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Published in: Neurological Sciences 5/2024

20-11-2023 | Vagus Nerve Stimulation | Original Article

Long-term effects of vagus nerve stimulation therapy on cognitive functioning in patients with drug-resistant epilepsy

Authors: Kristijonas Puteikis, Arminas Jasionis, Gabija Jasionytė, Rūta Mameniškienė

Published in: Neurological Sciences | Issue 5/2024

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Abstract

Background

Despite the increasing use of vagus nerve stimulation (VNS) for drug-resistant epilepsy, its impact on cognitive functioning remains insufficiently investigated.

Objective

We aimed to comprehensively assess changes in cognition after long-term VNS therapy in a prospective sample of adults with epilepsy.

Methods

Between December 2019 and March 2023, patients scheduled for VNS implantation were invited for neuropsychological assessment, including tests of executive functions, working and short-term memory (recall of a verbal logical story and the Rey-Osterrieth complex figure (ROCF)), and social cognition. Participants were re-evaluated after a year of VNS therapy and the pre- and postoperative scores were compared by means of the Student’s t or Wilcoxon’s signed rank tests for paired samples. Patients available only after a longer follow-up (more than 24 months) were also re-examined and included in a secondary analysis.

Results

The study included 28 PWE (16, 57.1% female, average age 33.7 ± 10.0 years). Twenty-two PWE followed-up at 14.5 ± 4.8 months had worse categorical verbal fluency than preoperatively (t = 2.613, p = 0.016). After including patients with long follow-up (n = 28, 21.6 ± 11.4 months), the group scored better on the delayed recall of the ROCF (17.09 ± 8.84 to 20.65 ± 8.32 points, t(22) =  − 2.618, p = 0.016) and the Happé strange stories test (5.0 ± 2.6 to 6.1 ± 2.1 points, t(14) =  − 3.281, p = 0.005). No significant changes were observed in other cognitive domains (p > 0.05).

Conclusion

We suggest improvements in a task of social cognition and short-term visual memory after longer use of VNS therapy. Such findings should be confirmed in larger trials after controlling for changes in ictal or interictal activity.
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Metadata
Title
Long-term effects of vagus nerve stimulation therapy on cognitive functioning in patients with drug-resistant epilepsy
Authors
Kristijonas Puteikis
Arminas Jasionis
Gabija Jasionytė
Rūta Mameniškienė
Publication date
20-11-2023
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 5/2024
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-023-07202-z

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