Guan Yuguang Guan Jian Zhou Jian Zhou Feng Zhai Feng Zhai Guoming Luan Guoming Luan Tianfu Li Tianfu Li |
| author_sort | Mengyi Guo |
| collection | DOAJ |
| description | BackgroundTraumatic brain injury (TBI) has been recognized as an important and common cause of epilepsy since antiquity. Posttraumatic epilepsy (PTE) is usually associated with drug resistance and poor surgical outcomes, thereby increasing the burden of the illness on patients and their families. Vagus nerve stimulation (VNS) is an adjunctive treatment for medically refractory epilepsy. This study aimed to determine the efficacy of VNS for refractory PTE and to initially evaluate the potential predictors of efficacy.MethodsWe retrospectively collected the outcomes of VNS with at least a 1-year follow-up in all patients with refractory PTE. Subgroups were classified as responders and non-responders according to the efficacy of VNS (≥50% or <50% reduction in seizure frequency). Preoperative data were analyzed to screen for potential predictors of VNS efficacy.ResultsIn total, forty-five patients with refractory PTE who underwent VNS therapy were enrolled. Responders were found in 64.4% of patients, and 15.6% of patients achieved seizure freedom at the last follow-up. In addition, the responder rate increased over time, with 37.8, 44.4, 60, and 67.6% at the 3-, 6-, 12-, and 24-month follow-ups, respectively. After multivariate analysis, generalized interictal epileptic discharges (IEDs) were found to be a negative predictor (OR: 4.861, 95% CI: 1.145–20.632) of VNS efficacy.ConclusionThe results indicated that VNS therapy was effective in refractory PTE patients and was well tolerated over a 1-year follow-up period. Patients with focal or multifocal IEDs were recognized to have better efficacy after VNS therapy. |
| first_indexed | 2024-04-14T03:41:50Z |
| format | Article |
| id | doaj.art-fad1bdc511b24ffbbf69cd7d6bcd2358 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-14T03:41:50Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-fad1bdc511b24ffbbf69cd7d6bcd23582022-12-22T02:14:30ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-07-011310.3389/fneur.2022.954509954509Vagus nerve stimulation for refractory posttraumatic epilepsy: Efficacy and predictors of seizure outcomeMengyi Guo0Mengyi Guo1Jing Wang2Chongyang Tang3Chongyang Tang4Jiahui Deng5Jing Zhang6Jing Zhang7Zhonghua Xiong8Zhonghua Xiong9Siqi Liu10Siqi Liu11Yuguang Guan12Yuguang Guan13Jian Zhou14Jian Zhou15Feng Zhai16Feng Zhai17Guoming Luan18Guoming Luan19Tianfu Li20Tianfu Li21Beijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Neurosurgery, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Neurosurgery, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Neurosurgery, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Neurosurgery, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Neurosurgery, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Epilepsy Research, Department of Brian Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Center of Epilepsy, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, ChinaBackgroundTraumatic brain injury (TBI) has been recognized as an important and common cause of epilepsy since antiquity. Posttraumatic epilepsy (PTE) is usually associated with drug resistance and poor surgical outcomes, thereby increasing the burden of the illness on patients and their families. Vagus nerve stimulation (VNS) is an adjunctive treatment for medically refractory epilepsy. This study aimed to determine the efficacy of VNS for refractory PTE and to initially evaluate the potential predictors of efficacy.MethodsWe retrospectively collected the outcomes of VNS with at least a 1-year follow-up in all patients with refractory PTE. Subgroups were classified as responders and non-responders according to the efficacy of VNS (≥50% or <50% reduction in seizure frequency). Preoperative data were analyzed to screen for potential predictors of VNS efficacy.ResultsIn total, forty-five patients with refractory PTE who underwent VNS therapy were enrolled. Responders were found in 64.4% of patients, and 15.6% of patients achieved seizure freedom at the last follow-up. In addition, the responder rate increased over time, with 37.8, 44.4, 60, and 67.6% at the 3-, 6-, 12-, and 24-month follow-ups, respectively. After multivariate analysis, generalized interictal epileptic discharges (IEDs) were found to be a negative predictor (OR: 4.861, 95% CI: 1.145–20.632) of VNS efficacy.ConclusionThe results indicated that VNS therapy was effective in refractory PTE patients and was well tolerated over a 1-year follow-up period. Patients with focal or multifocal IEDs were recognized to have better efficacy after VNS therapy.https://www.frontiersin.org/articles/10.3389/fneur.2022.954509/fullposttraumatic epilepsyvagus nerve stimulationefficacypredictorinterictal epileptic discharges |
| spellingShingle | Mengyi Guo Mengyi Guo Jing Wang Chongyang Tang Chongyang Tang Jiahui Deng Jing Zhang Jing Zhang Zhonghua Xiong Zhonghua Xiong Siqi Liu Siqi Liu Yuguang Guan Yuguang Guan Jian Zhou Jian Zhou Feng Zhai Feng Zhai Guoming Luan Guoming Luan Tianfu Li Tianfu Li Vagus nerve stimulation for refractory posttraumatic epilepsy: Efficacy and predictors of seizure outcome Frontiers in Neurology posttraumatic epilepsy vagus nerve stimulation efficacy predictor interictal epileptic discharges |
| title | Vagus nerve stimulation for refractory posttraumatic epilepsy: Efficacy and predictors of seizure outcome |
| title_full | Vagus nerve stimulation for refractory posttraumatic epilepsy: Efficacy and predictors of seizure outcome |
| title_fullStr | Vagus nerve stimulation for refractory posttraumatic epilepsy: Efficacy and predictors of seizure outcome |
| title_full_unstemmed | Vagus nerve stimulation for refractory posttraumatic epilepsy: Efficacy and predictors of seizure outcome |
| title_short | Vagus nerve stimulation for refractory posttraumatic epilepsy: Efficacy and predictors of seizure outcome |
| title_sort | vagus nerve stimulation for refractory posttraumatic epilepsy efficacy and predictors of seizure outcome |
| topic | posttraumatic epilepsy vagus nerve stimulation efficacy predictor interictal epileptic discharges |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.954509/full |
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