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Background <p>At present, a number of indicators have been analyzed for the relationship with the efficacy of vagus nerve stimulation&#xa0;(VNS) in drug-resistant epilepsy (DRE) patients, but there is still no definite predictor of efficacy.&#xa0;This study is to assess the long-term effectiveness and predictors of VNS in DRE patients.</p> Methods <p>We analyzed DRE patients monitored for over a year post-surgery (2016–2019) to evaluate VNS outcomes. Logistic regression was used&#xa0;to identify efficacy predictors.</p> Results <p>Out of 162 DRE patients with VNS, 99 were followed for over 12&#xa0;months, 80 for over 24&#xa0;months, and 70 for over 36&#xa0;months. At 12&#xa0;months, 33 (33.4%) showed effectiveness, including 7 (7.1%) who were&#xa0;seizure-free. At 24&#xa0;months, 32 (40.0%) were effective, including 12 (15.0%) who&#xa0;were&#xa0;seizure-free. At 36&#xa0;months, 36 (51.4%) were effective, including 11 (15.7%) who were&#xa0;seizure-free. After 5&#xa0;years, 27 (55.1%) were effective, including 8 (16.3%) who were&#xa0;seizure-free. Multivariate regression analysis identified structural etiology as a predictive factor for the effective VNS treatment (<i>P</i> = 0.039, OR = 0.35 [0.13–0.95]).</p> Conclusions <p>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.</p>

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Long-term efficacy and predictors of vagus nerve stimulation in drug-resistant epilepsy: a multicenter cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月1日

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  • Bojing Tan,
  • Yuye Liu,
  • Mingkun Gong,
  • Fangang Meng,
  • Anchao Yang,
  • Kai Zhang,
  • Lin Sang,
  • Jianguo Zhang

摘要

Background

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.

Methods

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.

Results

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]).

Conclusions

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.