Quality-of-life metrics with vagus nerve stimulation for epilepsy from provider survey data
Englot DJ, Hassnain KH, Rolston JD, Harward SC, Sinha SR, Haglund MM.
Epilepsy & Behavior 66 (2017) 4–9
https://doi.org/10.1016/j.yebeh.2016.10.005
This #registry study by Englot et al., 2016, aimed to evaluate the plausible effects of vagus nerve stimulation (#VNS) Therapy on quality of life (#QoL) characteristics in adult patients with drug resistant epilepsy (#DRE).
Highlights
• Following VNS implantation, improvements could be observed for multiple QoL outcomes (including #alertness, post-ictal states, and cluster #seizures).
• VNS response (≥50% reduction in seizure frequency) was significantly associated with net QoL improvements.
• Patients with better seizure control following VNS implantation were more likely to undergo replacement surgery.
Using the VNS Therapy Patient Outcome Registry (provided by LivaNova, Houston, TX, USA), the progression of seven QoL metrics (alertness, #memory, #mood, cluster seizures, oral communication, school/professional performance, and post-ictal state) was evaluated over time (from 0 months up to 48 months post VNS implantation) based on subjective reports from the treating physicians.
According to the database analysis (N=1194, mean age: 27.1±15.6 years), improvements for all seven QoL outcomes were reported following VNS Therapy. However, improvements in alertness (58-63%, patients reported as improved during follow-up), post-ictal states (55-62%), and cluster seizures (48-56%) were observed more frequently. No significant improvements over time could be identified.
Noteworthy, overall QoL improvements were significantly associated with VNS response and the likelihood of generator replacement.
The current results suggest VNS Therapy elicits beneficial effects on various QoL variables. These effects seem to be highly associated with generator replacement and seizure frequency reduction. For future studies, the use of standardized QoL questionnaires and/or evaluations pre and post VNS implantation should be considered to confirm the current results.
