PDF(Pubmed)
Abstract：
UNASSIGNED: Vagus nerve stimulation (VNS) has been widely used in the treatment of drug-resistant epilepsy (DRE) in children. We aimed to explore the efficacy and safety of VNS, focusing on factors that can influence the efficacy of VNS, and construct a prediction model for the efficacy of VNS in the treatment of DRE children.
UNASSIGNED: Retrospectively analyzed 45 DRE children who underwent VNS at Qilu Hospital of Shandong University from June 2016 to November 2022. A ≥50% reduction in seizure frequency was defined as responder, logistic regression analyses were performed to analyze factors affecting the efficacy of VNS, and a predictive model was constructed. The predictive model was evaluated by receiver operating characteristic curve (ROC), calibration curves, and decision curve analyses (DCA).
UNASSIGNED: A total of 45 DRE children were included in this study, and the frequency of seizures was significantly reduced after VNS treatment, with 25 responders (55.6%), of whom 6 (13.3%) achieved seizure freedom. There was a significant improvement in the Quality of Life in Childhood Epilepsy Questionnaire (15.5%) and Seizure Severity Score (46.2%). 16 potential factors affecting the efficacy of VNS were included, and three statistically significant positive predictors were ultimately screened: shorter seizure duration, focal seizure, and absence of intellectual disability. We developed a nomogram for predicting the efficacy of VNS in the treatment of DRE children. The ROC curve confirmed that the predictive model has good diagnostic performance (AUC = 0.864, P < 0.05), and the nomogram can be further validated by bootstrapping for 1,000 repetitions, with a C-index of 0.837. Besides, this model showed good fitting and calibration and positive net benefits in decision curve analysis.
UNASSIGNED: VNS is a safe and effective treatment for DRE children. We developed a predictive nomogram for the efficacy of VNS, which provides a basis for more accurate selection of VNS patients.
UNASSIGNED: Retrospectively analyzed 45 DRE children who underwent VNS at Qilu Hospital of Shandong University from June 2016 to November 2022. A ≥50% reduction in seizure frequency was defined as responder, logistic regression analyses were performed to analyze factors affecting the efficacy of VNS, and a predictive model was constructed. The predictive model was evaluated by receiver operating characteristic curve (ROC), calibration curves, and decision curve analyses (DCA).
UNASSIGNED: A total of 45 DRE children were included in this study, and the frequency of seizures was significantly reduced after VNS treatment, with 25 responders (55.6%), of whom 6 (13.3%) achieved seizure freedom. There was a significant improvement in the Quality of Life in Childhood Epilepsy Questionnaire (15.5%) and Seizure Severity Score (46.2%). 16 potential factors affecting the efficacy of VNS were included, and three statistically significant positive predictors were ultimately screened: shorter seizure duration, focal seizure, and absence of intellectual disability. We developed a nomogram for predicting the efficacy of VNS in the treatment of DRE children. The ROC curve confirmed that the predictive model has good diagnostic performance (AUC = 0.864, P < 0.05), and the nomogram can be further validated by bootstrapping for 1,000 repetitions, with a C-index of 0.837. Besides, this model showed good fitting and calibration and positive net benefits in decision curve analysis.
UNASSIGNED: VNS is a safe and effective treatment for DRE children. We developed a predictive nomogram for the efficacy of VNS, which provides a basis for more accurate selection of VNS patients.
摘要：
■迷走神经刺激（VNS）已广泛用于治疗儿童耐药性癫痫（DRE）。我们旨在探讨VNS的疗效和安全性，关注可能影响VNS疗效的因素，并构建VNS治疗DRE患儿疗效的预测模型。
■回顾性分析2016年6月至2022年11月在山东大学齐鲁医院接受VNS的45例DRE患儿。癫痫发作频率降低≥50%被定义为反应者，Logistic回归分析影响VNS疗效的因素，并构建了预测模型。通过受试者工作特征曲线(ROC)评估预测模型，校正曲线,和决策曲线分析(DCA)。
■本研究共纳入45名DRE儿童，VNS治疗后癫痫发作频率显著降低，有25名响应者(55.6%)，其中6人(13.3%)获得了缉获自由。儿童癫痫问卷(15.5%)和癫痫严重程度评分(46.2%)的生活质量有显著改善。包括影响VNS疗效的16个潜在因素，最终筛选出三个具有统计学意义的阳性预测因子：癫痫发作持续时间较短，局灶性癫痫发作,没有智力残疾。我们开发了一个列线图，用于预测VNS治疗DRE儿童的疗效。ROC曲线证实预测模型具有良好的诊断性能(AUC=0.864,P<0.05),并且可以通过引导1000次重复来进一步验证列线图，C指数为0.837。此外,该模型在决策曲线分析中表现出良好的拟合和校准以及正的净效益。
■VNS是DRE儿童的安全有效治疗方法。我们开发了VNS疗效的预测列线图，为更准确地选择VNS患者提供了依据。
■回顾性分析2016年6月至2022年11月在山东大学齐鲁医院接受VNS的45例DRE患儿。癫痫发作频率降低≥50%被定义为反应者，Logistic回归分析影响VNS疗效的因素，并构建了预测模型。通过受试者工作特征曲线(ROC)评估预测模型，校正曲线,和决策曲线分析(DCA)。
■本研究共纳入45名DRE儿童，VNS治疗后癫痫发作频率显著降低，有25名响应者(55.6%)，其中6人(13.3%)获得了缉获自由。儿童癫痫问卷(15.5%)和癫痫严重程度评分(46.2%)的生活质量有显著改善。包括影响VNS疗效的16个潜在因素，最终筛选出三个具有统计学意义的阳性预测因子：癫痫发作持续时间较短，局灶性癫痫发作,没有智力残疾。我们开发了一个列线图，用于预测VNS治疗DRE儿童的疗效。ROC曲线证实预测模型具有良好的诊断性能(AUC=0.864,P<0.05),并且可以通过引导1000次重复来进一步验证列线图，C指数为0.837。此外,该模型在决策曲线分析中表现出良好的拟合和校准以及正的净效益。
■VNS是DRE儿童的安全有效治疗方法。我们开发了VNS疗效的预测列线图，为更准确地选择VNS患者提供了依据。
