ArticleFrontiers in surgery2026
Longitudinal association of subjective sleep quality and health-related quality of life improvements with Vagus nerve stimulation in drug-resistant epilepsy: a 24-month retrospective cohort study.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the longitudinal trajectories of subjective sleep quality and health-related quality of life (HRQOL) over a 24-month period in adult patients with drug-resistant epilepsy (DRE) following vagus nerve stimulation (VNS) implantation, and to explore the adjusted longitudinal association of these improvements alongside concurrent seizure-frequency reduction. Methods: This retrospective cohort study consecutively enrolled 29 adult patients (≥18 years) with DRE who underwent VNS implantation. Data regarding seizure frequency, Pittsburgh Sleep Quality Index (PSQI), and Quality of Life in Epilepsy-31 (QOLIE-31) scores were extracted from medical records at baseline, 6, 12, and 24 months post-implantation. Repeated-measures analysis of variance (RM-ANOVA) and generalized estimating equations (GEE) were utilized to assess temporal trends and adjust for concurrent seizure frequency (as a continuous, time-varying covariate) and baseline psychiatric comorbidities. Results: Over the 24-month follow-up, the cohort demonstrated a significant and progressive reduction in mean monthly seizure frequency. Concurrently, profound and sustained improvements were observed in both overall PSQI scores and total QOLIE-31 scores (all Conclusion: VNS therapy provides significant, progressive, and sustained improvements in subjective sleep quality and overall HRQOL in adult patients with DRE. Furthermore, these neurobehavioral benefits demonstrate a robust adjusted longitudinal association that is not exclusively tethered to the degree of seizure-frequency reduction. However, causality and complete physiological independence cannot be established due to the observational, uncontrolled design.
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