Department of Neurosurgery, Sapporo Medical University.
Neurol Med Chir (Tokyo). 2020 May 15;60(5):244-251. doi: 10.2176/nmc.oa.2019-0221. Epub 2020 Apr 15.
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.
这项研究的目的是探讨迷走神经刺激（VNS）是否以及如何降低耐药性癫痫患者双侧大脑皮层的致痫活性。我们分析了 5 名因耐药性癫痫行胼胝体切开术患者的皮质脑电图（ECoG），这些患者在 VNS 植入后仍未缓解。我们记录了 ECoG 并在 VNS 关闭和开启两个阶段分析了功率谱。我们计算了棘波的数量和出现棘波的电极，并区分了单侧和双侧半球传播的棘波，以评估 VNS 关闭和开启两个阶段棘波的同步性。VNS 关闭和开启两个阶段的单侧传播棘波数分别为 24.80 ± 35.55 和 7.20 ± 9.93（P = 0.157），双侧传播棘波数分别为 35.8 ± 29.21 和 10.6 ± 13.50（P = 0.027）。VNS 关闭和开启两个阶段出现单侧和双侧传播棘波的电极数分别为 3.84 ± 2.13 和 3.59 ± 1.82（P = 0.415），8.20 ± 3.56 和 6.89 ± 2.89（P = 0.026）。我们还分析了 VNS 关闭和开启两个阶段的 ECoG 背景功率谱记录。与 VNS 关闭阶段相比，VNS 开启阶段高频带的频谱功率更大。本研究从电生理角度显示了 VNS 对致痫棘波数量和传播范围的即刻抑制作用。
