{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T14:49:47Z","timestamp":1781707787104,"version":"3.54.5"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Traumatic brain injury (TBI) has been recognized as an important and common cause of epilepsy since antiquity. Posttraumatic epilepsy (PTE) is usually associated with drug resistance and poor surgical outcomes, thereby increasing the burden of the illness on patients and their families. Vagus nerve stimulation (VNS) is an adjunctive treatment for medically refractory epilepsy. This study aimed to determine the efficacy of VNS for refractory PTE and to initially evaluate the potential predictors of efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively collected the outcomes of VNS with at least a 1-year follow-up in all patients with refractory PTE. Subgroups were classified as responders and non-responders according to the efficacy of VNS (\u226550% or &amp;lt;50% reduction in seizure frequency). Preoperative data were analyzed to screen for potential predictors of VNS efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, forty-five patients with refractory PTE who underwent VNS therapy were enrolled. Responders were found in 64.4% of patients, and 15.6% of patients achieved seizure freedom at the last follow-up. In addition, the responder rate increased over time, with 37.8, 44.4, 60, and 67.6% at the 3-, 6-, 12-, and 24-month follow-ups, respectively. After multivariate analysis, generalized interictal epileptic discharges (IEDs) were found to be a negative predictor (OR: 4.861, 95% CI: 1.145\u201320.632) of VNS efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results indicated that VNS therapy was effective in refractory PTE patients and was well tolerated over a 1-year follow-up period. Patients with focal or multifocal IEDs were recognized to have better efficacy after VNS therapy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.954509","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T09:37:26Z","timestamp":1659001046000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Vagus nerve stimulation for refractory posttraumatic epilepsy: Efficacy and predictors of seizure outcome"],"prefix":"10.3389","volume":"13","author":[{"given":"Mengyi","family":"Guo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongyang","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahui","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhonghua","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuguang","family":"Guan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoming","family":"Luan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianfu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1097\/00001199-200611000-00004","article-title":"A population-based outcomes study of persons hospitalized with traumatic brain injury: operations of the South Carolina Traumatic Brain Injury Follow-up Registry","volume":"21","author":"Pickelsimer","year":"2006","journal-title":"J Head Trauma Rehabil."},{"key":"B2","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1053\/seiz.2000.0458","article-title":"The risks of epilepsy after traumatic brain injury","volume":"9","author":"Annegers","year":"2000","journal-title":"Seizure."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.1212\/WNL.35.10.1406","article-title":"Epilepsy after penetrating head injury. I Clinical correlates: a report of the Vietnam Head Injury Study","volume":"35","author":"Salazar","year":"1985","journal-title":"Neurology."},{"key":"B4","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1056\/NEJM199801013380104","article-title":"A population-based study of seizures after traumatic brain injuries","volume":"338","author":"Annegers","year":"1998","journal-title":"N Engl J Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1007\/s10072-003-0144-9","article-title":"Posttraumatic epilepsy","volume":"24","author":"Rinaldi","year":"2003","journal-title":"Neurol Sci."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1535-7511.2005.00083.x","article-title":"Posttraumatic epilepsy: a major problem in desperate need of major advances","volume":"6","author":"Garga","year":"2006","journal-title":"Epilepsy currents."},{"key":"B7","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.seizure.2020.09.027","article-title":"Learnings from 30 years of reported efficacy and safety of vagus nerve stimulation (VNS) for epilepsy treatment: a critical review","volume":"83","author":"Toffa","year":"2020","journal-title":"Seizure."