title: Vagus nerve stimulation has a positive effect on mood in patients with refractory epilepsy.
abstract: BACKGROUND
  Preliminary research on the efficacy of vagus nerve stimulation (VNS) indicated additional effects on neuropsychological variables like mood and quality of life (QOL).
  
  
  OBJECTIVE
  The objectives of this prospective longitudinal observational cohort study were to assess the effects of VNS on mood, QOL and cognition in patients with refractory epilepsy and to determine whether these effects occur dependent of seizure control.
  
  
  METHODS
  We included 41 patients with refractory epilepsy; treated with VNS as part of usual patient care. A neuropsychological battery was performed during baseline and repeated after 6 months of VNS in order to compare neuropsychological variables before and after VNS. All patients completed seizure diaries.
  
  
  RESULTS
  Significant improvements were observed for both mood and QOL after 6 months of VNS; based on the results in the POMS and QOLIE-89 questionnaires (p<0.05). There was no significant change in cognition. Mean percentage change in seizure frequency was -9.0%, while 20% of the patients achieved a seizure frequency reduction of 50% or more. No significant correlation was found between changes in seizure frequency and improvements in mood or QOL.
  
  
  CONCLUSIONS
  VNS is associated with improvements in both mood and QOL in patients with refractory epilepsy. Since these improvements appeared to be independent of seizure control, the results of this study indicate an additional antidepressant effect of VNS, which can be of extra value in view of the high co-morbidity of mood disturbances in patients with epilepsy.
authors: Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands. S.Klinkenberg@mumc.nl
authors: S
authors: S
authors: Klinkenberg
authors: H J M
authors: HJ
authors: Majoie
authors: M M A A
authors: MM
authors: van der Heijden
authors: K
authors: K
authors: Rijkers
authors: L
authors: L
authors: Leenen
authors: A P
authors: AP
authors: Aldenkamp
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use; D003071:Cognition / Q000502:physiology; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000523:psychology; D004351:Drug Resistance; D004599:Electric Stimulation Therapy; D004827:Epilepsy / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011788:Quality of Life; D012640:Seizures / Q000523:psychology; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000379:methods*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants