The Immediate Effects of Vagus Nerve Stimulation in Intractable Epilepsy: An Intra-operative Electrocorticographic Analysis
The Immediate Effects of Vagus Nerve Stimulation in Intractable Epilepsy: An Intra-operative Electrocorticographic Analysis
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DOI：
10.2176/nmc.oa.2019-0221
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发表时间：
2020-05-01
影响因子：
1.9
通讯作者：
Mikuni, Nobuhiro
中科院分区：
文献类型：
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作者：
Yokoyama, Rintaro;Akiyama, Yukinori;Mikuni, Nobuhiro
本研究旨在探讨迷走神经刺激（VNS）是否以及如何减少难治性癫痫患者双侧大脑皮层的致痫活动。我们分析了5例因顽固性癫痫而接受胼胝体切开术的患者的皮层脑电图（ECoGs），即使在VNS植入后。记录VNS关闭和开启时的ECoGs并分析其功率谱。我们计算了癫痫棘波的棘波和电极的数量，区分单侧和双侧半球传播的棘波作为VNS OFF和ON阶段的癫痫棘波的同步性。在VNS关闭和开启阶段分别有24.80 +/- 35.55和7.20 +/- 9.93个单侧扩散尖峰（P = 0.157），在VNS关闭和开启阶段分别有35.8 +/- 29.21和10.6 +/- 13.50个双侧扩散尖峰（P = 0.027）。在VNS关闭和开启阶段，单侧和双侧扩散尖峰的电极数量分别为3.84 +/- 2.13和3.59 +/- 1.82（P = 0.415），8.20 +/- 3.56和6.89 +/- 2.89（P = 0.026）。分析了VNS OFF和ON时的ECoG背景功率谱记录。VNS ON相的频谱功率在高频带比OFF相的频谱功率更大。这项研究表明，减少癫痫棘波和蔓延面积的棘波VNS作为即时效应，电生理。
The purpose of this study was to investigate whether and how vagus nerve stimulation (VNS) reduces the epileptogenic activity in the bilateral cerebral cortex in patients with intractable epilepsy. We analyzed the electrocorticograms (ECoGs) of five patients who underwent callosotomy due to intractable epilepsy even after VNS implantation. We recorded ECoGs and analyzed power spectrum in both VNS OFF and ON phases. We counted the number of spikes and electrodes with epileptic spikes, distinguishing unilaterally and bilaterally hemispherically spread spikes as synchronousness of the epileptic spikes in both VNS OFF and ON phases. There were 24.80 +/- 35.55 and 7.20 +/- 9.93 unilaterally spread spikes in the VNS OFF and ON phases, respectively (P = 0.157), and 35.8 +/- 29.21 and 10.6 +/- 13.50 bilaterally spread spikes in the VNS OFF and ON phases, respectively (P = 0.027). The number of electrodes with unilaterally and bilaterally spread spikes in the VNS OFF and ON phases was 3.84 +/- 2.13 and 3.59 +/- 1.82 (P = 0.415), and 8.20 +/- 3.56 and 6.89 +/- 2.89 (P = 0.026), respectively. The ECoG background power spectra recordings in the VNS OFF and ON phases were also analyzed. The spectral power tended to be greater in the high-frequency band at VNS ON phase than OFF phase. This study showed the reduction of epileptogenic spikes and spread areas of the spikes by VNS as immediate effects, electrophysiologically.