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Can we predict response to vagus nerve stimulation in intractable epilepsy
Jinbiao Xiong1, Yiyao Cao1, Weidong Yang1
1Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
The International Journal of Neuroscience
|January 9, 2020
Summary
Vagus nerve stimulation (VNS) effectively reduces seizures in many epilepsy patients. However, predicting VNS treatment outcomes remains challenging, with some factors showing promise for identifying suitable candidates.
Area of Science:
- Neurology
- Epileptology
- Neurosurgery
Background:
- Vagus nerve stimulation (VNS) is FDA-approved for reducing seizure frequency.
- While effective for many, some patients exhibit poor or no clinical response to VNS.
Purpose of the Study:
- To identify predictive factors for VNS therapy effectiveness.
- To guide patient selection for optimal VNS treatment outcomes.
Main Methods:
- Systematic literature search of PubMed and Medline.
- Keywords: epilepsy, vagus nerve stimulation, VNS, intractable, refractory.
- Inclusion/exclusion criteria applied to selected studies.
Main Results:
- Numerous studies confirm VNS efficacy but lack clear predictive factors.
- Favorable factors include post-traumatic epilepsy, temporal lobe epilepsy, and focal interictal epileptiform discharges (IEDs).
- Poor indicators include comprehensive IEDs and neuronal migration disorders; younger patients and temporal lobe epilepsy patients benefit more. Novel biomarkers like cytokine profiles and HRV also show potential.
Conclusions:
- Further rigorous research is needed to validate conventional and novel factors for predicting VNS outcomes.
- Clearer correlations between specific factors and VNS therapy results require more scientific investigation.
