Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Frederik Bajers Vej 7D2, 9220 Aalborg, Denmark.
Med Biol Eng Comput. 2011 Feb;49(2):143-51. doi: 10.1007/s11517-010-0683-1. Epub 2010 Oct 2.
Continuous, scheduled vagus nerve stimulation (VNS) is used for the treatment of refractory epilepsy. On-demand VNS, started prior to or at the onset of a seizure may improve the effect of the treatment, however, this requires seizures to be predicted or detected early. This study investigates the possibility of early seizure detection based on the cervical vagus electroneurogram (VENG). Fourteen anesthetized rats received an intravenous infusion (IV) of either saline (control, n = 6) or pentylenetetrazol (PTZ) diluted in saline (PTZ-treated, n = 8). A cardiac-related VENG profile (CrVENG) was derived by using R-peak triggered averaging of the VENG energy. Following, changes in this profile were evaluated as a seizure predictor. Using left nerve VENG, seizures were detected in all PTZ-treated rats 103 ± 51 s (mean ± SD) before they developed tonic seizures. Control rats did not develop seizures and our method did also not detected seizures in these rats. Seizures can be early detecting based on left nerve VENG in anesthetized rats. Preictal CrVENG changes may reflect central-mediated changes and/or changes in the relation between the respiration and the cardiac cycle. Further research is needed to evaluate the method in awake and freely moving animals and eventually in humans.
持续、有规律的迷走神经刺激(VNS)用于治疗难治性癫痫。按需 VNS,在癫痫发作之前或发作时开始,可能会提高治疗效果,但这需要早期预测或检测到癫痫发作。本研究基于颈迷走神经电图(VENG)探讨了早期癫痫发作检测的可能性。14 只麻醉大鼠接受静脉内输注生理盐水(对照,n = 6)或戊四氮(PTZ)稀释生理盐水(PTZ 处理,n = 8)。通过使用 R 波触发的 VENG 能量平均,得出与心脏相关的 VENG 图谱(CrVENG)。随后,评估该图谱的变化作为癫痫预测指标。使用左神经 VENG,在所有 PTZ 处理的大鼠出现强直发作前 103 ± 51 秒(平均值 ± 标准差)即可检测到癫痫发作。对照大鼠未发生癫痫发作,我们的方法也未在这些大鼠中检测到癫痫发作。在麻醉大鼠中,可以根据左神经 VENG 进行早期癫痫检测。发作前 CrVENG 的变化可能反映了中枢介导的变化和/或呼吸与心脏周期之间关系的变化。需要进一步的研究来评估该方法在清醒和自由活动的动物中,最终在人类中的应用。