Epilepsy patients with and without perceived benefit from vagus nerve stimulation: A long-term observational single center study

ConclusionHalf of the patients had not perceived clear benefit from VNS, and all but one terminated VNS without worsening of seizures within one year. The true outcome of long-term VNS is difficult to assess in real-world practice. The effect may be overestimated due to confounding factors, particularly the common introduction of novel AEDs and the natural course of the disorder. Patients without perceived benefit from long-term VNS should not routinely remain on treatment and be subject to undue generator re-implantations.
Source: Seizure - Category: Neurology Source Type: research

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ConclusionOur results suggest that pulsed FUS exposure effectively suppresses epileptic spikes in an acute epilepsy animal model, and finds that ultrasound pulsation interferes with neuronal activity and affects the PTZ-induced PI3K-Akt-mTOR pathway, which might help explain the mechanism underlying ultrasound-related epileptic spike control.
Source: Brain Stimulation - Category: Neurology Source Type: research
ConclusionOur results suggest that pulsed FUS exposure effectively suppresses epileptic spikes in an acute epilepsy animal model, and finds that ultrasound pulsation interferes with neuronal activity and affects the PTZ-induced PI3K-Akt-mTOR pathway, which might help explain the mechanism underlying ultrasound-related epileptic spike control.
Source: Brain Stimulation - Category: Neurology Source Type: research
Epilepsy is a neurological disorder characterized by abnormal neuron discharge, and one-third of epilepsy patients suffer from drug-resistant epilepsy (DRE). The current management for DRE includes epileptogenic lesion resection, disconnection, and neuromodulation. Neuromodulation is achieved through invasive electrical stimulus including deep brain stimulation, vagus nerve stimulation, or responsive neurostimulation (RNS). As an alternative therapy, transcranial focused ultrasound (FUS) can transcranially and non-invasively modulate neuron activity.
Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation - Category: Neurology Authors: Source Type: research
Publication date: Available online 5 September 2019Source: Trends in Pharmacological SciencesAuthor(s): Omid Kavehei, Tara Julia Hamilton, Nhan Duy Truong, Armin NikpourEpilepsy is a neurological disorder that affects ~1% of the world population. Nearly 30% of epilepsy patients suffer from pharmacoresistant epilepsy that cannot be treated with antiepileptic drugs. Depending on seizure type, a diverse range of therapies are available, including surgery, vagus nerve stimulation, and deep brain stimulation. We review the sensing and stimulation technologies most used in neurological disorders, and provide a vision of minimall...
Source: Trends in Pharmacological Sciences - Category: Drugs & Pharmacology Source Type: research
Publication date: Available online 21 August 2019Source: Neurochemistry InternationalAuthor(s): Jingxi Ma, Peifeng Qiao, Qin Li, Yangyang Wang, Lan Zhang, Liang-Jun Yan, Zhiyou CaiAbstractThe Food and Drug Administration has approved vagus-nerve stimulation (VNS) for the treatment of patients with epilepsy, depression, and headache. By targeting diverse neuroprotective and neuroplasticity pathways, VNS has the potential to be expanded as a treatment for ischemic stroke. VNS has been found to attenuate infarct volume, reduce neurological deficits, and improve memory and cognition in rats with stroke injuries. Some pilot stu...
Source: Neurochemistry International - Category: Neuroscience Source Type: research
Refractory and super refractory status epilepticus (RSE/SRSE) require effective action to avoid death or serious and irreversible consequences on neurological functions. Regrettably, there is a considerable lack of evidence on the optimal treatment strategy [1]. Vagus nerve stimulation (VNS), an approved chronic therapy for pharmacoresistant epilepsy, was initiated acutely in less than 40 patients with RSE/SRSE, interrupting 74% of cases [2]. However, several studies failed to provide adequate information on patient clinical characteristics, concomitant and previous treatments, stimulation protocols and data on long-term prognosis [2].
Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation - Category: Neurology Authors: Source Type: research
Abstract The International League Against Epilepsy (ILAE) defined drug-resistant epilepsy (DRE) that epilepsy seizure symptoms cannot be controlled with two well-tolerated and appropriately chosen antiepileptic drugs, whether they are given as monotherapy or in combination. According to the WHO reports, there is about 30%-40% of epilepsy patients belong to DRE. These patients need some treatments other than drugs, such as epilepsy surgery, and neuromodulation treatment. Traditional surgical approaches may be limited by the patient's clinical status, pathological tissue location, or overall prognosis. Thus, neuromo...
Source: CNS Neuroscience and Therapeutics - Category: Neuroscience Authors: Tags: CNS Neurosci Ther Source Type: research
Autonomic Regulation Therapy (ART) is a novel therapy for heart failure (HF) that has been shown in a pilot study to be associated with improvement in left ventricular function, 6-minute walk distance, NYHA class, and quality of life. ART is provided using chronic stimulation through a self-sizing lead that is placed on the cervical vagus nerve without any need for response-mapping. The lead is functionally identical in its design and manufacture to a commercially available lead that has been implanted since February 2009 for the treatment of refractory epilepsy and treatment-resistant depression.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 486 Source Type: research
In previous animal experiments, we demonstrated that cervical vagus nerve stimulation (VNS) inhibits pancreatic insulin secretion and raises blood glucose levels. Thus, we tested the hypothesis that chronic cervical VNS raises blood glucose levels in patients with epilepsy. Based on a retrospective medical record analysis, we conclude that chronic cervical VNS in patients with epilepsy is unlikely to induce glucose intolerance or hyperglycemia with commonly used stimulation parameters. AbstractIn previous animal experiments, we demonstrated that cervical vagus nerve stimulation (VNS) inhibits pancreatic insulin secretion, ...
Source: Physiological Reports - Category: Physiology Authors: Tags: Original Research Source Type: research
Vagus nerve stimulation (VNS) is a promising therapy to treat patients with epilepsy and heart failure. Outcomes of preclinical studies and clinical trials indicate that the selection of stimulation parameters has a direct impact on therapeutic efficacy and patient tolerability, suggesting that both the efficacy and tolerability of VNS could potentially be improved with a change in stimulation parameters. In this review, the success of translating stimulation parameters for epilepsy and heart failure from preclinical studies in animal models to human use in the clinic is evaluated on the basis of patient outcomes and stimu...
Source: Cold Spring Harbor perspectives in medicine - Category: Research Authors: Tags: Bioelectronic Medicine TECHNIQUES Source Type: research
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