Long-term outcome of vagus nerve stimulation therapy in drug-resistant epilepsy: a retrospective single-center study
IntroductionVagus nerve stimulation (VNS) has garnered widespread application in patients with drug-resistant epilepsy (DRE), while the efficacy and prognostic factors of VNS in DRE remain elusive. Moreover, clinical determinants associated with rapid response to VNS have never been uncovered. This...
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Frontiers Media S.A.
2025-05-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1564735/full |
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| author | Si Chen Xiaxin Yang Shujun Xu Baomin Li Chao Li Ning Yang Xue Yang Xiaotang Wang Shuo Xu Xiuhe Zhao Xiuhe Zhao |
| author_facet | Si Chen Xiaxin Yang Shujun Xu Baomin Li Chao Li Ning Yang Xue Yang Xiaotang Wang Shuo Xu Xiuhe Zhao Xiuhe Zhao |
| author_sort | Si Chen |
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| description | IntroductionVagus nerve stimulation (VNS) has garnered widespread application in patients with drug-resistant epilepsy (DRE), while the efficacy and prognostic factors of VNS in DRE remain elusive. Moreover, clinical determinants associated with rapid response to VNS have never been uncovered. This study aimed to elucidate factors influencing efficacy and rapid response to VNS.MethodsA consecutive series of patients with DRE undergoing VNS surgery from January 2014 to December 2023 was collected to describe VNS efficacy. Both univariate and multivariate analyses were performed to identify statistically significant prognostic factors, and a predictive model was developed. Furthermore, we examined clinical determinants of rapid/slow response to VNS and VNS current changes.ResultsA total of 65 patients underwent VNS implantation. Seizure frequency significantly decreased post-VNS, with mean seizure reduction rates of 35.7, 49.0, 48.5, 52.8, 63.2, and 66.8% at 6 (n = 65), 12 (n = 65), 24 (n = 50), 36 (n = 40), 60 (n = 31), and 84 (n = 19) months, respectively. At final follow-up, 61.5% (40/65) were responders (50–100% seizure reduction), and 10.8% (7/65) achieved seizure freedom for ≥1 year. Univariate analysis identified age at seizure onset ≥6 years (p = 0.003), baseline seizure frequency ≤30/month (p = 0.001), focal seizures (p = 0.002), developmental and epileptic encephalopathies (p = 0.037), and surgical history (p < 0.001) as significant prognostic factors. Multivariate analysis confirmed age at seizure onset ≥6 years (OR: 5.726, p = 0.039), baseline seizure frequency ≤30/month (OR: 4.697, p = 0.048), and focal seizures (OR: 4.791, p = 0.025) as independent predictors, enabling the development of a predictive model for VNS efficacy. Additionally, among responders, the median response duration was 6 months (range: 1–60 months), with baseline seizure frequency ≤30/month significantly associated with rapid response of VNS in DRE (<6 months, p = 0.033).ConclusionVagus nerve stimulation is effective for treating DRE, with efficacy increasing with follow-up duration. Age at seizure onset ≥6 years, baseline seizure frequency ≤30/month, and focal seizure were predictive of VNS success, underscoring the need for careful preoperative assessment of patients with DRE before VNS surgery. |
| format | Article |
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| institution | DOAJ |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-05-01 |
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| spelling | doaj-art-22fae5f7dcd0454cb553e5da8e26b1822025-08-20T02:56:09ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15647351564735Long-term outcome of vagus nerve stimulation therapy in drug-resistant epilepsy: a retrospective single-center studySi Chen0Xiaxin Yang1Shujun Xu2Baomin Li3Chao Li4Ning Yang5Xue Yang6Xiaotang Wang7Shuo Xu8Xiuhe Zhao9Xiuhe Zhao10Department of Neurology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaDepartment of Neurology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaDepartment of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaDepartment of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, ChinaDepartment of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, ChinaDepartment of Neurology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaDepartment of