Changes in Response Inhibition, Visual Anticipation and Verbal Fluency During Vagus Nerve Stimulation Therapy in Patients With Drug‐Resistant Epilepsy
ABSTRACT Background The effect of vagus nerve stimulation (VNS) on cognitive domain of attention and executive functions (AEFs) has not been extensively researched. This study was set up to investigate performance variability on cognitive tests assessing AEFs in drug‐resistant epilepsy (DRE) patient...
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Wiley
2024-12-01
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| Series: | Brain and Behavior |
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| Online Access: | https://doi.org/10.1002/brb3.70176 |
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| author | Niina Lähde Pabitra Basnyat Jani Raitanen Leena Kämppi Kai Lehtimäki Eija Rosti‐Otajärvi Jukka Peltola |
| author_facet | Niina Lähde Pabitra Basnyat Jani Raitanen Leena Kämppi Kai Lehtimäki Eija Rosti‐Otajärvi Jukka Peltola |
| author_sort | Niina Lähde |
| collection | DOAJ |
| description | ABSTRACT Background The effect of vagus nerve stimulation (VNS) on cognitive domain of attention and executive functions (AEFs) has not been extensively researched. This study was set up to investigate performance variability on cognitive tests assessing AEFs in drug‐resistant epilepsy (DRE) patients receiving VNS therapy during a follow‐up of up to 5 years. Methods Thirty‐three DRE patients were assessed with the interference, maze, and written verbal fluency tests as a part of EpiTrack screening before and after VNS implantation through repeated follow‐ups according to the clinical VNS protocol. A linear mixed‐effects model was used to analyse changes in test scores. Results Maze performance improved significantly by an average of 0.20 s per month (95% confidence interval (CI): –0.365 to –0.041; p = 0.014). Interference performance improved by an average of 0.05 s per month (p = 0.207) and number of words increased by an average of 0.03 words per month (p = 0.079) on the verbal fluency test. On the maze test, patients with psychiatric comorbidities improved the most (0.52 s/month, p = 0.001), while on the interference test, patients with frontal lobe epilepsy (FLE), those taking 1–2 antiseizure medications (ASMs) and patients with focal to bilateral tonic–clonic seizures improved the most (0.14 s/month, p = 0.005; 0.14 s/month, p = 0.033 and 0.16 s/month, p = 0.087, respectively). For verbal fluency, no clinically meaningful improvement was noted in any of the groups. Conclusion During the follow‐up, maze performance markedly improved, while performance on the interference and verbal fluency tasks remained relatively stable at the group level. Accordingly, visual anticipation and planning improved during VNS therapy whereas response inhibition was unchanged at the group level despite significant enhancements in patients with FLE and those taking 1–2 ASM. Furthermore, the presence of psychiatric comorbidities correlated with even greater improvement on maze performance. |
| format | Article |
| id | doaj-art-ed984bd72a1a487da6956555b2d9aae8 |
| institution | DOAJ |
| issn | 2162-3279 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
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| series | Brain and Behavior |
| spelling | doaj-art-ed984bd72a1a487da6956555b2d9aae82025-08-20T02:50:48ZengWileyBrain and Behavior2162-32792024-12-011412n/an/a10.1002/brb3.70176Changes in Response Inhibition, Visual Anticipation and Verbal Fluency During Vagus Nerve Stimulation Therapy in Patients With Drug‐Resistant EpilepsyNiina Lähde0Pabitra Basnyat1Jani Raitanen2Leena Kämppi3Kai Lehtimäki4Eija Rosti‐Otajärvi5Jukka Peltola6Department of Neurology Tampere University Hospital Tampere FinlandFaculty of Medicine and Health Technology Tampere University Tampere FinlandFaculty of Social Sciences, Health Sciences Tampere University Tampere FinlandEpilepsia Helsinki, Member of EpiCARE ERN, Department of Neurology Helsinki University Hospital and University of Helsinki Helsinki FinlandDepartment of Neurosurgery Tampere University Hospital Tampere FinlandDepartment of Neurology Tampere University Hospital Tampere FinlandDepartment of Neurology Tampere University Hospital Tampere FinlandABSTRACT Background The effect of vagus nerve stimulation (VNS) on cognitive domain of attention and executive functions (AEFs) has not been extensively researched. This study was set up to investigate performance variability on cognitive tests assessing AEFs in drug‐resistant epilepsy (DRE) patients receiving VNS therapy during a follow‐up of up to 5 years. Methods Thirty‐three DRE patients were assessed with the interference, maze, and written verbal fluency tests as a part of EpiTrack screening before and after VNS implantation through repeated follow‐ups according to the clinical VNS protocol. A linear mixed‐effects model was used to analyse changes in test scores. Results Maze performance improved significantly by an average of 0.20 s per month (95% confidence interval (CI): –0.365 to –0.041; p = 0.014). Interference performance improved by an average of 0.05 s per month (p = 0.207) and number of words increased by an average of 0.03 words per month (p = 0.079) on the verbal fluency test. On the maze test, patients with psychiatric comorbidities improved the most (0.52 s/month, p = 0.001), while on the interference test, patients with frontal lobe epilepsy (FLE), those taking 1–2 antiseizure medications (ASMs) and patients with focal to bilateral tonic–clonic seizures improved the most (0.14 s/month, p = 0.005; 0.14 s/month, p = 0.033 and 0.16 s/month, p = 0.087, respectively). For verbal fluency, no clinically meaningful improvement was noted in any of the groups. Conclusion During the follow‐up, maze performance markedly improved, while performance on the interference and verbal fluency tasks remained relatively stable at the group level. Accordingly, visual anticipation and planning improved during VNS therapy whereas response inhibition was unchanged at the group level despite significant enhancements in patients with FLE and those taking 1–2 ASM. Furthermore, the presence of psychiatric comorbidities correlated with even greater improvement on maze performance.https://doi.org/10.1002/brb3.70176attention and executive functionscognitiondrug‐resistant epilepsyvagus nerve stimulation |
| spellingShingle | Niina Lähde Pabitra Basnyat Jani Raitanen Leena Kämppi Kai Lehtimäki Eija Rosti‐Otajärvi Jukka Peltola Changes in Response Inhibition, Visual Anticipation and Verbal Fluency During Vagus Nerve Stimulation Therapy in Patients With Drug‐Resistant Epilepsy Brain and Behavior attention and executive functions cognition drug‐resistant epilepsy vagus nerve stimulation |
| title | Changes in Response Inhibition, Visual Anticipation and Verbal Fluency During Vagus Nerve Stimulation Therapy in Patients With Drug‐Resistant Epilepsy |
| title_full | Changes in Response Inhibition, Visual Anticipation and Verbal Fluency During Vagus Nerve Stimulation Therapy in Patients With Drug‐Resistant Epilepsy |
| title_fullStr | Changes in Response Inhibition, Visual Anticipation and Verbal Fluency During Vagus Nerve Stimulation Therapy in Patients With Drug‐Resistant Epilepsy |
| title_full_unstemmed | Changes in Response Inhibition, Visual Anticipation and Verbal Fluency During Vagus Nerve Stimulation Therapy in Patients With Drug‐Resistant Epilepsy |
| title_short | Changes in Response Inhibition, Visual Anticipation and Verbal Fluency During Vagus Nerve Stimulation Therapy in Patients With Drug‐Resistant Epilepsy |
| title_sort | changes in response inhibition visual anticipation and verbal fluency during vagus nerve stimulation therapy in patients with drug resistant epilepsy |
| topic | attention and executive functions cognition drug‐resistant epilepsy vagus nerve stimulation |
| url | https://doi.org/10.1002/brb3.70176 |
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