Vagus nerve stimulation has a positive effect on mood in patients with refractory epilepsy

Klinkenberg, Sylvia; Majoie, Marian; Heijden, M.M.A.A. van der; Rijkers, Kim; Leenen, Loes; Aldenkamp, Albert P.

doi:10.1016/j.clineuro.2011.11.016

Cited by 58 publications

(45 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies have shown that VNS improves quality of life and mood in patients with epilepsy. 3,22 And, in epilepsy in general, there is some evidence linking seizure frequency with quality of life. 26,34 However, other authors dispute that there is any significant quality-of-life improvement when there is anything less than complete seizure freedom.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of vagus nerve stimulation in posttraumatic versus nontraumatic epilepsy

Englot

Rolston

Wang

et al. 2012

JNS

View full text Add to dashboard Cite

Object In the US, approximately 500,000 individuals are hospitalized yearly for traumatic brain injury (TBI), and posttraumatic epilepsy (PTE) is a common sequela of TBI. Improved treatment strategies for PTE are critically needed, as patients with the disorder are often resistant to antiepileptic medications and are poor candidates for definitive resection. Vagus nerve stimulation (VNS) is an adjunctive treatment for medically refractory epilepsy that results in a ≥ 50% reduction in seizure frequency in approximately 50% of patients after 1 year of therapy. The role of VNS in PTE has been poorly studied. The aim of this study was to determine whether patients with PTE attain more favorable seizure outcomes than individuals with nontraumatic epilepsy etiologies. Methods Using a case-control study design, the authors retrospectively compared seizure outcomes after VNS therapy in patients with PTE versus those with nontraumatic epilepsy (non-PTE) who were part of a large prospectively collected patient registry. Results After VNS therapy, patients with PTE demonstrated a greater reduction in seizure frequency (50% fewer seizures at the 3-month follow-up; 73% fewer seizures at 24 months) than patients with non-PTE (46% fewer seizures at 3 months; 57% fewer seizures at 24 months). Overall, patients with PTE had a 78% rate of clinical response to VNS therapy at 24 months (that is, ≥ 50% reduction in seizure frequency) as compared with a 61% response rate among patients with non-PTE (OR 1.32, 95% CI 1.07–1.61), leading to improved outcomes according to the Engel classification (p < 0.0001, Cochran-Mantel-Haenszel statistic). Conclusions Vagus nerve stimulation should be considered in patients with medically refractory PTE who are not good candidates for resection. A controlled prospective trial is necessary to further examine seizure outcomes as well as neuropsychological outcomes after VNS therapy in patients with intractable PTE.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of vagus nerve stimulation in posttraumatic versus nontraumatic epilepsy

Englot

Rolston

Wang

et al. 2012

JNS

View full text Add to dashboard Cite

show abstract

“…VNS seizure patients report enhanced mood, 70,71 reduced daytime sleepiness and increase alertness 72 independent of seizure control, increased slow wave sleep, 73 improved cognition, 74 memory, 75 and quality of life. 71,76 Children with VNS are noted to have enhanced verbal communication, school performance, 77 quality of life, and cost savings.…”

Section: Vns For Epilepsymentioning

confidence: 99%

“…71,76 Children with VNS are noted to have enhanced verbal communication, school performance, 77 quality of life, and cost savings. 78 Grill, et al described 2 nonverbal children (8 and 9 years) who began to speak within months of VNS implantation for the treatment of refractory epilepsy.…”

Section: Vns For Epilepsymentioning

confidence: 99%

Vagus nerve stimulation to augment recovery from severe traumatic brain injury impeding consciousness: a prospective pilot clinical trial

Chen

Flanagan

Samadani

2013

Neurological Research

View full text Add to dashboard Cite

Objectives-Traumatic brain injury has a high morbidity and mortality in both civilian and military populations. Blast and other mechanisms of traumatic brain injury damage the brain by causing neurons to disconnect and atrophy. Such traumatic axonal injury can lead to persistently vegetative and minimally conscious states, for which limited treatment options exist, including physical, occupational, speech and cognitive therapies.More than 60,000 patients have received vagus nerve stimulation for epilepsy and depression. In addition to decreased seizure frequency and severity, patients report enhanced mood, reduced daytime sleepiness independent of seizure control, increased slow wave sleep, and improved cognition, memory, and quality of life.Early stimulation of the vagus nerve accelerates the rate and extent of behavioral and cognitive recovery after fluid percussion brain injury in rats.Methods-We recently obtained FDA approval for a pilot prospective randomized crossover trial to demonstrate objective improvement in clinical outcome by placement of a vagus nerve stimulator in patients who are recovering from severe traumatic brain injury. Our hypothesis is that stimulation of the vagus nerve results in increased cerebral blood flow and metabolism in the forebrain, thalamus and reticular formation, which promotes arousal and improved consciousness, thereby improving outcome after traumatic brain injury resulting in minimally conscious or persistent vegetative states.Discussion-If this study demonstrates that vagus nerve stimulation can safely and positively impact outcome, then a larger randomized prospective crossover trial will be proposed.

show abstract

“…4 Other potentially relevant benefits that have been reported include decreased severity and duration of ictal or postictal phases, and improved mood, vigilance, communication, cognition, and possibility of reducing antiepileptic drugs (AEDs) and associated adverse effects. [5][6][7][8][9][10] Such benefits could have a significant impact on health-related quality of life (HRQoL), in addition to reduction in seizure frequency, and may partially explain the observation that >70% of patients choose to continue receiving VNS therapy once their battery needs to be replaced, an average of 6 years after implantation (data on file; Cyberonics, Inc., 2009; Houston, TX, U.S.A.). However, apart from seizure frequency, none of the above VNS outcomes were assessed in patients with epilepsy in the setting of a randomized controlled trial.…”

mentioning

confidence: 99%

The long-term effect of vagus nerve stimulation on quality of life in patients with pharmacoresistant focal epilepsy: The PuLsE (Open Prospective Randomized Long-term Effectiveness) trial

Ryvlin

Gilliam

Nguyen

et al. 2015

Epilepsy & Behavior

View full text Add to dashboard Cite

Vagus nerve stimulation has a positive effect on mood in patients with refractory epilepsy

Cited by 58 publications

References 32 publications

Efficacy of vagus nerve stimulation in posttraumatic versus nontraumatic epilepsy

Efficacy of vagus nerve stimulation in posttraumatic versus nontraumatic epilepsy

Vagus nerve stimulation to augment recovery from severe traumatic brain injury impeding consciousness: a prospective pilot clinical trial

The long-term effect of vagus nerve stimulation on quality of life in patients with pharmacoresistant focal epilepsy: The PuLsE (Open Prospective Randomized Long-term Effectiveness) trial

Contact Info

Product

Resources

About