Neurology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaDepartment of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, ChinaDepartment of Neurology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaNational Medicine-Engineering Interdisciplinary Industry-Education Integration Innovation Platform, Shandong Key Laboratory:Magnetic Field-free Medicine & Functional Imaging, Research Institute of Shandong University:Magnetic Field-free Medicine & Functional Imaging, Jinan, Shandong, ChinaIntroductionVagus nerve stimulation (VNS) has garnered widespread application in patients with drug-resistant epilepsy (DRE), while the efficacy and prognostic factors of VNS in DRE remain elusive. Moreover, clinical determinants associated with rapid response to VNS have never been uncovered. This study aimed to elucidate factors influencing efficacy and rapid response to VNS.MethodsA consecutive series of patients with DRE undergoing VNS surgery from January 2014 to December 2023 was collected to describe VNS efficacy. Both univariate and multivariate analyses were performed to identify statistically significant prognostic factors, and a predictive model was developed. Furthermore, we examined clinical determinants of rapid/slow response to VNS and VNS current changes.ResultsA total of 65 patients underwent VNS implantation. Seizure frequency significantly decreased post-VNS, with mean seizure reduction rates of 35.7, 49.0, 48.5, 52.8, 63.2, and 66.8% at 6 (n = 65), 12 (n = 65), 24 (n = 50), 36 (n = 40), 60 (n = 31), and 84 (n = 19) months, respectively. At final follow-up, 61.5% (40/65) were responders (50–100% seizure reduction), and 10.8% (7/65) achieved seizure freedom for ≥1 year. Univariate analysis identified age at seizure onset ≥6 years (p = 0.003), baseline seizure frequency ≤30/month (p = 0.001), focal seizures (p = 0.002), developmental and epileptic encephalopathies (p = 0.037), and surgical history (p < 0.001) as significant prognostic factors. Multivariate analysis confirmed age at seizure onset ≥6 years (OR: 5.726, p = 0.039), baseline seizure frequency ≤30/month (OR: 4.697, p = 0.048), and focal seizures (OR: 4.791, p = 0.025) as independent predictors, enabling the development of a predictive model for VNS efficacy. Additionally, among responders, the median response duration was 6 months (range: 1–60 months), with baseline seizure frequency ≤30/month significantly associated with rapid response of VNS in DRE (<6 months, p = 0.033).ConclusionVagus nerve stimulation is effective for treating DRE, with efficacy increasing with follow-up duration. Age at seizure onset ≥6 years, baseline seizure frequency ≤30/month, and focal seizure were predictive of VNS success, underscoring the need for careful preoperative assessment of patients with DRE before VNS surgery.https://www.frontiersin.org/articles/10.3389/fneur.2025.1564735/fullepilepsyvagus nerve stimulationdrug-resistant epilepsyprognostic factorsrapid response |
| spellingShingle | Si Chen Xiaxin Yang Shujun Xu Baomin Li Chao Li Ning Yang Xue Yang Xiaotang Wang Shuo Xu Xiuhe Zhao Xiuhe Zhao Long-term outcome of vagus nerve stimulation therapy in drug-resistant epilepsy: a retrospective single-center study Frontiers in Neurology epilepsy vagus nerve stimulation drug-resistant epilepsy prognostic factors rapid response |
| title | Long-term outcome of vagus nerve stimulation therapy in drug-resistant epilepsy: a retrospective single-center study |
| title_full | Long-term outcome of vagus nerve stimulation therapy in drug-resistant epilepsy: a retrospective single-center study |
| title_fullStr | Long-term outcome of vagus nerve stimulation therapy in drug-resistant epilepsy: a retrospective single-center study |
| title_full_unstemmed | Long-term outcome of vagus nerve stimulation therapy in drug-resistant epilepsy: a retrospective single-center study |
| title_short | Long-term outcome of vagus nerve stimulation therapy in drug-resistant epilepsy: a retrospective single-center study |
| title_sort | long term outcome of vagus nerve stimulation therapy in drug resistant epilepsy a retrospective single center study |
| topic | epilepsy vagus nerve stimulation drug-resistant epilepsy prognostic factors rapid response |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1564735/full |
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