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Child's Nervous System
Erschienen in: Child's Nervous System 12/2015

01.12.2015 | Original Paper

Meta-analysis of vagus nerve stimulation treatment for epilepsy: correlation between device setting parameters and acute response

verfasst von: S. Ghani, J. Vilensky, B. Turner, R. S. Tubbs, M. Loukas

Erschienen in: Child's Nervous System | Ausgabe 12/2015

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Abstract

Background

Vagus nerve stimulation (VNS) is an adjunctive neurophysiological treatment for those patients who have pharmacoresistant or surgically resistant partial onset epilepsy.

Objective

The aim of this study is to determine the effects of high and low stimulation paradigms on a responder rate of ≥50 and ≥75 % reduction in seizure frequency and associated adverse effects in adults and children.

Method

A literature search was performed using Medline, PubMed, EMBASE, and Cochrane library for studies using vagus nerve stimulation published from January 1980 until July 2014 for medically or surgically resistant partial onset seizures, in children and adults. No restrictions on languages were imposed.

Data collection and analysis

Four authors reviewed and selected studies for inclusion and exclusion. The search identified five randomized control trials that fit with our inclusion criteria. The following outcomes were evaluated: 50 % or greater reduction in total seizure frequency, 75 % or greater reduction in total seizure frequency, and adverse effects.

Results

Four randomized controlled trials were analyzed in this meta-analysis. Results indicate high stimulation is more effective in adult patients who experienced ≥50 and ≥75 % reduction in seizure frequency with a significant difference within both high and low stimulation groups. In children, there was no significant difference between the two groups and patients with ≥50 % reduction in seizures. Adverse effects such as hoarseness and dyspnea were more common in the high stimulation group where the remaining side effects were not statistically different among both groups.

