接受迷走神经刺激治疗的癫痫患者的日间警觉性和生活质量。

Daytime vigilance and quality of life in epileptic patients treated with vagus nerve stimulation.

作者信息

Galli Renato, Bonanni Enrica, Pizzanelli Chiara, Maestri Michelangelo, Lutzemberger Ludovico, Giorgi Filippo Sean, Iudice Alfonso, Murri Luigi

机构信息

Department of Neurosciences, University of Pisa, via Roma, 67, I-56126 Pisa, Italy.

出版信息

Epilepsy Behav. 2003 Apr;4(2):185-91. doi: 10.1016/s1525-5050(03)00003-9.

DOI:10.1016/s1525-5050(03)00003-9

PMID:12697145

Abstract

OBJECTIVES

The goal of this study was to determine if vagus nerve stimulation (VNS) has any effect on daytime vigilance and perceived sense of well-being.

METHODS

Multiple Sleep Latency Tests (MSLTs) were performed and visual reaction times (VRTs) obtained in eight epileptic patients before and during treatment with VNS. Prior to VNS initiation patients' baseline MSLT and VRT scores were recorded. Six months after VNS was initiated, treatment MSLT and VRT scores were obtained. A group of 12 age-matched healthy subjects served as controls. In addition, there was a global evaluation of well-being at baseline and during a follow-up of 6 months.

RESULTS

As expected, patients evaluated both at baseline and during VNS showed more sleepiness than controls. In this group, baseline sleep latencies on the MSLT were significantly shorter, while VRT latencies were significantly longer than those of controls. After 6 months of VNS, MSLT scores in the eight patients did not change significantly with respect to baseline. However, if the single patient treated with relatively high stimulus intensities (1.75 mA) was excluded from the group and only the seven patients treated with low stimulus intensities (<or=1.5 mA) were considered, a significant effect of chronic VNS on MSLT scores could be observed. In fact, the mean sleep latency (MSL) average of the seven subjects significantly improved from 9.9+/-2.5 minutes during baseline to 10.9+/-2.3 minutes after 6 months of VNS (P<0.05). Conversely, the only patient treated with high stimulus intensities showed increased sleepiness, with MSL decreasing from 14.4 to 9.8 minutes. On the other hand, VRT latencies did not significantly change during VNS. Patients considered as a whole had significant improvements on global evaluation scores of quality of life.

CONCLUSION

VNS at low stimulus intensities promotes daytime vigilance in adult epileptic patients and has a positive effect on quality of life.

摘要

目的

本研究的目的是确定迷走神经刺激（VNS）对白天警觉性和幸福感是否有任何影响。

方法

对8例癫痫患者在VNS治疗前和治疗期间进行多次睡眠潜伏期测试（MSLT）并获得视觉反应时间（VRT）。在开始VNS之前，记录患者的基线MSLT和VRT分数。VNS开始6个月后，获得治疗后的MSLT和VRT分数。一组12名年龄匹配的健康受试者作为对照。此外，在基线时和6个月的随访期间对幸福感进行了全面评估。

结果

正如预期的那样，在基线时和VNS期间评估的患者比对照组表现出更多的嗜睡。在该组中，MSLT的基线睡眠潜伏期明显更短，而VRT潜伏期明显长于对照组。VNS治疗6个月后，8例患者的MSLT分数与基线相比没有显著变化。然而，如果将接受相对高刺激强度（1.75 mA）治疗的单一患者排除在该组之外，仅考虑接受低刺激强度（≤1.5 mA）治疗的7例患者，则可以观察到慢性VNS对MSLT分数有显著影响。事实上，7名受试者的平均睡眠潜伏期（MSL）从基线时的9.9±2.5分钟显著改善为VNS 6个月后的10.9±2.3分钟（P<0.05）。相反，接受高刺激强度治疗的唯一患者嗜睡增加，MSL从14.4分钟降至9.8分钟。另一方面，VRT潜伏期在VNS期间没有显著变化。总体而言，患者在生活质量的全面评估分数上有显著改善。