Leon-Ariza Juan S, Mosquera Mario A, Siomin Vitaly, Fonseca Angelo, Leon-Ariza Daniel S, Gualdron Mayra A, Leon-Sarmiento Fidias E
Mediciencias Research Group, Miami, FL, USA.
Miami Neuroscience Institute, Baptist Hospital South Florida, Miami, FL, USA.
Clin EEG Neurosci. 2022 May;53(3):256-263. doi: 10.1177/15500594211001221. Epub 2021 Mar 12.
To review the scientific publications reporting vagal nerve somatosensory-evoked potential (VSEP) findings from individuals with brain disorders, and present novel physiological explanations on the VSEP origin. We did a systematic review on the papers reporting VSEP findings from individuals with brain disorders and their controls. We evaluated papers published from 2003 to date indexed in PubMed, Web of Science, and Scielo databases. We extracted the following information: number of patients and controls, type of neural disorder, age, gender, stimulating/recording and grounding electrodes as well as stimulus side, intensity, duration, frequency, and polarity. Information about physiological parameters, neurobiological variables, and correlation studies was also reviewed. Representative vignettes were included to add support to our conclusions. The VSEP was studied in 297 patients with neural disorders such as Parkinson's disease (PD), Alzheimer's disease, vascular dementia, mild cognitive impairment, subjective memory impairment, major depression, and multiple sclerosis. Scalp responses marked as the VSEP showed high variability, low validity, and poor reproducibility. VSEP latencies and amplitudes did not correlate with disease duration, unified PD rating scale score, or heart function in PD patients nor with cerebrospinal fluid β amyloid, phosphor-τ, and cognitive tests from patients with mental disorders. Vignettes demonstrated that the VSEP was volume conduction propagating from muscles surrounding the scalp recording electrodes. The VSEP is not a brain-evoked potential of neural origin but muscle activity induced by electrical stimulation of the tragus region of the ear. This review and illustrative vignettes argue against assessing the parasympathetic system using the so-called VSEP.
回顾报告脑疾病患者迷走神经体感诱发电位（VSEP）结果的科学出版物，并对VSEP的起源提出新的生理学解释。我们对报告脑疾病患者及其对照的VSEP结果的论文进行了系统综述。我们评估了2003年至今在PubMed、科学网和SciELO数据库中索引的论文。我们提取了以下信息：患者和对照的数量、神经疾病类型、年龄、性别、刺激/记录和接地电极以及刺激侧、强度、持续时间、频率和极性。还综述了有关生理参数、神经生物学变量和相关性研究的信息。纳入了代表性病例以支持我们的结论。对297例患有帕金森病（PD）、阿尔茨海默病、血管性痴呆、轻度认知障碍、主观记忆障碍、重度抑郁症和多发性硬化症等神经疾病的患者进行了VSEP研究。标记为VSEP的头皮反应显示出高度变异性、低有效性和差的可重复性。VSEP潜伏期和波幅与PD患者的病程、统一PD评定量表评分或心脏功能均无相关性，也与精神障碍患者的脑脊液β淀粉样蛋白、磷酸化τ蛋白和认知测试无关。病例表明，VSEP是从头皮记录电极周围肌肉传播的容积传导。VSEP不是神经源性的脑诱发电位，而是耳屏区域电刺激诱发的肌肉活动。这篇综述和说明性病例反对使用所谓的VSEP评估副交感神经系统。
