Association of Reductions in Rescue Medication Requirements With Vagus Nerve Stimulation: Results of Long-Term Community Collected Data From a Seizure Diary App
Authors
Cameron P. Beaudreault, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA. Electronic address: Cbeaudre@student.nymc.edu.
Sharon Chiang, Epilepsy AI, P.O. Box 225039, San Francisco, CA 94122, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA, 94131, USA. Electronic address: sharon.chiang@ucsf.edu.
Ariel Sacknovitz, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA. Electronic address: Asacknov2@student.nymc.edu.
Robert Moss, Seizure Tracker™, P.O. Box 8005, Springfield, VA 22151, USA. Electronic address: Rob@seizuretracker.com.
Paige Brabant, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA. Electronic address: Pbrabant@student.nymc.edu.
David Zuckerman, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA. Electronic address: Dzuckerm3@student.nymc.edu.
Jessica R. Dorilio, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA. Electronic address: Jdorilio@student.nymc.edu.
Eris Spirollari, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA. Electronic address: Espiroll@student.nymc.edu.
Alexandria F. Naftchi, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA. Electronic address: Anaftchi@student.nymc.edu.
Patricia E. McGoldrick, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA; Division of Pediatric Neurology, Department of Pediatrics, Maria Fareri Children's Hospital, 100 Woods Road, Valhalla, NY 10595, USA. Electronic address: Patricia_McGoldrick@bchphysicians.org.
Carrie R. Muh, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA; Department of Neurosurgery, Westchester Medical Center, 100 Woods Road, Valhalla, NY 10595, USA. Electronic address: Carrie.Muh@wmchealth.org.
Richard Wang, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA. Electronic address: Rwang5@student.nymc.edu.
Bridget Nolan, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA; Department of Neurosurgery, Westchester Medical Center, 100 Woods Road, Valhalla, NY 10595, USA. Electronic address: Bnolan2@student.nymc.edu.
Kevin Clare, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA; Department of Neurosurgery, Westchester Medical Center, 100 Woods Road, Valhalla, NY 10595, USA. Electronic address: Kclare@student.nymc.edu.
Vishad V. Sukul, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA; Department of Neurosurgery, Westchester Medical Center, 100 Woods Road, Valhalla, NY 10595, USA. Electronic address: Vishad.Sukul@wmchealth.org.
Steven M. Wolf, New York Medical College, 15 Dana Road, Valhalla, NY, 10595, USA; Division of Pediatric Neurology, Department of Pediatrics, Maria Fareri Children's Hospital, 100 Woods Road, Valhalla, NY 10595, USA; Boston Children's Hospital Physicians, 40 Saw Mill River Road, Hawthorne, NY 10532, USA. Electronic address: Steven_Wolf@BCHPhysicians.org.
Author Type(s)
Student, Faculty
DOI
10.1016/j.yebeh.2024.110008
Journal Title
Epilepsy & Behavior
Publication Date
10-1-2024
Second Department
Neurosurgery
Abstract
OBJECTIVE: To assess the impact of vagus nerve stimulation (VNS) on quality of life contributors such as rescue medications. METHODS: Using the seizure diary application SeizureTracker™ database, we examined trends in rescue administration frequency before and after the first recorded VNS magnet swipe in patients with drug-resistant epilepsy who had 1) At least one VNS magnet swipe recorded in the diary, and 2) Recorded usage of a benzodiazepine rescue medication (RM) within 90 days prior to the first swipe. A paired Wilcoxon rank-sum test was used to assess changes in RM usage frequency between 30-, 60-, 90-, 180- and 360-day intervals beginning 30 days after first magnet swipe. Longitudinal changes in RM usage frequency were assessed with a generalized estimating equation model. RESULTS: We analyzed data of 95 patients who met the inclusion criteria. Median baseline seizure frequency was 8.3 seizures per month, with median baseline rescue medication usage frequency of 2.1 administrations per month (SD 3.3). Significant reductions in rescue medication usage were observed in the 91 to 180 day interval after first VNS magnet swipe, and at 181 to 360 days and at 361 to 720 days, with the magnitude of reduction increasing over time. Decreases in rescue medication usage were sustained when controlling for patients who did not record rescue medication use after the first VNS magnet swipe (N=91). Significant predictors of reductions in rescue medication included baseline frequency of rescue medication usage and time after first VNS magnet swipe. SIGNIFICANCE: This retrospective analysis suggests that usage of rescue medications is reduced following the start of VNS treatment in patients with epilepsy, and that the magnitude of reduction may progressively increase over time.
Recommended Citation
Beaudreault, C. P., Chiang, S., Sacknovitz, A., Moss, R., Brabant, P., Zuckerman, D., Dorilio, J. R., Spirollari, E., Naftchi, A. F., McGoldrick, P. E., Muh, C. R., Wang, R., Nolan, B., Clare, K., Sukul, V. V., & Wolf, S. M.
(2024). Association of Reductions in Rescue Medication Requirements With Vagus Nerve Stimulation: Results of Long-Term Community Collected Data From a Seizure Diary App. Epilepsy & Behavior, 159, 110008.
https://doi.org/10.1016/j.yebeh.2024.110008
