Department of Epileptology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
Helmholtz-Institute for Radiation and Nuclear Physics, University of Bonn, Nussallee 14-16, 53115, Bonn, Germany.
Sci Rep. 2021 Apr 12;11(1):7906. doi: 10.1038/s41598-021-87032-1.
Transcutaneous auricular vagus nerve stimulation (taVNS) is a novel non-invasive brain stimulation technique considered as a potential supplementary treatment option for subjects with refractory epilepsy. Its exact mechanism of action is not yet fully understood. We developed an examination schedule to probe for immediate taVNS-induced modifications of large-scale epileptic brain networks and accompanying changes of cognition and behaviour. In this prospective trial, we applied short-term (1 h) taVNS to 14 subjects with epilepsy during a continuous 3-h EEG recording which was embedded in two standardized neuropsychological assessments. From these EEG, we derived evolving epileptic brain networks and tracked important topological, robustness, and stability properties of networks over time. In the majority of investigated subjects, taVNS induced measurable and persisting modifications in network properties that point to a more resilient epileptic brain network without negatively impacting cognition, behaviour, or mood. The stimulation was well tolerated and the usability of the device was rated good. Short-term taVNS has a topology-modifying, robustness- and stability-enhancing immediate effect on large-scale epileptic brain networks. It has no detrimental effects on cognition and behaviour. Translation into clinical practice requires further studies to detail knowledge about the exact mechanisms by which taVNS prevents or inhibits seizures.
经皮耳迷走神经刺激(taVNS)是一种新颖的非侵入性脑刺激技术,被认为是难治性癫痫患者的一种潜在辅助治疗选择。其确切的作用机制尚不完全清楚。我们制定了一个检查方案,以探究 taVNS 即刻诱导的大型癫痫大脑网络的改变,以及伴随的认知和行为改变。在这项前瞻性试验中,我们在连续 3 小时的 EEG 记录中,对 14 例癫痫患者进行了短期(1 小时) taVNS,该记录嵌入在两个标准化神经心理学评估中。从这些 EEG 中,我们得出了不断发展的癫痫大脑网络,并跟踪了网络随时间的重要拓扑、鲁棒性和稳定性特征。在大多数研究对象中,taVNS 诱导了网络特性的可测量和持续的改变,这表明癫痫大脑网络更具弹性,而不会对认知、行为或情绪产生负面影响。刺激耐受性良好,设备的可用性评分良好。短期 taVNS 对大型癫痫大脑网络具有拓扑结构修饰、鲁棒性和稳定性增强的即时效应。它对认知和行为没有不利影响。要将其转化为临床实践,需要进一步的研究来详细了解 taVNS 预防或抑制癫痫发作的确切机制。
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