{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:50:33Z","timestamp":1792273833099,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"\n Objective<\/jats:title>\n Lennox\u2013Gastaut syndrome (LGS) is a severe treatment\u2010resistant epilepsy. Although vagus nerve stimulation (VNS) and deep brain stimulation (DBS) are established therapies, comparative data and the impact of dual neuromodulation remain limited. We compared seizure outcomes across VNS, DBS, and combined DBS\u2009+\u2009VNS therapy in LGS.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This retrospective cohort study at Mayo Clinic (2005\u20132024) included\n LGS<\/jats:styled-content>\n patients treated with\n VNS<\/jats:styled-content>\n and\/or\n DBS<\/jats:styled-content>\n . Seizure frequency was assessed at 6, 12, and 24\u2009months post\u2010stimulation. Responder was defined as 50% or more seizure reduction.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Forty patients were included (42% female, median, 150 seizures\/month). Eleven patients underwent sequential\n VNS<\/jats:styled-content>\n followed by\n DBS<\/jats:styled-content>\n and contributed data to 2 treatment epochs, yielding 3 treatment groups:\n VNS<\/jats:styled-content>\n alone (n\u2009=\u200929),\n DBS<\/jats:styled-content>\n alone (n\u2009=\u200912), and\n DBS<\/jats:styled-content>\n \u2009+\u2009\n VNS<\/jats:styled-content>\n (n\u2009=\u200910). At 24\u2009months, median seizure reduction rate was comparable between\n VNS<\/jats:styled-content>\n (50%; 95% confidence interval [\n CI],<\/jats:styled-content>\n 44\u201375%) and the overall\n DBS<\/jats:styled-content>\n cohort (59%, 95%\n CI,<\/jats:styled-content>\n 33\u201386%) (\n p<\/jats:italic>\n \u2009=\u20090.54). However, a significant difference emerged when comparing the 3 treatment arms (\n p<\/jats:italic>\n \u2009=\u20090.027). Specifically,\n DBS<\/jats:styled-content>\n \u2009+\u2009\n VNS<\/jats:styled-content>\n therapy yielded significantly greater median reduction rate (81%, 95%\n CI,<\/jats:styled-content>\n 60\u201399%) than\n DBS<\/jats:styled-content>\n alone (43%, 95%\n CI,<\/jats:styled-content>\n 0\u201358%) (\n p<\/jats:italic>\n adj<\/jats:sub>\n \u2009=\u20090.027) or\n VNS<\/jats:styled-content>\n alone (50%, 95%\n CI,<\/jats:styled-content>\n 44.4\u201375.0%) (\n p<\/jats:italic>\n adj<\/jats:sub>\n \u2009=\u20090.048). Four patients attained sustained seizure freedom above 1 year at last follow\u2010up.\n <\/jats:p>\n <\/jats:sec>\n \n Interpretation<\/jats:title>\n VNS and DBS provide comparable seizure reduction in LGS over a 2\u2010year follow\u2010up period. DBS\u2009+\u2009VNS was associated with further improvements in seizure reduction in this small, retrospective dataset. This possibility warrants further investigation. ANN NEUROL 2026;100:879\u2013892<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ana.78308","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:49:32Z","timestamp":1784033372000},"page":"879-892","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Seizure Outcomes of Vagus Nerve Stimulation, Deep Brain Stimulation, and Their Combination in Lennox\u2013Gastaut Syndrome"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8406-3660","authenticated-orcid":false,"given":"Cheng\u2010Yen","family":"Kuo","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester MN USA"},{"name":"Division of Pediatric Neurology Chang Gung Memorial Hospital Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raunak","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo 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