{"doi":"10.1101/2024.12.30.24319582","title":"Long-Term Seizure Reduction Associated with Vagal Nerve Stimulation in Dravet Syndrome","abstract":"Abstract SCN1A variants cause a range of epilepsy syndromes, including Dravet syndrome, leading to early cognitive and functional impairment. Despite advances in medical management, drug-resistant epilepsy remains common. Vagal nerve stimulation (VNS) has been suggested reducing seizure frequency in these patients but there is a lack of long-term follow-up, quantitative analysis that corrected for confounding factors such as antiseizure medications (ASMs) and the impact of VNS settings on response. This two-center, retrospective cohort study analyzed 12-month and for the first time up to ten-year seizure outcomes in therapy-refractory epilepsy patients with loss-of-function SCN1A variants (93.75% Dravet Syndrome) who underwent VNS implantation. A ≥50% seizure frequency reduction was observed in 93.75% (15/16) of patients in the 12-month and 87.5% (14/15) in the ten-year period. Median seizure frequency was significantly lower in both follow-up periods than in the pre-implantation period. Linear mixed-effects regression showed that the reduction in seizure burden was independent of ASM use, and the VNS duty cycle was significantly associated with seizure reduction. Three individuals (18.8%) experienced minor side effects. Our results highlight the benefits of genotype-driven therapeutic interventions such as VNS in patients with SCN1A -related epilepsy. This study emphasizes the need for further implementation of genotype-driven clinical decision-making.","journal":"medRxiv","year":2025,"id":560032,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9469,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":883711,"name":"Alina Ivaniuk","orcid":"0000-0001-9912-3112","position":1,"is_corresponding":false},{"id":1357849,"name":"Tobias Bruenger","orcid":"0000-0003-2591-432X","position":2,"is_corresponding":false},{"id":1462206,"name":"Émile Moura Coelho Da Silva","orcid":null,"position":3,"is_corresponding":false},{"id":1116330,"name":"Emily A. 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