Effects of Stable Vagus Nerve Stimulation Efficacy on Autistic Behaviors in Ten Pediatric Patients With Drug Resistant Epilepsy: An Observational Study

Abstract

Vagus nerve stimulation (VNS) is a safe and effective therapy for pediatric patients with drug-resistant epilepsy (DRE). However, in children with DRE, the effects of VNS on autistic behaviors remain controversial. We retrospectively collected data from 10 children with DRE who underwent VNS implantation and regular parameter regulation in three pediatric epilepsy centers, and completed the behavioral assessments, including the autistic behavior checklist and the child behavior checklist, at follow-ups 1 (mean 2.16 years) and 2 (mean 2.98 years). The 10 children maintained stable seizure control between the two follow-ups. Their autistic behaviors, especially in language, social and self-help, were reduced at follow-up 2 compared to follow-up 1 (p = 0.01, p = 0.01, respectively). Moreover, these improvements were not associated with their seizure control, whether it was positive or negative. These results suggested that the VNS had a positive effect on autistic behaviors, which provided a preliminary clinical basis that VNS may benefit to younger children with DRE comorbidity autism spectrum disorder (ASD).

The dual effect of vagus nerve stimulation in pediatric patients with drug- resistant epilepsy: Is there more than seizure control?

“…This is in line with the previously proposed treatment protocol by Jaseja that recommends VNS implantation for the treatment of DRE in children with cerebral palsy to improve their neurocognitive de cits and QOL through its dual antiepileptic and IED-suppression therapeutic mechanism [11]. Another promising study reported that VNS has a positive role in modifying autistic behaviors in younger children with autism and DRE regardless of seizure control and in the absence of training interventions [32]. In contrast to our results, Tsai and his colleagues didn't nd any signi cant improvement in cognitive functions but mainly reduced seizure frequency and stress-related family dynamics [33].…”

Pediatric Vagus Nerve Stimulation: Case Series Outcomes and Future Directions

“…35 One key aspect of patient selection relates to recent discoveries that VNS has a myriad of effects—systemically and neurologically—which are only now becoming apparent. In addition to VNS′ well-documented and U. S. Food and Drug Administration–approved indication for depression, 36 early reports document therapeutic benefit in seemingly unrelated and comorbid disorders in patients with epilepsy including autism spectrum disorder, 37 obesity, 38 heart failure, 39 and rheumatoid arthritis. 40 As our understanding of the role of VNS in these and other disorders evolves, it will be important to consider these factors as well when identifying surgical candidates for VNS implantation.…”

Traditional Chinese medicine formula Xiaoyaosan alleviates autistic behaviors and anxiety behaviors in valproic acid-induced autistic rats

“…Symptoms of ASD, such as stereotypic behaviors and di culties with mood and emotion recognition, are closely related to autonomic nervous system (ANS) dysfunction [31] . The ANS is a pathway system connecting the heart to the central nervous system, mediated by a variety of chemicals that maintain the body's ability to adapt acutely to stress, through parasympathetic and sympathetic stability to maintain homeostasis [32] .…”