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Updated: Sep 14, 2025
Transauricular Vagus Nerve Stimulation and Electroencephalographic Assessment in Disorders of Consciousness
Published on: July 11, 2025
Transcutaneous Vagus Nerve Stimulation Treatment of Epileptic Encephalopathy with Spike-and-Wave Activation in Sleep:
Jifeng Gong1, Zheng Yan1, Jingyi Zhang2
1College of Information Science and Engineering, Huaqiao University, Xiamen, China.
Insights
Transcutaneous vagus nerve stimulation improved cognitive function and reduced seizures in children with drug-resistant epileptic encephalopathy. This treatment shows promise for managing this challenging neurological condition.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Medical Devices
Background:
- Drug-resistant epileptic encephalopathy with spike-and-wave activation in sleep presents significant cognitive and seizure challenges in children.
- Current treatment options for this condition are often limited, necessitating the exploration of novel therapeutic approaches.
Purpose of the Study:
- To investigate the efficacy of transcutaneous vagus nerve stimulation (tVNS) in pediatric patients diagnosed with drug-resistant epileptic encephalopathy with spike-and-wave activation in sleep.
- To assess the impact of tVNS on cognitive function and seizure control in this specific pediatric population.
Main Methods:
- A prospective study involving seven pediatric patients with drug-resistant epileptic encephalopathy undergoing 12 weeks of tVNS.
- Cognitive changes were evaluated using the Chinese Revised Wechsler Intelligence Scale for Children (C-WISC).
- Electroencephalography (EEG) data were analyzed using microstate parameters and graph theory metrics to assess brain dynamics.
Main Results:
- A 12-week tVNS treatment led to a significant increase in Memory/Concentration Intelligence Quotient (M/CIQ) and achieved seizure cessation in 57.14% of patients.
- tVNS altered EEG microstate parameters, including a reduction in the mean duration of microstate C and changes in the predominance of microstates A, B, and D.
- Significant reductions were observed in the global efficiency, local efficiency, and strength of the microstate-based functional brain subnetwork.
Conclusions:
- Transcutaneous vagus nerve stimulation demonstrates efficacy in improving cognitive status in pediatric patients with drug-resistant epileptic encephalopathy with spike-and-wave activation in sleep.
- tVNS offers a potential therapeutic strategy for managing cognitive deficits and seizures in this challenging pediatric neurological disorder.
Abstract:
ObjectiveThe purpose of this study was to investigate the efficacy of transcutaneous vagus nerve stimulation in pediatric patients with drug-resistant epileptic encephalopathy with spike-and-wave activation in sleep.MethodsWe prospectively investigate seven drug-resistant epileptic encephalopathy with spike-and-wave activation in sleep children who underwent transcutaneous vagus nerve stimulation for 12 weeks. The Chinese Revised Wechsler Intelligence Scale for Children (C-WISC) was used to assess cognitive changes before and after stimulation. Microstate parameters (mean duration, occurrence, and coverage) were obtained by quantifying each patient's electroencephalography (EEG) findings. Correlation analyses were used to assess the association between microstate parameters and cognitive scores. We analyzed the brain dynamics of the patients based on 4 categories of classical microstates using weighted phase lag index to construct a whole brain dynamic network. Finally, the brain network was quantitatively analyzed based on graph theory metrics (including global efficiency, local efficiency, and strength).ResultsA 12-week transcutaneous vagus nerve stimulation resulted in a significant increase in M/CIQ (Memory/Concentration Intelligence Quotient) and in seizure cessation in 57.14% of patients. The mean duration of microstate C was significantly reduced and enlarged the bidirectional predominance of microstate A and B, while weakening the directional predominance of microstates A, B, and D to C. The global efficiency, local efficiency, and strength of the microstate-based functional subnetwork were significantly reduced. And M/CIQ showed a strong correlation with the mean duration.SignificanceThis study revealed the efficacy of transcutaneous vagus nerve stimulation in improving the cognitive state of drug-resistant epileptic encephalopathy with spike-and-wave activation in sleep pediatric patients.
