Effects of vagus nerve stimulation on symptoms of depression in patients with difficult-to-treat epilepsy
Effects of vagus nerve stimulation on symptoms of depression in patients with difficult-to-treat epilepsy
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DOI：
10.1016/j.seizure.2019.04.001
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发表时间：
2019-07-01
影响因子：
3
通讯作者：
Schneider, Ulf Christoph
中科院分区：
文献类型：
--
作者：
Spindler, Philipp;Bohlmann, Katja;Schneider, Ulf Christoph
目的：迷走神经刺激（VNS）是公认的治疗癫痫和抑郁症。抑郁症的患病率是高的癫痫患者，但仍不清楚患者的癫痫和抑郁症状的并发症如何应对VNS.Methods：我们调查了59例不同亚型的抑郁症作为癫痫的并发症，谁接受了VNS手术。在VNS术前及术后1年由精神科医生采用Montgomery-Asberg抑郁量表（MADRS）和Beck-Depression-Inventory（BDI）评定抑郁症状的严重程度。对癫痫的反应是通过癫痫发作减少至少50%来衡量的。结果：所有患者的抑郁症状在VNS治疗后均得到改善，MADRS为29 - 18（p <0.001），BDI为24 - 14（p <0.001），所有抑郁症亚型均得到改善。癫痫发作减少至少50%，在两个所有患者的三分之二，两年后VNS。结论：我们能够显示VNS在治疗药物抵抗性癫痫患者和抑郁症状的并发症的有益效果。
Purpose: Vagus nerve stimulation (VNS) is well established in the treatment of epilepsy and disorders of depression. The prevalence of depression is high in patients with epilepsy, but still it remains unclear how patients with a comorbidity of epilepsy and symptoms of depression respond to VNS.Methods: We investigated 59 patients with different subtypes of disorders of depression as a comorbidity of epilepsy, who underwent VNS-surgery. Before and one year after VNS surgery, the severity of symptoms of depression was evaluated by a psychiatrist using Montgomery-Asberg Depression Rating Scale (MADRS) and Beck-Depressions-Inventory (BDI). Response towards epilepsy was measured by a seizure reduction of at least 50%.Results: Symptoms of depression ameliorated in response to VNS in the overall of all patients MADRS 29 to 18 (p < 0,001) and BDI 24 to 14 (p < 0,001) and all subtypes of disorders of depression. Seizure reduction of at least 50% was achieved in two out of three of all patients two years after VNS.Conclusion: We were able to show the beneficial effect of VNS in the treatment of patients with pharmacoresistant epilepsy and a comorbidity of symptoms of depression.