},{"key":"B8","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1002\/ana.25574","article-title":"Connectomic profiling identifies responders to vagus nerve stimulation","volume":"86","author":"Mithani","year":"2019","journal-title":"Ann Neurol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.3171\/2011.7.JNS11977","article-title":"Vagus nerve stimulation for epilepsy: a meta-analysis of efficacy and predictors of response","volume":"115","author":"Englot","year":"2011","journal-title":"J Neurosurg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"107253","DOI":"10.1016\/j.yebeh.2020.107253","article-title":"Vagus nerve stimulation in patients with therapy-resistant generalized epilepsy","volume":"111","author":"Suller Marti","year":"2020","journal-title":"Epilepsy Behav."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1046\/j.1528-1157.2001.23900.x","article-title":"Vagus nerve stimulation in children with refractory seizures associated with Lennox-Gastaut syndrome","volume":"42","author":"Frost","year":"2001","journal-title":"Epilepsia."},{"key":"B12","doi-asserted-by":"publisher","first-page":"20406223211066738","DOI":"10.1177\/20406223211066738","article-title":"Efficacy and potential predictors of vagus nerve stimulation therapy in refractory postencephalitic epilepsy","volume":"13","author":"Liu","year":"2022","journal-title":"Ther Adv Chronic Dis."},{"key":"B13","doi-asserted-by":"publisher","first-page":"196","DOI":"10.3340\/jkns.2008.44.4.196","article-title":"Effect of vagus nerve stimulation in post-traumatic epilepsy and failed epilepsy surgery: preliminary report","volume":"44","author":"Lee","year":"2008","journal-title":"J Korean Neurosurg Soc."},{"key":"B14","doi-asserted-by":"publisher","first-page":"970","DOI":"10.3171\/2012.8.JNS122","article-title":"Efficacy of vagus nerve stimulation in posttraumatic versus nontraumatic epilepsy","volume":"117","author":"Englot","year":"2012","journal-title":"J Neurosurg."},{"key":"B15","doi-asserted-by":"publisher","first-page":"3856","DOI":"10.1038\/s41598-018-21669-3","article-title":"Preoperative heart rate variability as predictors of vagus nerve stimulation outcome in patients with drug-resistant epilepsy","volume":"8","author":"Liu","year":"2018","journal-title":"Sci Rep."},{"key":"B16","doi-asserted-by":"publisher","first-page":"726","DOI":"10.3171\/2021.3.JNS21141","article-title":"Genetic variations of adenosine kinase as predictable biomarkers of efficacy of vagus nerve stimulation in patients with pharmacoresistant epilepsy","volume":"136","author":"Zhang","year":"2022","journal-title":"J Neurosurg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1111\/j.1528-1167.2008.02004.x","article-title":"Epilepsy after head injury: an overview","volume":"50","author":"Lowenstein","year":"2009","journal-title":"Epilepsia."},{"key":"B18","doi-asserted-by":"publisher","first-page":"108431","DOI":"10.1016\/j.yebeh.2021.108431","article-title":"Vagus nerve stimulation for drug-resistant epilepsy induced by tuberous sclerosis complex","volume":"126","author":"Tong","year":"2022","journal-title":"Epilepsy Behav."},{"key":"B19","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1111\/epi.13709","article-title":"ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology","volume":"58","author":"Scheffer","year":"2017","journal-title":"Epilepsia."},{"key":"B20","doi-asserted-by":"publisher","first-page":"97","DOI":"10.3171\/2016.1.PEDS15534","article-title":"Complications and safety of vagus nerve stimulation: 25 years of experience at a single center","volume":"18","author":"R\u00e9v\u00e9sz","year":"2016","journal-title":"J Neurosurg Pediatr."},{"key":"B21","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.1212\/WNL.59.6_suppl_4.S31","article-title":"Vagus nerve stimulation therapy, epilepsy, and device parameters: scientific basis and recommendations for use","volume":"59","author":"Heck","year":"2002","journal-title":"Neurology."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1568","DOI":"10.3171\/2019.7.JNS191233","article-title":"Resective surgery for drug-resistant posttraumatic epilepsy: predictors of seizure outcome","volume":"133","author":"He","year":"2019","journal-title":"J Neurosurg."},{"key":"B23","doi-asserted-by":"publisher","first-page":"22:443","DOI":"10.1016\/j.nec.2011.07.002","article-title":"Efficacy of vagus nerve stimulation for epilepsy by patient age, epilepsy duration, and seizure type","author":"Englot","year":"2011","journal-title":"Neurosurg Clin N Am."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1731","DOI":"10.1212\/WNL.53.8.1731","article-title":"Long-term treatment with vagus nerve stimulation in patients with refractory epilepsy The Vagus Nerve Stimulation Study Group E01-E05","volume":"53","author":"Morris GL","year":"1999","journal-title":"Neurology."},{"key":"B25","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1111\/j.1528-1167.2009.02384.x","article-title":"population-based study of risk of epilepsy after hospitalization for traumatic brain injury","volume":"51","author":"Ferguson","year":"2010","journal-title":"Epilepsia."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.1111\/epi.13470","article-title":"Prognostic models for predicting posttraumatic seizures during acute hospitalization, and at 1 and 2 years following traumatic brain injury","volume":"57","author":"Ritter","year":"2016","journal-title":"Epilepsia."