Effect of Long-Term Treatment with Vagus Nerve Stimulation on Mood and Quality of Life in Korean Patients with Drug-Resistant Epilepsy

Abstract

Background and Purpose This study aimed to determine the long-term effects of vagus nerve stimulation (VNS) treatment on suicidality, mood-related symptoms, and quality of life (QOL) in patients with drug-resistant epilepsy (DRE). We also investigated the relationships among these main effects, clinical characteristics, and VNS parameters. Methods Among 35 epilepsy patients who underwent VNS implantation consecutively in our epilepsy center, 25 patients were recruited to this study for assessing the effects of VNS on suicidality, mood-related symptoms, and QOL. The differences in these variables between before and after VNS treatment were analyzed statistically using paired t -tests. Multiple linear regression analyses were also performed to determine how the patients' demographic and clinical characteristics influenced the variables that showed statistically significant changes after long-term VNS treatment. Results After VNS, our patients showed significant improvements not only in the mean seizure frequency but also in suicidality, depression, and QOL. The reduction in depression was associated with the improvement in QOL and more-severe depression at baseline. The reduction in suicidality was associated with higher suicidality at baseline, smaller changes in depression, and less-severe depression at baseline. Improved QOL was associated with lower suicidality at baseline. Conclusions This study found that VNS decreased the mean seizure frequency in patients with DRE, and also improved their depression, suicidality, and QOL. These results provide further evidence for therapeutic effect of VNS on psychological comorbidities of patients with DRE.

Vagus Nerve Stimulation (VNS) Therapy System in pharmacoresistant epilepsy: A literature review

“…Kim et al evaluated VNS effects (on depression, anxiety and suicide) on 25 patients who underwent implantation and observed (both in seizure responders and also in non-responders) an important reduction in suicidality, depressive symptoms and an improvement in the quality of life. This improvement increased gradually over time with a considerable result at 1-2 years follow-up [25].…”

Neuropsychiatric Treatments for Epilepsy: Nonpharmacological Approaches

“…Finally, in a study from South Korea, Kim et al, found that VNS therapy was associated with significant improvements in measures of suicidality, depression, and QoL in 25 PWE. 83 In conclusion, while these data are based on open trials and should be interpreted with caution, it is reasonable to conclude that VNS therapy can yield improvement in seizure frequency, depressive disorders, and QoL in PWE suffering from comorbid mood disorders. The effect on seizures and mood seems to be independent…”