VNS parameters for clinical response in epilepsy
Fahoum F, Boffini M, Kann L, Faini S, Gordon C, Tzadok M, El Tahry R.
Brain Stimul. 2022 May-Jun;15(3):814-821.
https://doi.org/10.1016/j.brs.2022.05.016
What are the most favorable vagus nerve stimulation (#VNS) parameter settings when treating patients with drug-resistant epilepsy (#DRE)?
This study by Fahoum et al. (May. 2022) proposed a generalized linear mixed model to understand the relationship between VNS parameter setting and clinical response in DRE patients. The model was based on data from 12 clinical studies (1178 patients).
Results indicated the output current to be the principal consideration for dose titration. The population level targets for VNS output current and duty cycle were 1.61 mA and 17.1% duty cycle. Other statistically significant contributors for #seizure control, unrelated to dosing parameters, were age at implantation, duration of epilepsy, and follow-up time.
Noteworthy, patient data originated from multiple publications with different study designs, follow-up durations, VNS generator models, and calendar years. Hence, further #prospective studies, such as the CORE-VNS registry (NCT03529045), are needed to verify the current results.