Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.
BEAMS Department, Université libre de Bruxelles, Brussels, Belgium.
Int J Neural Syst. 2021 Jul;31(7):2150024. doi: 10.1142/S0129065721500246. Epub 2021 May 24.
On-demand stimulation improves the efficacy of vagus nerve stimulation (VNS) in refractory epilepsy. The vagus nerve is the main peripheral parasympathetic connection and seizures are known to exhibit autonomic symptoms. Therefore, we hypothesized that seizure detection is possible through vagus nerve electroneurogram (VENG) recording. We developed a metric able to measure abrupt changes in amplitude and frequency of spontaneous vagus nerve action potentials. A classifier was trained using a "leave-one-out" method on a set of 6 seizures and 3 control recordings to utilize the VENG spike feature-based metric for seizure detection. We were able to detect pentylenetetrazol (PTZ) induced acute seizures in 6/6 animals during different stages of the seizure with no false detection. The classifier detected the seizure during an early stage in 3/6 animals and at the onset of tonic clonic stage of the seizure in 3/6 animals. EMG and motion artefacts often accompany epileptic activity. We showed the "epileptic" neural signal to be independent from EMG and motion artefacts. We confirmed the existence of seizure related signals in the VENG recording and proved their applicability for seizure detection. This detection might be a promising tool to improve efficacy of VNS treatment by developing new responsive stimulation systems.
按需刺激可提高迷走神经刺激（VNS）治疗难治性癫痫的疗效。迷走神经是主要的外周副交感神经连接，已知癫痫发作会出现自主症状。因此，我们假设通过迷走神经电神经图（VENG）记录可以检测到癫痫发作。我们开发了一种能够测量自发性迷走神经动作电位幅度和频率突然变化的指标。使用“留一法”在 6 次癫痫发作和 3 次对照记录的集合上训练分类器，以利用 VENG 尖峰特征为基础的指标进行癫痫发作检测。我们能够在 6/6 只动物的不同发作阶段检测到戊四氮（PTZ）诱导的急性发作，且没有假阳性检测。在 3/6 只动物中，分类器在癫痫发作的早期阶段检测到癫痫发作，在 3/6 只动物中检测到强直阵挛性癫痫发作的起始阶段。肌电图和运动伪影通常伴随着癫痫活动。我们表明“癫痫”神经信号与肌电图和运动伪影无关。我们证实了 VENG 记录中存在与癫痫发作相关的信号，并证明了它们在癫痫发作检测中的适用性。这种检测可能是通过开发新的响应式刺激系统来提高 VNS 治疗效果的有前途的工具。
