迷走神经刺激对儿科耐药性癫痫患者的双重作用:不仅能控制癫痫发作吗?

IF 1.8 Q3 CLINICAL NEUROLOGY
Mohamed Ashraf Mahmoud , Omnia El Rashidi , George Halim , Mohamed Amgad Elkholy , Osama Aglan , Abdel Rahman El Sabbagh , Ahmed Kamel Basha , Hussein Hamdi , Ahmed M. El Sayed , Dina Amin Saleh , R.H. Shatla , Walid Abdel Ghany
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引用次数: 0

摘要

这是一项回顾性对比试验研究,旨在探讨迷走神经刺激(VNS)在改善儿科年龄组耐药癫痫(DRE)患者认知功能方面的作用。研究时间为 2018 年 1 月至 2023 年 2 月。4至18岁的儿童被分为两组,即 "VNS组 "和 "最佳药物治疗(BMT)组"。随访期为 12 个月。记录了人口统计学、临床、病因学和研究数据。每组患者在基线和 12 个月后均使用 "改良儿童智力状态测验"(MMSE)进行认知评估。76.4%的患者被归类为脑瘫继发性癫痫。在 VNS 治疗组中,75% 的患者癫痫发作频率减少了 50%,而在 BMT 治疗组中仅减少了 12.5%。两组患者均未出现癫痫发作。在 12 个月时,BMT 组和 VNS 组的总体认知评分分别比基线记录(p = 0.027)和(p = 0.012)有显著的统计学改善,其中 VNS 组的改善幅度更大。此外,我们还对两组脑瘫患者的认知分量表进行了统计子分析,结果显示 VNS 组患者的认知分量表有明显改善(p = 0.02)。我们的结论是,VNS 在改善认知功能方面具有潜在作用,这一点已通过使用一种具有成本效益的筛查工具得到证实。特别是在脑瘫患者中观察到了明显的效果。这对资源有限的国家非常有益,因为 VNS 具有良好的安全性、较高的癫痫发作控制能力和认知功能附加值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The dual effect of vagus nerve stimulation in pediatric patients with drug-resistant epilepsy: Is there more than seizure control?

This is a retrospective and comparative pilot study to investigate the role of vagus nerve stimulation (VNS) in improving cognitive functions in the pediatric age group with drug resistant epilepsy (DRE). It was conducted from January 2018 to February 2023. Children between the ages of 4 and 18 years were divided into two groups, the “VNS group” and the “best medical treatment (BMT) group”. Follow up period was 12 months. Demographic, clinical, etiological and investigational data were recorded. Cognitive assessment using the Modified Mini-Mental State Examination for children (MMSE) was recorded at baseline and 12 months later for each group. 76.4 % of patients were classified as epilepsy secondary to cerebral palsy. 75 % of patients showed ≥ 50 % seizure frequency reduction among the VNS group as compared to 12.5 % in the BMT group. None of both groups achieved seizure freedom. At 12 months, both BMT and VNS groups showed statistically significantly improved overall cognitive score from baseline records (p = 0.027) and (p = 0.012), respectively, with a significantly higher improvement in VNS group. Also, statistical sub-analysis of cognitive subscales in cerebral palsy patients in both groups was conducted and revealed a significant improvement (p = 0.02) in the VNS group. We concluded that there is a potential role of VNS in improving cognitive functions which was shown by using a cost-effective screening tool. A significant effect was observed specially in cerebral palsy patients. This is very beneficial in limited-resources countries since VNS has good safety profile, high seizure control, and added value to cognitive functions.

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来源期刊
Epilepsy and Behavior Reports
Epilepsy and Behavior Reports Medicine-Neurology (clinical)
CiteScore
2.70
自引率
13.30%
发文量
54
审稿时长
50 days
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