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: | Andreas Schulze-Bonhage, Volker A. Coenen, Herbert Rooijakkers, Kristl Vonck, Wim Van Grunderbeek, Richard Selway, Soheyl Noachtar, Nandini Mullatti, Louis Wagner, Katherine S. Eggleston, Hajo M. Hamer, Ryan M. McGuire, Dirk Van Roost, Markus Reuber, Hrisimir Kostov, Olaf E. M. G. Schijns, Benjamin Legros, Christian E. Elger, Kenou van Rijckevorsel, Paul Boon, Yvonne G. Weber, Beate Diehl, Riem El Tahry, Amara K. Jayewardene |
| المساهمون: | MUMC+: MA Med Staf Spec Neurochirurgie (9), RS: FHML non-thematic output |
| المصدر: | Seizure, 32 SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, 32, 52-61. Elsevier Saunders SEIZURE-EUROPEAN JOURNAL OF EPILEPSY |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Tachycardia, Male, Drug Resistant Epilepsy, medicine.medical_treatment, Severity of Illness Index, Pattern Recognition, Automated, Epilepsy, Electrocardiography, Heart Rate, Cardiac based seizure detection, Medicine and Health Sciences, EEG, Prospective Studies, EPILEPSY, Refractory epilepsy, medicine.diagnostic_test, Electroencephalography, General Medicine, Middle Aged, Neurology, Anesthesia, Female, medicine.symptom, Vagus nerve stimulation, Algorithms, Quality of life, Adult, Vagus Nerve Stimulation, DURATION, Ictal tachycardia, Clinical Neurology, PATIENT, Sensitivity and Specificity, Young Adult, Seizures, Neurologie, Heart rate, Severity of illness, medicine, Humans, Ictal, Aged, business.industry, MINIMALLY IMPORTANT CHANGE, medicine.disease, SEVERITY QUESTIONNAIRE, Quality of Life, Neurology (clinical), business, SYSTEM, Follow-Up Studies |
| 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. SCOPUS: ar.j info:eu-repo/semantics/published |
| وصف الملف: | 1 full-text file(s): application/pdf; application/pdf |
| تدمد: | 1532-2688 1059-1311 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e18b65b424569eca0a610b1d3078d171Test https://pubmed.ncbi.nlm.nih.gov/26552564Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e18b65b424569eca0a610b1d3078d171 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15322688 10591311 |
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