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...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Keisuke Hatano, Ayataka Fujimoto, Takamichi Yamamoto, Hideo Enoki, Tohru Okanishi
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	vagus nerve stimulation (VNS) corpus callosotomy (CC) drug-resistant epilepsy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/23fab148d47e4650ad5b76cf257c6366
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:23fab148d47e4650ad5b76cf257c6366
record_format	dspace
spelling	oai:doaj.org-article:23fab148d47e4650ad5b76cf257c63662021-11-25T16:56:27ZEffects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy10.3390/brainsci111113952076-3425https://doaj.org/article/23fab148d47e4650ad5b76cf257c63662021-10-01T00:00:00Zhttps://www.mdpi.com/2076-3425/11/11/1395https://doaj.org/toc/2076-3425Objective: 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.Keisuke HatanoAyataka FujimotoTakamichi YamamotoHideo EnokiTohru OkanishiMDPI AGarticlevagus nerve stimulation (VNS)corpus callosotomy (CC)drug-resistant epilepsyNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENBrain Sciences, Vol 11, Iss 1395, p 1395 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	vagus nerve stimulation (VNS) corpus callosotomy (CC) drug-resistant epilepsy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	vagus nerve stimulation (VNS) corpus callosotomy (CC) drug-resistant epilepsy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Keisuke Hatano Ayataka Fujimoto Takamichi Yamamoto Hideo Enoki Tohru Okanishi Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy
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.
format	article
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
title	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_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_sort	effects of vagus nerve stimulation following corpus callosotomy for patients with drug-resistant epilepsy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/23fab148d47e4650ad5b76cf257c6366
work_keys_str_mv	AT keisukehatano effectsofvagusnervestimulationfollowingcorpuscallosotomyforpatientswithdrugresistantepilepsy AT ayatakafujimoto effectsofvagusnervestimulationfollowingcorpuscallosotomyforpatientswithdrugresistantepilepsy AT takamichiyamamoto effectsofvagusnervestimulationfollowingcorpuscallosotomyforpatientswithdrugresistantepilepsy AT hideoenoki effectsofvagusnervestimulationfollowingcorpuscallosotomyforpatientswithdrugresistantepilepsy AT tohruokanishi effectsofvagusnervestimulationfollowingcorpuscallosotomyforpatientswithdrugresistantepilepsy
_version_	1718412825075908608

Effects of Vagus Nerve Stimulation following Corpus Callosotomy for Patients with Drug-Resistant Epilepsy

Ejemplares similares