Key result
Preoperative heart rate variability complexity, specifically Area 6-20, strongly predicted any response to vagus nerve stimulation with an AUC of 0.891, while RMSSD predicted a 50% or greater seizure reduction.
Why the study?
Can preoperative heart rate variability predict vagus nerve stimulation outcomes in patients with drug-resistant epilepsy?
Cohort (n=113)
Yes
Can preoperative heart rate variability predict vagus nerve stimulation outcomes in patients with drug-resistant epilepsy?
Answers are grounded in this paper and cite their sources.
Preoperative assessment of heart rate variability using linear and multiscale entropy analysis may help predict which patients with drug-resistant epilepsy will respond to vagus nerve stimulation.
Vagus nerve stimulation (VNS) is an adjunctive treatment for drug-resistant epilepsy (DRE). However, it is still difficult to predict which patients will respond to VNS treatment and to what extent. We aim to explore the relationship between preoperative heart rate variability (HRV) and VNS outcome. 50 healthy control subjects and 63 DRE patients who had received VNS implants and had at least one year of follow up were included. The preoperative HRV were analyzed by traditional linear methods and heart rhythm complexity analyses with multiscale entropy (MSE). DRE patients had significantly lower complexity indices (CI) as well as traditional linear HRV measurements than healthy controls. We also found that non-responders 0 had significantly lower preoperative CI including Area 1–5, Area 6–15 and Area 6–20 than those in the responders 0 while those of the non-responders 50 had significantly lower RMSSD, pNN50, VLF, LF, HF, TP and LF/HF than the responders 50 . In receiver operating characteristic (ROC) curve analysis, Area 6–20 and RMSSD had the greatest discriminatory power for the responders 0 and non-responders 0 , responders 50 and non-responders 50 , respectively. Our results suggest that preoperative assessment of HRV by linear and MSE analysis can help in predicting VNS outcomes in patients with DRE.
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Liu et al. (2018) conducted a cohort in Drug-resistant Epilepsy (DRE) (n=113). Preoperative Heart Rate Variability (HRV) vs. Non-responders was evaluated on Discriminatory power of Area 6-20 complexity index for predicting any seizure reduction (responders0) (AUC 0.891). Preoperative heart rate variability complexity, specifically Area 6-20, strongly predicted any response to vagus nerve stimulation with an AUC of 0.891, while RMSSD predicted a 50% or greater seizure reduction.
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