Chronic vagus nerve stimulation for drug-resistant epilepsy may influence fasting blood glucose concentration

Hongyun Liu, Ping Zhan, Fangang Meng, Weidong Wang, Hongyun Liu, Ping Zhan, Fangang Meng, Weidong Wang

Abstract

Background: Cervical vagus nerve stimulation (VNS) has been widely accepted as adjunctive therapy for drug-resistant epilepsy and major depression. Its effects on glycemic control in humans were however poorly understood. The aim of our study was to investigate the potential effects of VNS on fasting blood glucose (FBG) in patients with drug-resistant epilepsy.

Methods: Patients with drug-resistant epilepsy who had received VNS implants at the same hospital were retrospectively studied. Effects on FBG, weight, body mass index and blood pressure were evaluated at 4, 8 and 12 months of follow-up.

Results: 32 subjects (11 females/21 males, 19 ± 9 years, body mass index 22.2 ± 4.0 kg/m2) completed 12-month follow-up. At the 4 months, there were no significant changes in FBG concentrations from baseline to follow-up in both Sham-VNS (4.89 ± 0.54 vs. 4.56 ± 0.54 mmol/L, N = 13, p = 0.101) and VNS (4.80 ± 0.54 vs. 4.50 ± 0.56 mmol/L, N = 19, p = 0.117) groups. However, after 8 (4.90 ± 0.42 mmol/L, N = 32, p = 0.001) and 12 (4.86 ± 0.40 mmol/L, N = 32, p = 0.002) months of VNS, FBG levels significantly increased compared to baseline values (4.52 ± 0.54 mmol/L, N = 32). Changes in FBG concentrations at both 8 (R2 = 0.502, N = 32, p < 0.001) and 12 (R2 = 0.572, N = 32, p < 0.001) months were negatively correlated with baseline FBG levels.

Conclusions: Our study suggests that chronic cervical VNS elevates FBG levels with commonly used stimulation parameters in patients with epilepsy. Trial registration VNSRE, NCT02378792. Registered 4 March 2015-Retrospectively registered, https://ichgcp.net/clinical-trials-registry/NCT02378792.

Keywords: Autonomic nervous system; Blood glucose; Glucose homeostasis; Glycemic control; Vagus nerve stimulation.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
FBG concentration and its changes in sham-VNS and VNS groups. a FBG levels at baseline and at 4-month follow-up in the two groups. b Changes in FBG levels at 4-month follow-up in Sham-VNS and VNS groups. There were no significant differences in FBG levels between Sham-VNS and VNS groups. The FBG levels at 4-month follow-up were not significantly different from baseline values in both groups
Fig. 2
Fig. 2
FBG concentration and its changes for the 32 patients receiving VNS treatment. a FBG levels at baseline, 8, and 12 months of long-term follow-up. b Changes in FBG levels at 8- and 12-month follow-up in the study subjects (N = 32). Significant differences were noted in FBG concentrations for patients receiving VNS treatment at both 8 months’ (p = 0.001) and 12 months’ (p = 0.002) follow-up compared to baseline values
Fig. 3
Fig. 3
Correlations between FBG levels at follow-up and BMI at follow-up, age, and FBG levels at baseline. The straight lines and the statistics (R2, N, p) are for the linear correlations and regressions between the two parameters with the study subjects according to the multiple linear regression analysis
Fig. 4
Fig. 4
Effects of age and FBG levels at baseline, BMI, and stimulation amplitude at corresponding follow-up period on changes in FBG levels from baseline to different follow-up periods. The straight lines and the statistics (R2, N, p) are for the linear correlations between the two parameters with the study subjects according to the multiple linear regression analysis

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