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Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
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Vagus nerve stimulation: anti-inflammatory effects in epilepsy
Veronika Abzalova1,2, Sholpan Kauynbekova1,2, Gabit Makhambayev1,2
1Department of Surgical Diseases, Karaganda Medical University, Karaganda, Kazakhstan.
Frontiers in Human Neuroscience
|May 8, 2026
Summary
Vagus Nerve Stimulation (VNS) for epilepsy shows therapeutic effects linked to blood-brain barrier stabilization and systemic immunomodulation. Biomarker monitoring offers an objective measure of VNS treatment response.
Area of Science:
- Neurology
- Biomarkers
- Epilepsy Treatment
Background:
- Vagus Nerve Stimulation (VNS) is a standard treatment for drug-resistant epilepsy.
- The precise biological mechanisms behind VNS's cumulative therapeutic effect are not fully understood.
- Objective methods are needed to monitor VNS treatment response.
Purpose of the Study:
- To evaluate neuroinflammation and neurodegeneration biomarkers for monitoring VNS therapeutic response in pediatric epilepsy.
- To investigate the temporal relationship between biomarker changes and seizure frequency reduction.
Main Methods:
- Prospective longitudinal study of 40 pediatric epilepsy patients (20 active VNS, 20 controls).
- Plasma levels of UCH-L1, HMGB1, and NSE were measured at baseline and 3, 6, 12 months.
- Clinical efficacy was assessed by seizure frequency reduction.
Main Results:
- Active VNS significantly reduced seizure frequency by 44.4% at 12 months (p < 0.001).
- UCH-L1 decreased by 6 months (p = 0.009), suggesting early blood-brain barrier stabilization.
- HMGB1 decreased by 12 months (p < 0.001), correlating with clinical improvement (r = 0.63).
- NSE levels showed no significant longitudinal changes.
Conclusions:
- VNS efficacy involves a multi-phasic biological response, including early blood-brain barrier stabilization and delayed systemic immunomodulation.
- Dynamic assessment of peripheral biomarkers provides an objective correlate of VNS clinical improvement.
- This biomarker panel can aid in monitoring VNS response and personalizing neuromodulation parameters.
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