Conclusion

High stimulation is more effective than low stimulation in producing a greater reduction in seizure frequency in patients with medically and surgically resistant epilepsy.
Literatur
1.
Alexopoulos AV, Kotagal P, Loddenkemper T, Hammel J, Bingaman WE (2006) Long term results with vagus nerve stimulation in children with pharmacoresistant epilepsy. Seizure 15:491–503CrossRefPubMed
2.
Amar AP, DeGiorgio CM, Tarver WB, Apuzzo ML (1999) Long-term multicenter experience with vagus nerve stimulation for intractable partial seizures: results of the XE5 trial. Stereotact Funct Neurosurg 73:104–108CrossRefPubMed
3.
Ardesch JJ, Buschman HPJ, Wagener-Schimmel LJJC, van der Aa HE, Hageman G (2007) Vagus nerve stimulation for medically refractory epilepsy: A long-term follow-up study. Seizure 16:579–585CrossRefPubMed
4.
Asconape JJ, Moore DD, Zipes DP, Hartman LM, Duffell WH Jr (1999) Bradycardia and asystole with the use of vagus nerve stimulation for the treatment of epilepsy: a rare complication of intraoperative device testing. Epilepsia 40:1452–1454CrossRefPubMed
5.
Ben-Menachem E, Manon-Espaillat R, Ristanovic R, Wilder BJ, Stefan H, Mirza W, Tarver WB, Wernicker JF (1994) Vagus nerve stimulation for treatment of partial seizures: 1. A controlled study of effect on seizures. First Int Vagus Nerve Stimulation Study Group Epilepsia 35:616–626
6.
Ben-Menachem E, Hellstrom K, Waldton C, Augustinsson LE (1999) Evaluation of refractory epilepsy treated with vagus nerve stimulation for up to 5 years. Neurology 52(6):1265–1267CrossRefPubMed
7.
Boon P, Vonck K, Vandekerckhove T, D’have M, Nieuwenhuis L, Michielsen G, Vanbelleghem H, Goethals I, Caemaert J, Calliauw L, De Reuck J (1999) Vagus nerve stimulation for medically refractory epilepsy; efficacy and cost-benefits analysis. Acta Neurochir (Wien) 141:447–452CrossRef
8.
Chavel SM, Westerveld M, Spencer S (2003) Long-term outcome of vagus nerve stimulation for refractory partial epilepsy. Epilepsy Behav 4(3):302–309CrossRefPubMed
9.
Clarke BM, Upton AR, Griffin H, Fitzpatrick D, DeNardis M (1997) Seizure control after stimulation of the vagus nerve: clinical outcome measures. Can J Neurol Sci 24(3):222–225PubMed
10.
Cyberonics (1998) Physician’s manual for the Model 100 NCP pulse generator. Houston, TX, Cyberonics, Ref Type: Pamphlet
11.
Danielsson S, Viggedal G, Gillberg C, Olsson I (2008) Lack of effects of vagus nerve stimulation on drug-resistant epilepsy in eight pediatric patients with autism spectrum disorders: A prospective 2-year follow-up study. Epilepsy Behav 12:298–304CrossRefPubMed
12.
De Benedictis A, Freri E, Rizzi M, Franzini A, Ragona F, Specchio N, Rebessi E, Casazza M, Granata T, Marras CE (2013) Vagus nerve stimulation for drug-resistant Epilepsia Partialias Continua: Report of four cases. Epilepsy Res 107:163–171CrossRefPubMed
13.
DeGiorgio CM, Schachter SC, Handforth A, Salinsky M, Thompson J, Uthman B, Reed R, Collins S, Tecoma E, Morris GL, Vaughn B, Naritoku DK, Henry T, Labar D, Gilmartin R, Labiner D, Osorio I, Ristanovic R, Jones J, Murphy J, Ney G, Wheless J, Lewis P, Heck C (2000) Prospective Long-Term Study of Vagus Nerve Stimulation for the Treatment of Refractory Seizures. Epilepsia 41(9):1195–1200CrossRefPubMed
14.
DeGiorgio C, Heck C, Bunch S, Britton J, Green P, Lancman M, Murphy J, Olejniczak P, Shih J, Arrambide S, Soss J (2005) Vagus nerve stimulation for epilepsy: randomized comparison of three stimulation paradigms. Neurology 65:317–319CrossRefPubMed
15.
Elsharkawy AE, Alabbasi AH, Pannek H, Oppel F, Schulz R, Hoppe M, Hamad AP, Nayel M, Issa A, Ebner A (2009) Long term outcome after temporal lobe epilepsy surgery in 434 consecutive adult patients. J Neurosurg 110:1135–1146CrossRefPubMed
16.
Elsharkawy AE, Pannek H, Schulz R, Hoppe M, Pahs G, Gyimesi C, Nayel M, Issa A, Ebner A (2008) Outcome of extratemporal epilepsy surgery experience of a single center. Neurosurgery 63:516–525, Discussion 525–516 CrossRefPubMed
17.
Elsharkawy AE, Behne F, Oppel F, Pannek H, Schulz R, Hoppe M, Pahs G, Gyimesi C, Navel M, Issa A, Ebner A (2008) Long-term outcome of extratemporal epilepsy surgery among 154 adult patients. J Neurosurg 108:676–686CrossRefPubMed
18.
