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VNS parameters for clinical response in Epilepsy
- Source :
- Brain Stimulation, Vol 15, Iss 3, Pp 814-821 (2022)
- Publication Year :
- 2022
- Publisher :
- Elsevier, 2022.
-
Abstract
- Background: While vagus nerve stimulation (VNS) has been in use for over two decades, little professional guidance exists to describe dosing and titration of therapy which is the consequence of a limited amount of evidence developed during the pre-market phase of therapy development. Post-market surveillance of dosing practice has revealed significant deviations from dosing and titration guidance offered by professional societies as well as the manufacturer. Objective: This analysis aims to identify a target dose for VNS Therapy in Epilepsy. Methods: Herein, VNS clinical outcomes are linked to the patient-specific dosing parameters for each study visit (n = 1178 patients). A generalized linear mixed model was built to ascertain the relationship between key stimulation parameters (i.e., Output Current, Pulse Width, Signal Frequency, and Duty Cycle) and clinical response, defined as a 50% or greater reduction in seizure frequency from baseline. Other demographic parameters of interest, such as duration of epilepsy and age at implant, were also explored. Results: A population level target output current and duty cycle for VNS therapy for epilepsy was identified as 1.61 mA and 17.1% duty cycle. Patients with shorter duration of epilepsy were identified to have a higher likelihood to respond to VNS therapy (p
Details
- Language :
- English
- ISSN :
- 1935861X
- Volume :
- 15
- Issue :
- 3
- Database :
- Directory of Open Access Journals
- Journal :
- Brain Stimulation
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.01d6e08e265144dda3dec398f6252489
- Document Type :
- article
- Full Text :
- https://doi.org/10.1016/j.brs.2022.05.016