Changes in Response Inhibition, Visual Anticipation and Verbal Fluency During Vagus Nerve Stimulation Therapy in Patients with Drug-resistant Epilepsy
Abstract number :
3.505
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2024
Submission ID :
1575
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Jukka Peltola, MD, PhD – Tampere University Hospital
Niina Lähde, MD, PhD – Tampere University Hospital
Pabitra Basnyat, PhD – Tampere University Hospital
Leena Kämppi, MD, PhD – Helsinki University Hospital
Jani Raitanen, PhD – Tampere University Hospital
Eija Rosti-Otajärvi, PhD – Tampere University Hospital
Rationale: The effect of vagus nerve stimulation (VNS) on cognitive domain of attention and executive functions (AEFs) has not been extensively researched. This study was set up to investigate performance variability of cognitive tests assessing AEFs in drug-resistant epilepsy (DRE) patients receiving VNS therapy during a follow-up of up to 5 years.
Methods: 33 DRE patients were assessed with the interference, maze and written verbal fluency tests as part of EpiTrack screening before and after VNS implantation through repeated follow-ups according to the clinical VNS protocol. A linear mixed-effects model was used to analyze changes in tests scores.
Results: Maze performance improved significantly by an average of 0.20 seconds per month (95% confidence interval (CI): -0.365 to -0.041; p= 0.014). Interference performance improved by an average of 0.05 seconds per month (p=0.207) and number of words increased by an average of 0.03 word per months (p=0.079) on the verbal fluency test. On the maze test patients with psychiatric comorbidities improved the most (0.52 seconds /month, p=0.001)., while on the interference test, patients with frontal lobe epilepsy (FLE). those taking 1-2 antiseizure medications (ASMs) and patients with focal to bilateral tonic-clonic seizures improved the most (0.14 seconds/month, p=0.005; 0.14 seconds/month, p=0.033 and 0.16 seconds/month, p=0.087, respectively). For verbal fluency, no clinically meaningful improvement was noted in any of the groups.
Conclusions: During the follow-up, maze performance markedly improved, while performance on the interference and verbal fluency tasks remained relatively stable at the group level. Accordingly, visual anticipation and planning improved during VNS therapy whereas response inhibition was unchanged at the group level despite significant enhancement in patients with FLE and those taking 1-2 ASM. Furthermore, the presence of psychiatric comorbidities correlated with even greater improvement on maze performance.
Funding: Thhis research was funded by grants from LivaNova, the Pirkanmaa Regional Fund, and the Finnish Epilepsy Research Foundation.
Behavior