Fai AHC, Kuen JLM, Shing WK, Kay R, Sing PW (2004) Vagus nerve stimulation for refractory epilepsy long term efficacy and side-effects. Chin Med J (Engl) 117:58–61
19.
Gates J, Huf R, Frost M (2001) Vagus nerve stimulation for patients in residential treatment facilities. Epilepsy Behav 2:563–567CrossRefPubMed
20.
George R, Salinsky M, Kuzniecky R, Rosenfeld W, Bergen D, Tarver WB, Wernicke JF, First International Vagus Nerve Stimulation Study Group (1994) Vagus nerve stimulation for treatment of partial seizures: 3. Long-term follow-up on first 67 patients exiting a controlled study. Epilepsia 35(3):637–643CrossRefPubMed
21.
Hallbook T, Lundgren J, Stjernqvist K, Blennow G, Stromblad LG, Rosen I (2005) Vagus nerve stimulation in 15 children with therapy resistant epilepsy; its impact on cognition, quality of life, behaviour and mood. Seizure 14:504–513CrossRefPubMed
22.
Hammond BM, Uthman BM, Wilder BJ, Ben-Menachem E, Hamberger A, Hedner T, Ekman R (1992) Neurochemical effects of the vagus nerve stimulation in humans. Brain Res 583:300–303CrossRefPubMed
23.
Handforth A, DeGiorgio CM, Schachter SC, Uthman BM, Naritoku DK, Tecoma ES, Henry TR, Collins SD, Vaughn BV, Gilmartin RC, Labar DR, Morris GL III, Salinsky MC, Osorio I, Ristanovic RK, Labiner DM, Jones JC, Murphy JV, Ney GC, Wheless JW (1998) Vagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial. Neurology 51:48–55CrossRefPubMed
24.
Henry TR, Votaw JR, Pennell PB, Epstein C, Bakay RA, Faber TL, Grafton ST, Hoffman JM (1999) Acute blood flow changes and efficacy of vagus nerve stimulation in partial epilepsy. Neurology 52:1166–1173CrossRefPubMed
25.
Holmes MD, Silbergeld DL, Drouhard D, Wilensky AJ, Ojemann LM (2004) Effect of vagus nerve stimulation on adults with pharmacoresistant generalized epilepsy syndromes. Seizure 13:340–345CrossRefPubMed
26.
Hornig GW, Murphy JV, Schallert G, Tilton C (1997) Left vagus nerve stimulation in children with refractory epilepsy: An update. South Med J 90(5):484–488CrossRefPubMed
27.
Hosain S, Nikalov B, Harden C, Li M, Fraser R, Labar D (2000) Vagus nerve stimulation treatment for Lennox-Gastaut syndrome. J Child Neurol 15(8):509–512CrossRefPubMed
28.
Hsiang JN, Wong LK, Kay R, Poon WS (1998) Vagus nerve stimulation for seizure control: Local experience. J Clin Neurosci 5(3):294–297CrossRefPubMed
29.
Huf RL, Mamelak A, Kneedy-Cayem K (2005) Vagus nerve stimulation therapy: 2-year prospective open-label study of 40 subjects with refractory epilepsy and low IQ who are living in long-term care facilities. Epilepsy Behav 6:417–423CrossRefPubMed
30.
Kimura J (1989) Electrodiagnosis in diseases of nerve and muscle: principles and practice. FA Davis Company, Philadelphia
31.
Kim W, Clancy RR, Liu GT (2001) Horner syndrome associated with implantation of a vagus nerve stimulator. Am J Ophthalmol 131:383–384CrossRefPubMed
32.
Klinkenberg S, Aalbers MW, Vles JS, Cornips EM, Rijkers K, Leenen L, Kessels FG, Aldenkamp AP, Majoie M (2012) Vagus nerve stimulation in children with intractable epilepsy: a randomized controlled trial. Dev Med Child Neurol 54:855–861CrossRefPubMed
33.
Koo B, Ham SD, Sood S, Tarver B (2001) Human vagus nerve electrophysiology: a guide to vagus nerve stimulation parameters. J Clin Neurophysiol 18:429–433CrossRefPubMed
34.
Koszewski W, Bacia T, Rysz A (2003) Vagus nerve stimulation (VNS) in the treatment of drugresistant epilepsy. A 4-year follow-up evaluation of VNS treatment efficacy. Neurol Neurochir Pol 37(3):573–586PubMed
35.
Koutroumanidis M, Binnie CD, Hennessy MJ, Alarcon G, Elwes DC, Toone BK, Chandler C, Selway R, Polkey CE, O'Connor SA (2003) VNS in patients with previous unsuccessful resective epilepsy surgery: antiepileptic and psychotropic effects. Acta Neurol Scand 107:117–121CrossRefPubMed
36.
Krahl SE, Senanayake SS, Handforth A (1990) Destruction of peripheral C-fibers does not alter subsequent vagus nerve stimulation-induced seizure in rats. Epilepsia 31:S7–S19
37.
Labar D (2004) Vagus nerve stimulation for 1 year in 269 patients on unchanged antiepileptic drugs. Seizure 13:392–398CrossRefPubMed
38.
Labar D, Nikolov B, Tarver B, Fraser R (1998) Vagus nerve stimulation for symptomatic generalized epilepsy: a pilot study. Epilepsia 39(2):201–205CrossRefPubMed
39.
