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Effect of Vagus Nerve Stimulation on Blood Inflammatory Markers in Children with Drug-Resistant Epilepsy: A Pilot
Valentina Baro1, Maria Vittoria Bonavina2, Francesco Saettini3
1Academic Neurosurgery, Department of Neuroscience, University of Padova, 35128 Padova, Italy.
Insights
Vagus nerve stimulation (VNS) may reduce inflammation in pediatric epilepsy. Blood inflammatory markers like IL-1β and PTX-3 showed trends related to seizure outcome, but larger studies are needed.
Area of Science:
- Pediatric Neurology
- Immunology
- Biochemistry
Background:
- Vagus nerve stimulation (VNS) is explored for epilepsy treatment.
- Central inflammation is a proposed mechanism for VNS efficacy.
Purpose of the Study:
- To analyze blood inflammatory markers in children undergoing VNS surgery.
- To correlate these markers with epilepsy treatment outcomes.
Main Methods:
- Blood samples analyzed for inflammatory markers (IgA, IgE, IgG, CD19, PTX3, IL-1β, TNF-α) before (T0) and after (T1) VNS.
- Patients classified by McHugh score for outcome assessment.
Main Results:
- Tendencies for IgA, IgE, IgG, CD19, and PTX3 variations between T0 and T1.
- IL-1β and PTX-3 decreased more in patients with better outcomes (Group 1).
- TNF-α decreased in Group 2, while slightly increasing in Group 1.
Conclusions:
- IL-1β and PTX-3 variations may correlate with improved epilepsy outcomes.
- Statistical significance was not reached, requiring larger patient cohorts.
- Further research is needed to confirm biochemical changes linked to clinical VNS improvement.
Background:
Since one of the suggested mechanisms of action of VNS on epilepsy is the reduction of central inflammation, we carried out a comprehensive analysis of blood inflammatory markers in children considered for VNS surgery.
Materials And Methods:
Five pediatric patients were studied. An extensive analysis of blood inflammatory markers was performed before surgery (T0) and six weeks after VNS implantation (T1). An epileptological outcome was obtained according to the McHugh score.
Results:
The variations of IgA, IgE, IgG, CD19, and PTX3 displayed a tendency toward a positive statistical correlation between T0 and T1. According to McHugh score, the patients were divided into Group 1 (i.e., Class I) and Group 2 (i.e., Classes II and III). IL-1β and PTX-3 tended to decrease more in Group 1, while TNF-α decreased in Group 2 (-56.65%) and slightly increased (+3.61%) in Group 1 at T1 without statistical correlation.
Conclusions:
The variation of IL-1β and PTX-3 seem to be related to a better outcome; thus, they do not reach statistical significance. A larger series of patients is needed to determine whether biochemical changes could relay with the clinical improvement of epilepsy.
