Extended Long‐Term Effects of Cervical Vagal Nerve Stimulation on Headache Intensity/Frequency and Affective/Cognitive Headache Perception in Drug Resistant Complex‐Partial Seizure Patients

Objectives Invasive vagal nerve stimulation (iVNS) is an established treatment option for drug‐resistant focal seizures and has been assumed to diminish frequent co‐incidental daily headache/migraine. However, long‐term effects on cognitive/affective head pain perception, headache intensity/frequenc...

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Veröffentlicht in:Neuromodulation (Malden, Mass.) Mass.), 2017-06, Vol.20 (4), p.375-382
Hauptverfasser: Pintea, Bogdan, Hampel, Kevin, Boström, Jan, Surges, Rainer, Vatter, Hartmut, Lendvai, Ilana S., Kinfe, Thomas M.
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container_end_page 382
container_issue 4
container_start_page 375
container_title Neuromodulation (Malden, Mass.)
container_volume 20
creator Pintea, Bogdan
Hampel, Kevin
Boström, Jan
Surges, Rainer
Vatter, Hartmut
Lendvai, Ilana S.
Kinfe, Thomas M.
description Objectives Invasive vagal nerve stimulation (iVNS) is an established treatment option for drug‐resistant focal seizures and has been assumed to diminish frequent co‐incidental daily headache/migraine. However, long‐term effects on cognitive/affective head pain perception, headache intensity/frequency are lacking. We therefore investigated potential iVNS‐induced effects in patients with drug‐resistant focal seizure and daily headache/migraine. Materials and Methods A clinical database was used to select 325 patients with drug‐resistant epilepsy treated by either iVNS plus best medical treatment (BMT) or BMT alone, compared to a healthy control group (HC). We assessed headache intensity (VAS), headache frequency, affective/cognitive pain perception (PASS; FSVA), migraine disability scores (MIDAS), sleep architecture (PSQI), depressive symptoms (BDI), and body weight (BMI). Results Nineteen patients with daily headache/migraine composed the clinical groups (10 iVNS and 9 BMT; iVNS mean age 49 years, range 36–61 years; BMT mean age 45 years, range 23–63 years; equally distributed gender). Cervical iVNS was applied from 5–13 years (mean 8 years) with following stimulation patterns: 1.3 mA (0.5–2 mA), 20 Hz, 250 μsec, 30 sec on/1.9 min off (0.5–5 min). The iVNS group had significantly lower VAS scores (iVNS 5.4; BMT 7.8; p = 0.03) and PASS cognitive/anxiety subscores (iVNS 21; BMT 16; p = 0.02) compared to BMT and HC. Global PASS (p = 0.07), FSVA, PSQI, BDI, and BMI scores did not differ significantly between groups. Conclusions iVNS appears to have positive modulatory long‐term effects on headache and affective/cognitive head pain perception in patients with drug‐resistant focal epilepsy, thus deserving further attention.
doi_str_mv 10.1111/ner.12540
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However, long‐term effects on cognitive/affective head pain perception, headache intensity/frequency are lacking. We therefore investigated potential iVNS‐induced effects in patients with drug‐resistant focal seizure and daily headache/migraine. Materials and Methods A clinical database was used to select 325 patients with drug‐resistant epilepsy treated by either iVNS plus best medical treatment (BMT) or BMT alone, compared to a healthy control group (HC). We assessed headache intensity (VAS), headache frequency, affective/cognitive pain perception (PASS; FSVA), migraine disability scores (MIDAS), sleep architecture (PSQI), depressive symptoms (BDI), and body weight (BMI). Results Nineteen patients with daily headache/migraine composed the clinical groups (10 iVNS and 9 BMT; iVNS mean age 49 years, range 36–61 years; BMT mean age 45 years, range 23–63 years; equally distributed gender). Cervical iVNS was applied from 5–13 years (mean 8 years) with following stimulation patterns: 1.3 mA (0.5–2 mA), 20 Hz, 250 μsec, 30 sec on/1.9 min off (0.5–5 min). The iVNS group had significantly lower VAS scores (iVNS 5.4; BMT 7.8; p = 0.03) and PASS cognitive/anxiety subscores (iVNS 21; BMT 16; p = 0.02) compared to BMT and HC. Global PASS (p = 0.07), FSVA, PSQI, BDI, and BMI scores did not differ significantly between groups. Conclusions iVNS appears to have positive modulatory long‐term effects on headache and affective/cognitive head pain perception in patients with drug‐resistant focal epilepsy, thus deserving further attention.</description><identifier>ISSN: 1094-7159</identifier><identifier>EISSN: 1525-1403</identifier><identifier>DOI: 10.1111/ner.12540</identifier><identifier>PMID: 27873376</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Adult ; Affective/cognitive head pain perception ; Anxiety ; Body weight ; cervical vagal nerve stimulation ; Cognition - physiology ; Cognitive ability ; Drug resistance ; Drug Resistant Epilepsy - diagnosis ; Drug Resistant Epilepsy - therapy ; Epilepsy ; Female ; Headache ; Headaches ; Humans ; Long-term effects ; Male ; Mental depression ; Middle Aged ; Migraine ; Pain ; Pain perception ; Pain Perception - physiology ; Retrospective Studies ; seizure ; Seizures ; Seizures - diagnosis ; Seizures - therapy ; Sleep ; Time Factors ; Treatment Outcome ; Vagus nerve ; Vagus Nerve Stimulation - methods ; Vagus Nerve Stimulation - trends ; Young Adult</subject><ispartof>Neuromodulation (Malden, Mass.), 2017-06, Vol.20 (4), p.375-382</ispartof><rights>2016 International Neuromodulation Society</rights><rights>2016 International Neuromodulation Society.