Landy HJ, Ramsay RE, Slater J, Casiano RR, Morgan R (1993) Vagus nerve stimulation for complex partial seizures: surgical technique, safety and efficacy. J Neurosurg 78:26–31CrossRefPubMed
40.
Lockard JS, Congdon WC (1986) Effects of vagal stimulation on seizure rate in monkey model. Epilepsia 27:626
41.
Lundgren J, Amark P, Blennow G, Stromblad LG, Wallstedt L (1998) Vagus nerve stimulation in 16 children with refractory epilepsy. Epilepsia 39(8):809–813CrossRefPubMed
42.
Lundy DS, Casiano RR, Landy HJ, Gallo J, Gallo B, Ramsey RE (1993) Effects of vagal nerve stimulation on laryngeal function. J Voice 7:359–364CrossRefPubMed
43.
Majoie HJM, Berfelo MW, Aldenkamp AP, Evers SMAA, Kessels AGH, Renier WO (2001) Vagus nerve stimulation in children with therapy-resistant epilepsy diagnosed as Lennox-Gastaut syndrome. Clinical results, neuropsychological effects, and cost-effectiveness. J Clin Neurophysiol 18(5):419–428CrossRefPubMed
44.
Michael JE, Wegener K, Barnes DW (1993) Vagus nerve stimulation for intractable seizures: one year follow-up. J Neurosci Nurs 25(6):362–366CrossRefPubMed
45.
Mohanraj R, Brodie MJ (2006) Diagnosing refractory epilepsy: response to sequential treatment schedules. Eur J Neurol 13:277–282CrossRefPubMed
46.
Morris GL, Mueller W (1999) Long-term treatment with vagus nerve stimulation in patients with refractory epilepsy. Neurology 53(8):1731–1735CrossRefPubMed
47.
Morrow JI, Bingham E, Craig JJ, Gray WJ (2000) Vagal nerve stimulation in patients with refractory epilepsy. Effect on seizure frequency, severity and quality of life. Seizure 9:442–445CrossRefPubMed
48.
Muller K, Fabo D, Entz L, Kelemen A, Halasz P, Rasonyi G, Eross L (2010) Outcome of vagus nerve stimulation for epilepsy in Budapest. Epilepsia 51:98–101CrossRefPubMed
49.
Murphy JV (1999) Left vagal nerve stimulation in children with medically refractory epilepsy: the Pediatric VNS Study Group. J Pediatr 134:563–566CrossRefPubMed
50.
Parker AP, Polkey CE, Binnie CD, Madigan C, Ferrie CD, Robinson RO (1999) Vagal nerve stimulation in epileptic encephalopathies. Pediatrics 103:778–782CrossRefPubMed
51.
Patwardhan RV, Stong B, Bebin EM, Mathisen J, Grabb PA (2000) Efficacy of vagal nerve stimulation in children with medically refractory epilepsy. Neurosurgery 47:1353–1357CrossRefPubMed
52.
Penry JK, Dean JC (1990) Prevention of intractable partial seizures by intermittent vagal stimulation in humans: preliminary results. Epilepsia 31:S40–S43CrossRefPubMed
53.
Ramsay RE, Uthman BM, Augustinsson LE, Upton AR, Naritoku D, Willis J, Treig T, Barolat G, Wernicke JF, First International Vagus Nerve Stimulation Study Group (1994) Vagus nerve stimulation for treatment of partial seizures: 2. Safety, side effects, and tolerability. Epilepsia 35:627–636CrossRefPubMed
54.
Reid SA (1990) Surgical technique for implantation of the neurocybernetic prosthesis. Epilepsia 31(suppl 2):S38–S39CrossRefPubMed
55.
Roosevelt RW, Smith DC, Clough RW, Jensen RA, Browning RA (2006) Increased extracellular concentrations of norepinephrine in cortex and hippocampus following vagus nerve stimulation in the rat. Brain Res 1119:124–132PubMedCentralCrossRefPubMed
56.
Ryvlin P, Gilliam FG, Nguyen DK, Colicchio G, Iudice A, Tinuper P, Zamponi N, Aguglia U, Wagner L, Minotti L, Stefan H, Boon P, Sadler M, Benna P, Raman P, Perucca E (2014) The long-term effect of vagus nerve stimulation on quality of life in patients with pharmacoresistant focal epilepsy: The PuLsE (open prospective randomized long-term effectiveness) trial. Epilepsia 55(6):893–900PubMedCentralCrossRefPubMed
57.
Salinsky MC, Uthman BM, Ristanovic RK, Wernicke JF, Tarver WB (1996) Vagus nerve simulation for the treatment of medically intractable seizures. Results of a 1-year open extension trial. Vagus Nerve Stimulation Study group. Arch Neurol 53:1176–1180CrossRefPubMed
58.
Santiago-Rodriguez E, Alonso-Vanegas M, Cardenas-Morales L, Harmony T, Bernardino M, Fernandez-Bouzas A (2006) Effects of two different cycles of vagus nerve stimulation on interictal epileptiform discharges. Seizure 15:615–620CrossRefPubMed
59.
Scherrmann J, Hoppe C, Kral T, Schramm J, Elger CE (2001) Vagus nerve stimulation: clinical experience in a large patient series. J Clin Neurophysiol 18:408–414CrossRefPubMed
60.
