Kim Jeong Sik, Kim Dong Yeop, Jo Hyun Jin, Hwang Yoon Ha, Song Joo Yeon, Yang Kwang Ik, Hong Seung Bong
Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University School of Medicine, Seoul, Korea.
Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea.
J Clin Neurol. 2021 Jul;17(3):385-392. doi: 10.3988/jcn.2021.17.3.385.
This study aimed to determine the long-term effects of vagus nerve stimulation (VNS) treatment on suicidality, mood-related symptoms, and quality of life (QOL) in patients with drug-resistant epilepsy (DRE). We also investigated the relationships among these main effects, clinical characteristics, and VNS parameters.
Among 35 epilepsy patients who underwent VNS implantation consecutively in our epilepsy center, 25 patients were recruited to this study for assessing the effects of VNS on suicidality, mood-related symptoms, and QOL. The differences in these variables between before and after VNS treatment were analyzed statistically using paired t-tests. Multiple linear regression analyses were also performed to determine how the patients' demographic and clinical characteristics influenced the variables that showed statistically significant changes after long-term VNS treatment.
After VNS, our patients showed significant improvements not only in the mean seizure frequency but also in suicidality, depression, and QOL. The reduction in depression was associated with the improvement in QOL and more-severe depression at baseline. The reduction in suicidality was associated with higher suicidality at baseline, smaller changes in depression, and less-severe depression at baseline. Improved QOL was associated with lower suicidality at baseline.
This study found that VNS decreased the mean seizure frequency in patients with DRE, and also improved their depression, suicidality, and QOL. These results provide further evidence for therapeutic effect of VNS on psychological comorbidities of patients with DRE.
本研究旨在确定迷走神经刺激(VNS)治疗对耐药性癫痫(DRE)患者自杀倾向、情绪相关症状及生活质量(QOL)的长期影响。我们还研究了这些主要影响、临床特征与VNS参数之间的关系。
在我们癫痫中心连续接受VNS植入的35例癫痫患者中,招募了25例患者来评估VNS对自杀倾向、情绪相关症状及生活质量的影响。使用配对t检验对VNS治疗前后这些变量的差异进行统计学分析。还进行了多元线性回归分析,以确定患者的人口统计学和临床特征如何影响长期VNS治疗后显示出统计学显著变化的变量。
VNS治疗后,我们的患者不仅平均癫痫发作频率显著改善,而且自杀倾向、抑郁及生活质量也有显著改善。抑郁的减轻与生活质量的改善及基线时更严重的抑郁相关。自杀倾向的降低与基线时较高的自杀倾向、抑郁变化较小及基线时较轻的抑郁相关。生活质量的改善与基线时较低的自杀倾向相关。
本研究发现VNS降低了DRE患者的平均癫痫发作频率,还改善了他们的抑郁、自杀倾向及生活质量。这些结果为VNS对DRE患者心理合并症的治疗效果提供了进一步证据。