Tan Bojing, Liu Yuye, Gong Mingkun, Meng Fangang, Yang Anchao, Zhang Kai, Sang Lin, Zhang Jianguo
Department of Functional Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Department of Neurosurgery, Capital Institute of Pediatrics, Beijing, 100020, China.
Acta Epileptol. 2025 Sep 1;7(1):40. doi: 10.1186/s42494-025-00220-8.
At present, a number of indicators have been analyzed for the relationship with the efficacy of vagus nerve stimulation (VNS) in drug-resistant epilepsy (DRE) patients, but there is still no definite predictor of efficacy. This study is to assess the long-term effectiveness and predictors of VNS in DRE patients.
We analyzed DRE patients monitored for over a year post-surgery (2016-2019) to evaluate VNS outcomes. Logistic regression was used to identify efficacy predictors.
Out of 162 DRE patients with VNS, 99 were followed for over 12 months, 80 for over 24 months, and 70 for over 36 months. At 12 months, 33 (33.4%) showed effectiveness, including 7 (7.1%) who were seizure-free. At 24 months, 32 (40.0%) were effective, including 12 (15.0%) who were seizure-free. At 36 months, 36 (51.4%) were effective, including 11 (15.7%) who were seizure-free. After 5 years, 27 (55.1%) were effective, including 8 (16.3%) who were seizure-free. Multivariate regression analysis identified structural etiology as a predictive factor for the effective VNS treatment (P = 0.039, OR = 0.35 [0.13-0.95]).
VNS effectively controls seizures, with effectiveness and seizure-free rates improving over time. Patients with structural factors are at higher risk of ineffective VNS, suggesting epilepsy etiology may predict VNS outcomes.
目前，已对多项指标与迷走神经刺激术（VNS）治疗耐药性癫痫（DRE）患者疗效的关系进行了分析，但仍没有明确的疗效预测指标。本研究旨在评估VNS治疗DRE患者的长期疗效及疗效预测指标。
我们分析了术后接受一年以上监测（2016 - 2019年）的DRE患者，以评估VNS的治疗效果。采用逻辑回归分析来确定疗效预测指标。
162例接受VNS治疗的DRE患者中，99例随访超过12个月，80例随访超过24个月，70例随访超过36个月。12个月时，33例（33.4%）显示有效，其中7例（7.1%）无癫痫发作。24个月时，32例（40.0%）有效，其中12例（15.0%）无癫痫发作。36个月时，36例（51.4%）有效，其中11例（15.7%）无癫痫发作。5年后，27例（55.1%）有效，其中8例（16.3%）无癫痫发作。多因素回归分析确定结构病因是VNS治疗有效的预测因素（P = 0.039，OR = 0.35 [0.13 - 0.95]）。
VNS能有效控制癫痫发作，且有效率和无癫痫发作率随时间推移而提高。存在结构因素的患者VNS治疗无效的风险较高，提示癫痫病因可能预测VNS的治疗效果。