</rights><rights>2017 International Neuromodulation Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3530-caa71db42dc5e8f092302f692e6e7c47a4762ef21351a39ea0ca125f3027337d3</citedby><cites>FETCH-LOGICAL-c3530-caa71db42dc5e8f092302f692e6e7c47a4762ef21351a39ea0ca125f3027337d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27931,27932</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27873376$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pintea, Bogdan</creatorcontrib><creatorcontrib>Hampel, Kevin</creatorcontrib><creatorcontrib>Boström, Jan</creatorcontrib><creatorcontrib>Surges, Rainer</creatorcontrib><creatorcontrib>Vatter, Hartmut</creatorcontrib><creatorcontrib>Lendvai, Ilana S.</creatorcontrib><creatorcontrib>Kinfe, Thomas M.</creatorcontrib><title>Extended Long‐Term Effects of Cervical Vagal Nerve Stimulation on Headache Intensity/Frequency and Affective/Cognitive Headache Perception in Drug Resistant Complex‐Partial Seizure Patients</title><title>Neuromodulation (Malden, Mass.)</title><addtitle>Neuromodulation</addtitle><description>Objectives Invasive vagal nerve stimulation (iVNS) is an established treatment option for drug‐resistant focal seizures and has been assumed to diminish frequent co‐incidental daily headache/migraine. However, long‐term effects on cognitive/affective head pain perception, headache intensity/frequency are lacking. We therefore investigated potential iVNS‐induced effects in patients with drug‐resistant focal seizure and daily headache/migraine. Materials and Methods A clinical database was used to select 325 patients with drug‐resistant epilepsy treated by either iVNS plus best medical treatment (BMT) or BMT alone, compared to a healthy control group (HC). We assessed headache intensity (VAS), headache frequency, affective/cognitive pain perception (PASS; FSVA), migraine disability scores (MIDAS), sleep architecture (PSQI), depressive symptoms (BDI), and body weight (BMI). Results Nineteen patients with daily headache/migraine composed the clinical groups (10 iVNS and 9 BMT; iVNS mean age 49 years, range 36–61 years; BMT mean age 45 years, range 23–63 years; equally distributed gender). Cervical iVNS was applied from 5–13 years (mean 8 years) with following stimulation patterns: 1.3 mA (0.5–2 mA), 20 Hz, 250 μsec, 30 sec on/1.9 min off (0.5–5 min). The iVNS group had significantly lower VAS scores (iVNS 5.4; BMT 7.8; p = 0.03) and PASS cognitive/anxiety subscores (iVNS 21; BMT 16; p = 0.02) compared to BMT and HC. Global PASS (p = 0.07), FSVA, PSQI, BDI, and BMI scores did not differ significantly between groups. 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However, long‐term effects on cognitive/affective head pain perception, headache intensity/frequency are lacking. We therefore investigated potential iVNS‐induced effects in patients with drug‐resistant focal seizure and daily headache/migraine. Materials and Methods A clinical database was used to select 325 patients with drug‐resistant epilepsy treated by either iVNS plus best medical treatment (BMT) or BMT alone, compared to a healthy control group (HC). We assessed headache intensity (VAS), headache frequency, affective/cognitive pain perception (PASS; FSVA), migraine disability scores (MIDAS), sleep architecture (PSQI), depressive symptoms (BDI), and body weight (BMI). Results Nineteen patients with daily headache/migraine composed the clinical groups (10 iVNS and 9 BMT; iVNS mean age 49 years, range 36–61 years; BMT mean age 45 years, range 23–63 years; equally distributed gender). Cervical iVNS was applied from 5–13 years (mean 8 years) with following stimulation patterns: 1.3 mA (0.5–2 mA), 20 Hz, 250 μsec, 30 sec on/1.9 min off (0.5–5 min). The iVNS group had significantly lower VAS scores (iVNS 5.4; BMT 7.8; p = 0.03) and PASS cognitive/anxiety subscores (iVNS 21; BMT 16; p = 0.02) compared to BMT and HC. Global PASS (p = 0.07), FSVA, PSQI, BDI, and BMI scores did not differ significantly between groups. Conclusions iVNS appears to have positive modulatory long‐term effects on headache and affective/cognitive head pain perception in patients with drug‐resistant focal epilepsy, thus deserving further attention.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>27873376</pmid><doi>10.1111/ner.12540</doi><tpages>8</tpages></addata></record>
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subjects Adult
Affective/cognitive head pain perception
Anxiety
Body weight
cervical vagal nerve stimulation
Cognition - physiology
Cognitive ability
Drug resistance
Drug Resistant Epilepsy - diagnosis
Drug Resistant Epilepsy - therapy
Epilepsy
Female
Headache
Headaches
Humans
Long-term effects
Male
Mental depression
Middle Aged
Migraine
Pain
Pain perception
Pain Perception - physiology
Retrospective Studies
seizure
Seizures
Seizures - diagnosis
Seizures - therapy
Sleep
Time Factors
Treatment Outcome
Vagus nerve
Vagus Nerve Stimulation - methods
Vagus Nerve Stimulation - trends
Young Adult
title Extended Long‐Term Effects of Cervical Vagal Nerve Stimulation on Headache Intensity/Frequency and Affective/Cognitive Headache Perception in Drug Resistant Complex‐Partial Seizure Patients
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