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Beneficial effects on sleep of vagus nerve stimulation in children with therapy resistant epilepsy.

Hallböök, Tove LU ; Lundgren, Johan LU ; Köhler, Sven LU ; Blennow, Gösta LU ; Strömblad, Lars-Göran LU and Rosén, Ingmar LU (2005) In European Journal of Paediatric Neurology 9(6). p.399-407
Abstract
The study purpose was to evaluate sleep structure following Vagus Nerve Stimulation (VNS) in 15 children with therapy resistant epilepsy and to correlate possible alterations with changes in epileptiform activity and clinical effects. Fifteen children were examined with ambulatory polysomnographic recordings initially, and after 3 and 9 months of VNS-treatment. Sleep parameters, all-night delta power activity and movement times (MTs), used to account for arousals were estimated. Epileptiform activity was evaluated by spike detection. Seizure frequency was recorded in a diary. The severity of the seizures was scored with the National Hospital Seizure Severity Scale (NHS3). Quality of life (QOL) was assessed by a visual analogue scale.... (More)
The study purpose was to evaluate sleep structure following Vagus Nerve Stimulation (VNS) in 15 children with therapy resistant epilepsy and to correlate possible alterations with changes in epileptiform activity and clinical effects. Fifteen children were examined with ambulatory polysomnographic recordings initially, and after 3 and 9 months of VNS-treatment. Sleep parameters, all-night delta power activity and movement times (MTs), used to account for arousals were estimated. Epileptiform activity was evaluated by spike detection. Seizure frequency was recorded in a diary. The severity of the seizures was scored with the National Hospital Seizure Severity Scale (NHS3). Quality of life (QOL) was assessed by a visual analogue scale. Behaviour problems were quantified by using the total score of the Child Behaviour Checklist (CBCL). VNS induces a significant increase in slow wave sleep (SWS) and a decrease in sleep latency and in stage 1 sleep. The number and density of MTs during total night sleep were significantly increased. There was also a significant increase in the number of MTs immediately related to the VNS stimulation periods. Of the 14 children with increased MTs, 10 had a reduction in epileptiform activity, and in clinical seizures, all had an improvement in NHS3, and 11 in QOL. Of the 10 children with increased SWS, eight also improved in QOL and eight in behaviour. Our findings indicate that VNS counteracts known adverse effects of epilepsy on sleep and increases slow wave sleep. This possibly contributes to the reported improvement in well-being. We also see an increase in MTs. This arousal effect seems to be of minor importance for QOL and could possibly be related to the antiepileptic mechanisms in VNS. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
vagus nerve stimulation, sleep, slow wave sleep, delta power, behaviour, arousal, quality of life, children, epilepsy
in
European Journal of Paediatric Neurology
volume
9
issue
6
pages
399 - 407
publisher
Elsevier
external identifiers
  • wos:000234284900004
  • scopus:29644446804
ISSN
1090-3798
DOI
10.1016/j.ejpn.2005.08.004
language
English
LU publication?
yes
id
16abb09c-f352-44cb-b343-a2fe5101ca18 (old id 148257)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16257548&dopt=Abstract
date added to LUP
2007-07-13 15:01:35
date last changed
2017-10-01 03:58:19
@article{16abb09c-f352-44cb-b343-a2fe5101ca18,
  abstract     = {The study purpose was to evaluate sleep structure following Vagus Nerve Stimulation (VNS) in 15 children with therapy resistant epilepsy and to correlate possible alterations with changes in epileptiform activity and clinical effects. Fifteen children were examined with ambulatory polysomnographic recordings initially, and after 3 and 9 months of VNS-treatment. Sleep parameters, all-night delta power activity and movement times (MTs), used to account for arousals were estimated. Epileptiform activity was evaluated by spike detection. Seizure frequency was recorded in a diary. The severity of the seizures was scored with the National Hospital Seizure Severity Scale (NHS3). Quality of life (QOL) was assessed by a visual analogue scale. Behaviour problems were quantified by using the total score of the Child Behaviour Checklist (CBCL). VNS induces a significant increase in slow wave sleep (SWS) and a decrease in sleep latency and in stage 1 sleep. The number and density of MTs during total night sleep were significantly increased. There was also a significant increase in the number of MTs immediately related to the VNS stimulation periods. Of the 14 children with increased MTs, 10 had a reduction in epileptiform activity, and in clinical seizures, all had an improvement in NHS3, and 11 in QOL. Of the 10 children with increased SWS, eight also improved in QOL and eight in behaviour. Our findings indicate that VNS counteracts known adverse effects of epilepsy on sleep and increases slow wave sleep. This possibly contributes to the reported improvement in well-being. We also see an increase in MTs. This arousal effect seems to be of minor importance for QOL and could possibly be related to the antiepileptic mechanisms in VNS.},
  author       = {Hallböök, Tove and Lundgren, Johan and Köhler, Sven and Blennow, Gösta and Strömblad, Lars-Göran and Rosén, Ingmar},
  issn         = {1090-3798},
  keyword      = {vagus nerve stimulation,sleep,slow wave sleep,delta power,behaviour,arousal,quality of life,children,epilepsy},
  language     = {eng},
  number       = {6},
  pages        = {399--407},
  publisher    = {Elsevier},
  series       = {European Journal of Paediatric Neurology},
  title        = {Beneficial effects on sleep of vagus nerve stimulation in children with therapy resistant epilepsy.},
  url          = {http://dx.doi.org/10.1016/j.ejpn.2005.08.004},
  volume       = {9},
  year         = {2005},
}