Narayanan Jaishree T, Watts Richard, Haddad Naim, Labar Douglas R, Li P Mark, Filippi Christopher G
Department of Neurology, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York 10021, USA.
Epilepsia. 2002 Dec;43(12):1509-14. doi: 10.1046/j.1528-1157.2002.16102.x.
To study the short-term effects of vagus nerve stimulation (VNS) on brain activation and cerebral blood flow by using functional magnetic resonance imaging (fMRI).
Five patients (three women, two men; mean age, 35.4 years) who were treated for medically refractory epilepsy with VNS, underwent fMRI. All patients had a nonfocal brain MRI. The VNS was set at 30 Hz, 0.5-2.0 mA for intervals of activation of 30 s on and 30 s off, during which the fMRI was performed. Statistical parametric mapping (SPM) was used to determine significant areas of activation or inhibition during vagal nerve stimulation (p < 0.05).
VNS-induced activation was detected in the thalami bilaterally (left more than right), insular cortices bilaterally, ipsilateral basal ganglia and postcentral gyri, right posterior superior temporal gyrus, and inferomedial occipital gyri (left more than right). The most robust activation was seen in the thalami (left more than right) and insular cortices.
VNS-induced thalamic and insular cortical activation during fMRI suggests that these areas may play a role in modulating cerebral cortical activity, and the observed decrease in seizure frequency in patients who are given VNS may be a consequence of this increased activation.
运用功能磁共振成像（fMRI）研究迷走神经刺激（VNS）对脑激活和脑血流的短期影响。
5例（3名女性，2名男性；平均年龄35.4岁）因药物难治性癫痫接受VNS治疗的患者接受了fMRI检查。所有患者均有非局灶性脑MRI检查结果。VNS设置为30Hz，0.5 - 2.0mA，激活间隔为开启30秒、关闭30秒，在此期间进行fMRI检查。采用统计参数映射（SPM）来确定迷走神经刺激期间激活或抑制的显著区域（p < 0.05）。
在双侧丘脑（左侧多于右侧）、双侧岛叶皮质、同侧基底神经节和中央后回、右侧颞上回后部以及枕叶内侧回（左侧多于右侧）检测到VNS诱导的激活。最显著的激活出现在丘脑（左侧多于右侧）和岛叶皮质。
fMRI期间VNS诱导的丘脑和岛叶皮质激活表明，这些区域可能在调节大脑皮质活动中发挥作用，并且在接受VNS治疗的患者中观察到的癫痫发作频率降低可能是这种激活增加的结果。
