Journal ArticleDOI
Vagus nerve stimulation for treatment of partial seizures: 1. A controlled study of effect on seizures. First International Vagus Nerve Stimulation Study Group.
Elinor Ben-Menachem,R Mañon-Espaillat,Ruzica Ristanovic,B. J. Wilder,H Stefan,W Mirza,W. B. Tarver,J. F. Wernicke +7 more
TLDR
The effectiveness of VNS as treatment for epilepsy patients with refractory partial seizures was confirmed and high VNS was more effective in reducing partial seizure frequency than was low VNS.Abstract:
Vagus nerve stimulation (VNS) was shown to reduce seizure frequency in refractory epilepsy patients in two pilot studies. Based on these results, a multicenter, prospectively randomized, parallel, double-blind study of patients with refractory partial seizures was initiated. After a 12-week baseline period, identical vagus nerve stimulators were implanted and patients randomized to either a high or low 14-week VNS treatment paradigm. The primary objective was to demonstrate that high VNS (therapeutic parameters) was more effective in reducing partial seizure frequency than was low VNS (less or noneffective parameters). Patients continued receiving antiepileptic drugs (AEDs) with plasma concentrations held constant throughout the study. We report results of the first 67 patients to exit the 14-week acute phase. After 14 weeks of VNS, 31 patients receiving high VNS experienced a mean seizure frequency percentage reduction of 30.9%, which was statistically significant as compared with the mean seizure frequency percentage reduction of 11.3% in 36 patients receiving low VNS (p = 0.029, t test; p = 0.036, Wilcoxon rank-sum test). In addition to the significant intragroup p-values, mean seizure frequency percentage change reached statistical significance for high VNS (p < 0.001) but not low VNS (p = 0.072) as compared with baseline. Twelve of 31 (38.7%) patients receiving high VNS achieved at least 50% reduction in seizure frequency whereas 7 of 36 (19.4%) patients receiving low VNS experienced at least 50% reduction after 14 weeks. The implant procedure and VNS therapy were well tolerated. Our study confirmed the effectiveness of VNS as treatment for epilepsy patients with refractory partial seizures.read more
Citations
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Journal ArticleDOI
Vagus nerve stimulation therapy for partial-onset seizures A randomized active-control trial
Adrian Handforth,Adrian Handforth,Christopher M. DeGiorgio,Steven C. Schachter,Basim M. Uthman,Dean K. Naritoku,Evelyn S. Tecoma,Thomas R. Henry,Collins Stephen D,Bradley V. Vaughn,R. C. Gilmartin,Douglas Labar,George L. Morris,Martin C. Salinsky,Ivan Osorio,Ruzica Ristanovic,David M. Labiner,J. C. Jones,Jerome V. Murphy,G. C. Ney,J. Wheless +20 more
TL;DR: Vagus nerve stimulation is an effective and safe adjunctive treatment for patients with refractory partial-onset seizures and represents the advent of a new, nonpharmacologic treatment for epilepsy.
Journal Article
Vagus nerve stimulation therapy for partial-onset seizures
Adrian Handforth,Christopher M. Degiorgio,Steven C. Schachter,Basim M. Uthman,Dean K. Naritoku,Evelyn S. Tecoma,Thomas R. Henry,Collins Stephen D,Bradley V. Vaughn,R. C. Gilmartin,Douglas Labar,George L. Morris,Martin C. Salinsky,Ivan Osorio,Ruzica Ristanovic,David M. Labiner,J. C. Jones,Jerome V. Murphy,G. C. Ney,James W. Wheless +19 more
TL;DR: In this paper, the authors compared the efficacy and safety of therapeutic (high) vagus nerve stimulation with less (low) stimulation and found that the high stimulation was associated with more voice alteration and dyspnea.
Journal ArticleDOI
Vagal nerve stimulation: a review of its applications and potential mechanisms that mediate its clinical effects.
Duncan A. Groves,Verity J. Brown +1 more
TL;DR: Although the precise mechanism of action of VNS is still unknown, the search for the mechanism has the potential to lend new insight into the neuropathology of depression, a review of the pre-clinical and clinical literature relating to VNS concludes.
Journal ArticleDOI
Enhanced recognition memory following vagus nerve stimulation in human subjects.
TL;DR: This work examined word-recognition memory in patients enrolled in a clinical study evaluating the capacity of vagus nerve stimulation to control epilepsy and found Stimulation administered after learning significantly enhanced retention.
Journal ArticleDOI
Vagus nerve stimulation for treatment-resistant depression: a randomized, controlled acute phase trial.
A. John Rush,Lauren B. Marangell,Harold A. Sackeim,Mark S. George,Mark S. George,Stephen K. Brannan,Sonia M. Davis,Robert H Howland,Mitchel A. Kling,Barry R. Rittberg,William J. Burke,Mark Hyman Rapaport,John Zajecka,Andrew A. Nierenberg,Mustafa M. Husain,David Ginsberg,Robert G. Cooke +16 more
TL;DR: This study did not yield definitive evidence of short-term efficacy for adjunctive VNS in treatment-resistant depression.
References
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Journal ArticleDOI
Inhibition of experimental seizures in canines by repetitive vagal stimulation.
TL;DR: Repetitive electrical stimulation of the canine cervical vagus nerve interrupts or abolishes motor seizures induced by strychnine and tremors induced by pentylenetetrazol (PTZ) and may form the basis of a new therapeutic approach to epilepsy.
Journal ArticleDOI
Prevention of Intractable Partial Seizures by Intermittent Vagal Stimulation in Humans: Preliminary Results
J K Penry,J C Dean +1 more
TL;DR: Vagal stimulation represents a novel approach for seizure control in patients who have intractable epilepsy, but additional studies are needed to clarify the efficacy and safety of the procedure and to define selection criteria for patients.
Journal ArticleDOI
Effects of Vagal Stimulation on Experimentally Induced Seizures in Rats
Dixon M. Woodbury,J. W. Woodbury +1 more
TL;DR: These results, when taken together with similar results obtained from dogs, monkeys, and humans, strongly suggest that periodic stimulation of the vagus nerve using appropriate stimulation parameters is a powerful method for preventing seizures.
Journal ArticleDOI
Anatomical, physiological, and theoretical basis for the antiepileptic effect of vagus nerve stimulation.
TL;DR: The vagus provides an easily accessible, peripheral route to modulate CNS function and is likely to relate to effects on the reticular activating system.
Journal ArticleDOI
Vagus nerve stimulation for treatment of partial seizures: 2. Safety, side effects, and tolerability. First International Vagus Nerve Stimulation Study Group.
R. E. Ramsay,Basim M. Uthman,L. E. Augustinsson,Adrian R.M. Upton,Dean K. Naritoku,J. Willis,T. Treig,G. Barolat,J. F. Wernicke +8 more
TL;DR: Vagus nerve stimulation (VNS) significantly reduces the frequency of partial seizures in refractory epilepsy patients and is rated as more “improved” than those receiving low stimulation in regards to overallhealth status.
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