Effect of Long-Term Treatment with Vagus Nerve Stimulation on Mood and Quality of Life in Korean Patients with Drug-Resistant Epilepsy.
Kim JS, Kim DY, Jo HJ, Hwang YH, Song JY, Yang KI, Hong SB.
J Clin Neurol 2021;17(3):385-392
https://doi.org/10.3988/jcn.2021.17.3.385
Vagus nerve stimulation (VNS) is a proven therapy for reducing seizure burden in patients with drug-resistant epilepsy (DRE). Noteworthy, VNS Therapy also appears to exert beneficial effects beyond seizure reduction. This month we will put some extra focus on scientific publications that examine the effects of VNS Therapy on quality of life (QoL) characteristics in patients with DRE.
This recent publication by Kim et al. 2021, prospectively examined the effectiveness of VNS on QoL parameters, depressive mood, and suicidality in patients with DRE.
Highlights
• VNS Therapy resulted in significant improvements in QoL, depressive symptoms, and suicidality.
• Effects on quality of life were independent of seizure frequency reduction.
• Secondarily generalized tonic-clonic and complex partial seizures were significantly reduced following VNS implantation.
25 patients with DRE and complex partial seizures, who underwent VNS surgery, were recruited. The mean age at implantation was 30.4±9.5 years and the mean follow-up period was 13.7±5.5 months. Improvements in quality of life were measured using the Korean version of Patient-Weighted Quality of Life in Epilepsy Inventory-31 (K-QOLIE-31-P). Similarly, changes from baseline in depressive mood, anxiety, and suicidality were measured using the Korean version of Beck Depression Inventory-II (K-BDI-II), the Korean version of Beck Anxiety Inventory (K-BAI), and the Mini International Neuropsychiatric Interview Plus (MINI Plus), respectively. The study also examined changes in mean seizure frequency.
Long-term treatment with VNS resulted in significant improvements in QoL, symptoms of depression and suicidality. The results were independent of the effects on seizure frequency. Furthermore, no significant correlation between seizure burden and QoL improvements could be observed. Hence, the improvements in QoL might instead be related to the beneficial effects of VNS on other characteristics, such as depressive mood. A lower risk for suicidality at baseline was related to more extensive improvements in QoL. Improvements in depressive symptoms correlated with more severe depression prior to VNS implantation and improved QoL post VNS. Likewise, decreased suicidality was associated with an increased risk of suicide and mild depression at baseline, as well as a minor improvement in depressive symptoms post VNS implantation.
Notably, the frequency of complex partial seizures and secondarily generalized tonic-clonic seizures were significantly reduced by 51.8% and 93.8%, respectively, post VNS implantation.
To conclude, the current study highlights the possible beneficial effects of VNS Therapy beyond that of seizure frequency reduction in patients with DRE.
