Interpersonal communication skills related to seizure outcomes in pediatric patients with vagus nerve stimulation
Interpersonal communication skills related to seizure outcomes in pediatric patients with vagus nerve stimulation
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人际沟通技巧与迷走神经刺激儿科患者癫痫发作结果相关
DOI：
10.1016/j.inat.2020.101080
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
K. Iida
中科院分区：
文献类型：
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作者：
M. Katagiri;H. Otsubo;K. Kagawa;G. Seyama;A. Hashizume;Akitake Okamura;N. Ishikawa;R. Hanaya;K. Arita;K. Kurisu;K. Iida
各种临床参数与迷走神经刺激（VNS）后良好的癫痫发作结果相关；然而，这些参数都没有得到最终的验证。在这里，我们评估了使用VNS治疗的儿童患者的人际沟通技巧（IPCS）和癫痫发作结果。方法选取31例日本儿童患者（平均±SD: 9.0±3.4岁，年龄范围：3-15岁），接受VNS治疗，随访至少2年。我们将患者分为两组：反应组，发作次数比VNS前2个月的平均发作次数减少≥50%；无反应组癫痫发作减少率<50%。我们评估了预测VNS后反应者的临床参数，包括癫痫病因、发作特征、脑电图和MRI结果、药物、智商和/或发育商以及两组之间的人际沟通技巧（IPCS）。我们将IPCS分类为患者至少使用日语简单单词交流的能力。结果我们发现，与12例无ICPS患者中的1例（8.3%）相比，19例经2年VNS治疗的IPCS患者中有12例（63.2%）的癫痫发作减少（≥50%）显著有利（p= 0.0031， Fisher精确检验）。二项logistic回归分析显示，IPCS的优势比为14.6 (95% CI, 1.9-318)，与癫痫发作的良好结局显著相关（p= 0.0077）。结论临床医生对IPCS的可行性评估可以预测儿童VNS植入后2年以上的癫痫发作结果。
ObjectiveVarious clinical parameters have been reported to be associated with favorable seizure outcomes after vagus nerve stimulation (VNS); however, none of these parameters have been conclusively validated. Here, we evaluated interpersonal communication skills (IPCS) and seizure outcomes in pediatric patients treated with VNS.MethodsWe enrolled 31 Japanese pediatric patients (mean ± SD: 9.0 ± 3.4 years old, range: 3–15 years old) who were treated with VNS and had at least 2 years of follow-up. We divided the patients into two groups: a responder group with ≥50% seizure reduction from the average number of seizures 2 months before VNS; and a nonresponder group with <50% seizure reduction. We assessed the clinical parameters for predicting responders after VNS, including the etiology of epilepsy, seizure characteristics, EEG and MRI findings, medications, the intelligence quotient and/or developmental quotient, and interpersonal communication skills (IPCS) between the two groups. We classified IPCS as the ability of patients to use at least simple-word communication in Japanese.ResultsWe found significantly favorable seizure outcomes (≥50% seizure reduction) in 12 of 19 (63.2%) patients with IPCS after 2-year VNS compared with one of 12 (8.3%) patients without ICPS (p= 0.0031, Fisher exact test). IPCS showed an odds ratio of 14.6 (95% CI, 1.9–318) and a significant correlation with a favorable seizure outcome (p= 0.0077) in binominal logistic regression analysis.ConclusionFeasible evaluation of IPCS by clinicians might predict the seizure outcome more than 2 years after VNS implantation in a pediatric population.