دورية أكاديمية
A prospective, multicenter study of cardiac-based seizure detection to activate vagus nerve stimulation
| العنوان: | A prospective, multicenter study of cardiac-based seizure detection to activate vagus nerve stimulation |
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| المؤلفون: | Boon, Paul, Vonck, Kristl, Van Rijckevorsel, Germaine, El Tahry, Riëm, Elger, Christian E., Mullatti, Nandini, Schulze-Bonhage, Andreas, Wagner, Louis, Diehl, Beate, Hamer, Hajo, Reuber, Markus, Kostov, Hrisimir, Legros, Benjamin, Noachtar, Soheyl, Weber, Yvonne G., Coenen, Volker A., Rooijakkers, Herbert, Schijns, Olaf E.M.G., Selway, Richard, Van Roost, Dirk, Eggleston, Katherine S., Van Grunderbeek, Wim, Jayewardene, Amara K., McGuire, Ryan M. |
| المساهمون: | UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de neurologie, UCL - (SLuc) Service de neurochirurgie |
| المصدر: | Seizure - European Journal of Epilepsy, Vol. 32, p. 52-61 (2015) |
| بيانات النشر: | Elsevier Ltd |
| سنة النشر: | 2015 |
| المجموعة: | DIAL@UCL (Université catholique de Louvain) |
| مصطلحات موضوعية: | Cardiac based seizure detection, Ictal tachycardia, Quality of life, Refractory epilepsy, Vagus nerve stimulation |
| الوصف: | PURPOSE: This study investigates the performance of a cardiac-based seizure detection algorithm (CBSDA) that automatically triggers VNS (NCT01325623). METHODS: Thirty-one patients with drug resistant epilepsy were evaluated in an epilepsy monitoring unit (EMU) to assess algorithm performance and near-term clinical benefit. Long-term efficacy and safety were evaluated with combined open and closed-loop VNS. RESULTS: Sixty-six seizures (n=16 patients) were available from the EMU for analysis. In 37 seizures (n=14 patients) a ≥ 20% heart rate increase was found and 11 (n=5 patients) were associated with ictal tachycardia (iTC, 55% or 35 bpm heart rate increase, minimum of 100 bpm). Multiple CBSDA settings achieved a sensitivity of ≥ 80%. False positives ranged from 0.5 to 7.2/h. 27/66 seizures were stimulated within ± 2 min of seizure onset. In 10/17 of these seizures, where triggered VNS overlapped with ongoing seizure activity, seizure activity stopped during stimulation. Physician-scored seizure severity (NHS3-scale) showed significant improvement for complex partial seizures (CPS) at EMU discharge and through 12 months (p<0.05). Patient-scored seizure severity (total SSQ score) showed significant improvement at 3 and 6 months. Quality of life (total QOLIE-31-P score) showed significant improvement at 12 months. The responder rate (≥ 50% reduction in seizure frequency) at 12 months was 29.6% (n=8/27). Safety profiles were comparable to prior VNS trials. CONCLUSIONS: The investigated CBSDA has a high sensitivity and an acceptable specificity for triggering VNS. Despite the moderate effects on seizure frequency, combined open- and closed-loop VNS may provide valuable improvements in seizure severity and QOL in refractory epilepsy patients. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1059-1311 1532-2688 |
| العلاقة: | boreal:174340; http://hdl.handle.net/2078.1/174340Test; info:pmid/26552564; urn:ISSN:1059-1311; urn:EISSN:1532-2688 |
| DOI: | 10.1016/j.seizure.2015.08.011 |
| الإتاحة: | https://doi.org/10.1016/j.seizure.2015.08.011Test http://hdl.handle.net/2078.1/174340Test |
| حقوق: | info:eu-repo/semantics/restrictedAccess |
| رقم الانضمام: | edsbas.168CA6B7 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 10591311 15322688 |
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| DOI: | 10.1016/j.seizure.2015.08.011 |