Vagus Nerve Stimulation in Narcolepsy: Daily Dose

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On January 25, 2024, we reported on findings from a first of its kind open-label prospective comparative study published in the Brain Stimulation Journal that assessed the therapeutic effect of vagus nerve stimulation (VNS) on daily sleepiness and cataplexies in patients with narcolepsy.

The study

The study included patients with narcolepsy who were treated with VNS because of depression or epilepsy, who were compared to controls without narcolepsy treated with VNS for depression or epilepsy (18 patients in each group).

Researchers evaluated daily sleepiness using the Epworth Sleepiness Scale (ESS) and weekly cataplexy rate (WCR) before the implantation of VNS and at 3- and 6-month follow-ups.

The findings

Results showed that compared to baseline (ESS: 15.9), patients with narcolepsy showed a significant improvement on ESS after 3 months (11.2, P < .05) and 6 months (9.6, P < .001). Among the patients with narcolepsy, investigators also observed a trend in improvement of number of cataplexies per week following 6 months (WCR, 1.8) compared with baseline (WCR, 3.9).

The investigators did not observe a significant ESS-improvement in patients without narcolepsy who received VNS treatment (baseline, 14.9; 3 months, 13.6; 6 months, 13.2; P = .2).

Authors' comment

"In this first evaluation of VNS in narcolepsy, we found a significant improvement of daily sleepiness due to this type of neurostimulation. VNS could be a promising non-medical treatment in narcolepsy."

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