Effect of vagus nerve stimulation therapy on 1-year seizure freedom and quality of life in patients with drug-resistant epilepsy in Japan: plain language summary of a real-world study

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Plain Language SummaryWhat is this summary about?In patients with drug-resistant epilepsy, a form of epilepsy that is hard to treat with antiseizure medication, more days without seizures may be associated with a better quality of life. An add-on treatment for drug-resistant epilepsy is vagus nerve stimulation (VNS) therapy. This plain language summary presents the results of a study in Japan that looked at how many patients with drug-resistant epilepsy who were treated with VNS experienced periods of seizure freedom for at least 1 year. The researchers looked at VNS-treated patients’ data over a 3-year period to see if the number of all seizures or seizures of a specific type (focal or tonic-clonic) were reduced, as well as how long patients would experience seizure freedom. This was 1 of the first large, real-world studies to look at whether the length of time patients remained seizure free after VNS therapy may improve their quality of life.What were the results?After 36 months of VNS therapy, 60% of patients experienced at least a 50% reduction in their total number of seizures.About a quarter of patients with focal seizures and about half of those with tonic-clonic seizures experienced at least 12 months without those types of seizures after receiving VNS therapy for 3 years.When patients did not have seizures, they reported an improved quality of life.Completely stopping all seizures after VNS therapy is rare, but after 3 years of treatment, almost half of the patients who experienced tonic-clonic seizures achieved at least 1 year of freedom from tonic-clonic seizures. This finding is important because generalized tonic-clonic seizures are one of the most common seizure types that leads to sudden and unexpected death. What do the results mean?The majority of patients with drug-resistant epilepsy treated with VNS had a lower number of seizures and improved quality of life. Half of patients who had tonic-clonic seizures before VNS experienced extended periods of seizure freedom by the time they had VNS for 3 years. These results support the use of VNS therapy for people with drug-resistant epilepsy.How to say…Epilepsy: eh-puh-lep-seeSeizure: see-zherVagus nerve stimulation: vay-guhs nurv stim-yuh-lay-shunDrug-resistant epilepsy: A form of epilepsy in which a person still experiences seizures despite trying at least 2 antiseizure medications.Epilepsy: A condition that causes a person to experience seizures multiple times throughout their life.Antiseizure medication: Medication for the treatment of seizures.Seizures: An overload of electrical signals in the brain that may lead to episodes affecting someone’s awareness, changing their behavior, or causing uncontrolled muscle movements.Vagus nerves: Nerves on each side of the body that begin in the brain and travel through the neck carrying electrical signals between the brain, heart, and digestive system.Vagus nerve stimulation (VNS) therapy: A straightforward surgical procedure in which a surgeon implants a small device under the skin in the chest that connects to the left vagus nerve. The device sends a mild electrical signal to the vagus nerve to change the way the nerve signals to the brain. This effect can reduce the number and intensity of seizures. In experienced hands, implanting VNS therapy is a generally safe and relatively uncomplicated procedure.Seizure freedom: A period during which a patient with epilepsy has no seizures at all (complete seizure freedom) or when a patient does not have a specific seizure type they had before (e.g., tonic-clonic seizure freedom for patients that had no more tonic-clonic seizures). In this study, patients were considered to have achieved seizure freedom if they did not have any seizures (or did not have a specific seizure type) for at least 12 months.Focal-onset (or partial-onset) seizures: A seizure in which the electrical overload starts in 1 part of the brain. In this study, the focal seizures group does not include tonic-clonic seizures that start as focal seizures.Tonic-clonic seizures: A seizure in which the electrical overload happens in both sides of the brain and can spread across the whole brain. These seizures are associated with the highest risk of injury and of sudden unexpected death in epilepsy. In this study, tonic-clonic seizures included those that started both in one part of the brain and those that started from both sides of the brain.Real-world study: A study that uses medical information about patients that doctors record in their electronic record in normal, everyday clinics and hospitals (i.e., not in clinical research trials that have rigid rules for what types of patients can participate).This is an abstract of the Plain Language Summary of Publication article.View the full Plain Language Summary PDF of this article to read the full-textLink to original article hereTrial registration: UMIN Japan identifier: UMIN000014728.

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