Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Riëm El Tahry, Université Catholique de Louvain, Belgium
- Second opponent: Associate Professor Christian Samsonsen, Norwegian University of Science and Technology, Trondheim
- Third member and chair of the evaluation committee: Professor Bjørnar Hassel, University of Oslo
Chair of the Defence
Professor Emeritus Leif Gjerstad, University of Oslo
Principal Supervisor
Professor II Morten Ingvar Lossius, University of Oslo
Summary
This doctoral thesis investigates the long-term efficacy, tolerability, and optimization of vagus nerve stimulation (VNS) therapy for drug-resistant epilepsy, utilizing data from the Norwegian National Centre for Epilepsy's VNS quality registry. The study encompasses a cohort of 436 patients implanted between 1993 and 2012, with follow-up extending to 2017, and is organized around three pivotal papers.
Paper I evaluates the long-term efficacy of VNS therapy, revealing an increasing therapeutic effect over time, even for patients with unchanged antiseizure medication. Aetiology emerged as a significant predictor of outcome, with post-traumatic and post-stroke epilepsy displaying the highest response rates, while patients with intellectual disabilities were associated with poorer outcomes.
Paper II examines the efficacy of VNS in patients with developmental and epileptic encephalopathies, finding lower seizure reductions compared to patients without intellectual disabilities. Notably, VNS proved highly effective for atonic and tonic seizures within this group, who also exhibited additional positive effects leading to higher retention rates.
Paper III focuses on optimizing VNS settings, identifying output current as the most critical stimulation parameter linked to positive outcomes.
This thesis underscores the necessity of personalized treatment approaches through careful patient selection and parameter optimization, thereby enhancing the overall efficacy of VNS therapy in managing epilepsy.
Additional information
Contact the research support staff.