},{"key":"B27","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1136\/jnnp.2004.037085","article-title":"Vagus nerve stimulation: predictors of seizure freedom","volume":"76","author":"Janszky","year":"2005","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B28","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1016\/j.seizure.2010.03.002","article-title":"Vagus nerve stimulation: outcome and predictors of seizure freedom in long-term follow-up","volume":"19","author":"Ghaemi","year":"2010","journal-title":"Seizure."},{"key":"B29","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s00381-016-3261-5","article-title":"An interictal EEG can predict the outcome of vagus nerve stimulation therapy for children with intractable epilepsy","volume":"33","author":"Kim","year":"2017","journal-title":"Child Nerv Syst."},{"key":"B30","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.yebeh.2010.10.017","article-title":"Vagus nerve stimulation in 436 consecutive patients with treatment-resistant epilepsy: long-term outcomes and predictors of response","volume":"20","author":"Elliott","year":"2011","journal-title":"Epilepsy Behav."},{"key":"B31","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1212\/WNL.51.2.465","article-title":"Predictors of outcome of anterior temporal lobectomy for intractable epilepsy: a multivariate study","volume":"51","author":"Radhakrishnan","year":"1998","journal-title":"Neurology."},{"key":"B32","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1111\/j.1528-1157.2000.tb00210.x","article-title":"Interictal EEG and ictal scalp EEG propagation are highly predictive of surgical outcome in mesial temporal lobe epilepsy","volume":"41","author":"Schulz","year":"2000","journal-title":"Epilepsia."},{"key":"B33","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/S0920-1211(01)00307-2","article-title":"Spatiotemporal relationship between seizure activity and interictal spikes in temporal lobe epilepsy","volume":"47","author":"Janszky","year":"2001","journal-title":"Epilepsy Res."},{"key":"B34","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1016\/S1059-1311(03)00069-4","article-title":"Clinical differences in patients with unilateral hippocampal sclerosis and unitemporal or bitemporal epileptiform discharges","volume":"12","author":"Janszky","year":"2003","journal-title":"Seizure."},{"key":"B35","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1111\/j.1528-1157.1985.tb05704.x","article-title":"Electrographic and clinical correlates of secondary bilateral synchrony","volume":"26","author":"Blume","year":"1985","journal-title":"Epilepsia."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1089\/neu.2011.1914","article-title":"Natural history of headache after traumatic brain injury","volume":"28","author":"Hoffman","year":"2011","journal-title":"J Neurotrauma."},{"key":"B37","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1016\/j.psc.2010.08.004","article-title":"Traumatic brain injury and its neurobehavioral sequelae","volume":"33","author":"Riggio","year":"2010","journal-title":"Psychiatr Clin North Am."},{"key":"B38","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1016\/j.seizure.2005.08.007","article-title":"Vagus nerve stimulation in 15 children with therapy resistant epilepsy; its impact on cognition, quality of life, behaviour and mood","volume":"14","author":"Hallb\u00f6\u00f6k","year":"2005","journal-title":"Seizure."},{"key":"B39","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/ner.13528","article-title":"A Comprehensive review of vagus nerve stimulation for depression","volume":"25","author":"Austelle","year":"2022","journal-title":"Neuromodulation."},{"key":"B40","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.brs.2008.02.001","article-title":"A pilot study of vagus nerve stimulation (VNS) for treatment-resistant anxiety disorders","volume":"1","author":"George","year":"2008","journal-title":"Brain Stimul."},{"key":"B41","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.ejpn.2021.02.008","article-title":"The bottom-up approach: Non-invasive peripheral neurostimulation methods to treat migraine: a scoping review from the child neurologist's perspective","volume":"32","author":"B\u00f6rner","year":"2021","journal-title":"Eur J Paediatr Neurol."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.954509\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T09:37:28Z","timestamp":1659001048000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.954509\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,28]]},"references-count":41,"alternative-id":["10.3389\/fneur.2022.954509"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2022.954509","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,28]]},"article-number":"954509"}}