Effect of short-term transcutaneous trigeminal nerve stimulation on EEG activity in drug-resistant epilepsy
Effect of short-term transcutaneous trigeminal nerve stimulation on EEG activity in drug-resistant epilepsy
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DOI：
10.1016/j.jns.2019.03.004
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发表时间：
2019-05-15
影响因子：
4.4
通讯作者：
Deriu, Franca
中科院分区：
文献类型：
--
作者：
Ginatempo, Francesca;Fois, Chiara;Deriu, Franca
背景：经皮三叉神经刺激（TNS）对耐药性癫痫（DRE）患者具有抗癫痫作用。然而，TNS是否以及如何调节DRE患者的脑电图（EEG）背景活动仍不清楚。目的：通过定性和定量分析探讨短期TNS对DRE患者脑电图背景活动的影响。方法：29名DRE患者参与了该研究。 22 人被随机分为“假 TNS”组或“真实 TNS”组；七名患者接受了手腕正中神经（MNS）刺激。 Real-TNS 被双侧递送至眶下神经（1-20 mA、120 Hz、循环模式的训练，持续 20 分钟）。假 TNS 协议模仿真实 TNS 协议，但强度为零。对于 MNS，使用与真实 TNS 相同的参数。连续采集 EEG 40 分钟：刺激前 10'、刺激中 20' 和刺激后 10'。目视检查 EEG 的发作间期癫痫样放电 (IED) 变化，并通过频谱分析处理每个频带的平均频率和绝对功率的变化。结果：与假 TNS 相比，在真实 TNS 期间观察到 EEG 绝对 α 功率显着增加（F-34、F-680 = 1.748；p = 0.006）。相反，无论是对于其他频段的定量分析还是对于简易爆炸装置的检测，都没有发现显着的影响。事实证明，MNS 无法调节 EEG 活动。结论：短期 TNS 通过增加绝对 α 波段功率，对 DRE 的背景 EEG 产生急性且特异性的影响。脑电图α节律增强可能会指示皮质功能抑制并充当癫痫预防机制。
Background: Transcutaneous trigeminal nerve stimulation (TNS) has antiepileptic effects in patients with drug-resistant epilepsy (DRE). However, whether and how TNS is able to modulate the electroencephalogram (EEG) background activity in patients with DRE is still unknown.Objectives: To investigate the effect of short-term TNS on EEG background activity in DRE by qualitative and quantitative analyses.Methods: Twenty-nine DRE patients participated in the study. Twenty-two were randomly divided into a "sham-TNS" or "real-TNS" group; seven patients underwent stimulation of the median nerve (MNS) at the wrist. Real-TNS was delivered bilaterally to the infraorbital nerve (trains of 1-20 mA, 120 Hz, cyclic modality for 20 min). The sham-TNS protocol mimicked the real-TNS one but at a zero intensity. For MNS, the same parameters as real-TNS were used. EEG was continuously acquired for 40 min: 10' pre, 20' during and 10' post stimulation. EEG was visually inspected for interictal epileptiform discharge (IEDs) changes and processed by spectral analysis for changes in mean frequency and absolute power of each frequency band.Results: A significant increase of EEG absolute alpha power was observed during real-TNS compared with the sham-TNS (F-34,F-680 = 1.748; p = 0.006). Conversely, no significant effects were noticed either for quantitative analysis of other frequency bands or for IEDs detection. MNS proved unable to modulate EEG activity.Conclusions: Short-term TNS induces an acute and specific effect on background EEG of DRE by increasing the absolute alpha band power. EEG alpha rhythm enhancement may index a cortical functional inhibition and act as a seizure-preventing mechanism.