Reduction of generalized tonic–clonic seizures following vagus nerve stimulation therapy: <scp>CORE</scp> ‐ <scp>VNS</scp> Study 24‐month follow‐up
Bibliographic record
Abstract
OBJECTIVE: Generalized tonic-clonic seizures (GTCS) are considered to be among the most devastating seizures due to increased health risks. Use of device-based therapies, such as vagus nerve stimulation (VNS), is common for those resistant to antiseizure medications and important for those in whom resective surgery is not feasible. Our objective is to investigate whether adjunctive VNS can reduce the frequency of GTCS. METHODS: Participants were enrolled in an international, multicenter, prospective observational study (CORE-VNS) on seizure and nonseizure outcomes following the implantation of VNS. Participants with GTCS at baseline were selected for analysis. Baseline seizure frequency data and patient-reported outcome measures were collected at 3, 6, 12, 24, and 36 months. This interim analysis compared baseline data to VNS therapy outcomes through 24 months. RESULTS: A total of 115 participants met the inclusion criteria. Following 12 months of VNS, participants experienced a median GTCS reduction of 73.9%, with 37% of participants reporting seizure freedom from GTCS for the 3 months prior to the 12-month follow-up. This outcome remained stable at 24 months, with a median GTCS reduction of 77% and 42.6% of participants reporting seizure freedom for the 3 months prior to the 24-month visit. After 12 months of VNS, the number of participants reporting the postictal severity of their most debilitating seizure as "severe" or "very severe" dropped from 52.8% to 25.3% (21/83). After 24 months of VNS, the percentage of participants reporting these levels of postictal severity was 26.3% (20/76). The participants' drug load did not change significantly during the follow-up. Adverse events were typical of those previously documented in patients with drug-resistant epilepsy (DRE) using VNS. SIGNIFICANCE: Adjunctive VNS therapy was effective in reducing GTCS frequency in study participants. The sustained and consistent nature of the response further supports VNS as a long-term effective therapy in patients with DRE who have GTCS.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".