Vagus nerve stimulation has a positive effect on mood in patients with refractory epilepsy

• Published in: Clinical neurology and neurosurgery 2012-05, Vol.114 (4), p.336-340
• Main Authors: Klinkenberg, S, Majoie, H.J.M, van der Heijden, M.M.A.A, Rijkers, K, Leenen, L, Aldenkamp, A.P
• Format: Article
• Language: English
• Subjects: Adult; Affect - physiology; Age of Onset; Anticonvulsants - therapeutic use; Antidepressants; Biological and medical sciences; Children & youth; Clinical trials; Cognition; Cognition & reasoning; Cognition - physiology; Cohort Studies; Convulsions & seizures; Depression; Depression - complications; Depression - psychology; Drug Resistance; Electric Stimulation Therapy; Emotional disorders; Epilepsy; Epilepsy - psychology; Epilepsy - therapy; Female; Humans; Intelligence Tests; Inventories; Longitudinal Studies; Male; Medical sciences; Middle Aged; Mood; Neurology; Neuropsychological Tests; Neurosurgery; Placebo effect; Prospective Studies; Quality of Life; Seizures; Seizures - psychology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Vagus nerve; Vagus Nerve Stimulation - methods; Variables; Young Adult
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2011.11.016

Abstract Background Preliminary research on the efficacy of vagus nerve stimulation (VNS) indicated additional effects on neuropsychological variables like mood and quality of life (QOL). Objectives The objectives of this prospective longitudinal observational cohort study were to assess the effects of VNS on mood, QOL and cognition in patients with refractory epilepsy and to determine whether these effects occur dependent of seizure control. Methods We included 41 patients with refractory epilepsy; treated with VNS as part of usual patient care. A neuropsychological battery was performed during baseline and repeated after 6 months of VNS in order to compare neuropsychological variables before and after VNS. All patients completed seizure diaries. Results Significant improvements were observed for both mood and QOL after 6 months of VNS; based on the results in the POMS and QOLIE-89 questionnaires ( p < 0.05). There was no significant change in cognition. Mean percentage change in seizure frequency was −9.0%, while 20% of the patients achieved a seizure frequency reduction of 50% or more. No significant correlation was found between changes in seizure frequency and improvements in mood or QOL. Conclusions VNS is associated with improvements in both mood and QOL in patients with refractory epilepsy. Since these improvements appeared to be independent of seizure control, the results of this study indicate an additional antidepressant effect of VNS, which can be of extra value in view of the high co-morbidity of mood disturbances in patients with epilepsy.