Shimizu H, Ishijima B, Nakamura K, Asakura T, Ohtsuki T, Yoshimoto T, Taira T, Kawamura H, Takakura K (1995) Effect of vagal stimulation on intractable epilepsy. Psychiatry Clin Neurosci 49:S254–S255CrossRefPubMed
61.
Shorvon SD (1996) The epidemiology and treatment of chronic and refractory epilepsy. Epilepsia 37 (Suppl. 2): S1-3
62.
63.
Smyth MD, Tubbs RS, Bebin EM, Grabb PA, Blount JP (2003) Complications of chronic vagus nerve stimulation for epilepsy in children. J Neurosurg 99:500–503CrossRefPubMed
64.
Spanaki MV, Allen LS, Mueller WM, Morris GL III (2004) Vagus nerve stimulation therapy: 5-year or greater outcome at a university-based epilepsy center. Seizure 13:587–590CrossRefPubMed
65.
Stefan H, Kreiselmeyer G, Kerling F, Kurzbuch K, Rauch C, Heers M, Kasper BS, Hammen T, Rzonsa M, Pauli E, Ellrich J, Graf W, Hopfengartner R (2012) Transcutaneous vagus nerve stimulation (t-VNS) in pharmacoresistant epilepsies: A proof of concept trial. Epilepsia 53(7):e115–e118CrossRefPubMed
66.
Tanganelli P, Ferrero S, Colotto P, Regesta G (2002) Vagus nerve stimulation for treatment of medically intractable seizures. Evaluation of long-term outcome. Clin Neurol Neurosurg 105:9–13CrossRefPubMed
67.
Tatum WO, Johnson KD, Goff S, Ferreira JA, Vale FL (2001) Vagus nerve stimulation and drug reduction. Neurology 56:561–563CrossRefPubMed
68.
Terry R, Tarver WB, Zabara J (1990) An implantable neurocybernetic prosthesis system. Epilepsia 31(suppl 2):S33–S37CrossRefPubMed
69.
Terry R, Tarver WB, Zabara J (1991) The implantable neurocybernetic prosthesis system. Pacing Clin Electrophysiol 14:86–93CrossRefPubMed
70.
Uthman BM, Wilder BJ, Hammond EJ, Reid SA (1990) Efficacy and safety of vagus nerve stimulation in patients with complex partial seizures. Epilepsia 31(2):S44–S50CrossRefPubMed
71.
Uthman BM, Wilder BJ, Penry JK, Dean C, Ramsay RE, Reid SA, Hammond EJ, Tarver WB, Wernicke JF (1993) Treatment of epilepsy by stimulation of the vagus nerve. Neurology 43:1338–1345CrossRefPubMed
72.
The Vagus Nerve Stimulation Study Group (1995) A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. Neurology 45:224–230CrossRef
73.
Vonck K, Boon P, D’Have M, Vandekerckhove T, O’Connor S, De Reuck J (1999) Long term results of vagus nerve stimulation in refractory epilepsy. Seizure 8:328–334CrossRefPubMed
74.
Vonck K, Thadani V, Gilbert K, Dedeurwaerdere S, De Groote L, De Herdt V, Goossens L, Gossiaux F, Achten E, Thiery E, Vingerhoets G, Van Roost D, Caemaert J, De Reuck J, Roberts D, Williamson P, Boon P (2004) Vagus nerve stimulation for refractory epilepsy: a transatlantic experience. J Clin Neurophysiol 21:283–289CrossRefPubMed
75.
Walker BR, Easton A, Gale K (1999) Regulation of limbic motor seizures by GABA and glutamate transmission into the nucleus tract of solitaries. Epilepsia 40:1051–1057CrossRefPubMed
76.
Wilder BJ, Uthman BM, Hammond EJ (1991) Vagal stimulation for control of complex partial seizures in medically refractory epileptic patients. PACE 14:108–115CrossRefPubMed
77.
Woodbury DM, Woodbury JW (1990) Effects of vagal nerve stimulation on experimentally induced seizures in rats. Epilepsia 31(Suppl 2):S7–S19CrossRefPubMed
78.
Woodbury JW, Woodbury DM (1991) Vagal stimulation reduces the severity of maximal electroshock seizures in intact rats; use of cuff electrode for stimulating and recording. Pacing Clin Electrophysiol 14:94–107CrossRefPubMed
79.
Zabara J (1992) Inhibition of experimental seizures in canines by repetitive vagal stimulation. Epilepsia 33:1005–1012CrossRefPubMed
80.
Zamponi N, Rychlicki F, Cardinali C, Luchetti A, Trignani R, Ducati A (2002) Intermittent vagal nerve stimulation in paediatric patients: 1-year follow-up. Childs Nerv Syst 18:61–66CrossRefPubMed
81.
Zumsteg D, Jenny D, Wieser HG (2000) Vocal cord adduction during vagus nerve stimulation for treatment of epilepsy. Neurology 54:1388–1389CrossRefPubMed
Metadaten
Titel
Meta-analysis of vagus nerve stimulation treatment for epilepsy: correlation between device setting parameters and acute response
verfasst von
S. Ghani
J. Vilensky
B. Turner
R. S. Tubbs
M. Loukas
Publikationsdatum
01.12.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 12/2015
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-015-2921-1

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