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经皮耳迷走神经刺激对不同癫痫类型患者的功能性脑网络有不同的影响。

Transcutaneous Auricular Vagus Nerve Stimulation Differently Modifies Functional Brain Networks of Subjects With Different Epilepsy Types.

作者信息

von Wrede Randi, Rings Thorsten, Bröhl Timo, Pukropski Jan, Schach Sophia, Helmstaedter Christoph, Lehnertz Klaus

机构信息

Department of Epileptology, University Hospital Bonn, Bonn, Germany.

Helmholtz-Institute for Radiation and Nuclear Physics, University of Bonn, Bonn, Germany.

出版信息

Front Hum Neurosci. 2022 Jun 23;16:867563. doi: 10.3389/fnhum.2022.867563. eCollection 2022.


DOI:10.3389/fnhum.2022.867563
PMID:35814953
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9260140/
Abstract

Epilepsy types differ by pathophysiology and prognosis. Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive treatment option in epilepsy. Nevertheless, its mode of action and impact on different types of epilepsy are still unknown. We investigated whether short-term taVNS differently affects local and global characteristics of EEG-derived functional brain networks in different types of epilepsy. Thirty subjects (nine with focal epilepsy, 11 with generalized epilepsy, and 10 without epilepsy or seizures) underwent a 3-h continuous EEG-recording (1 h pre-stimulation, 1 h taVNS stimulation, 1 h post-stimulation) from which we derived evolving functional brain networks. We assessed-in a time-resolved manner-important global (topological, robustness, and stability properties) and local (centralities of vertices and edges) network characteristics. Compared to the subjects with focal epilepsies and without epilepsy, those with generalized epilepsies clearly presented with different topological properties of their functional brain network already at rest. Furthermore, subjects with focal and generalized epilepsies reacted differently to the stimulation, expressed as different taVNS-induced immediate and enduring reorganization of global network characteristics. On the local network scale, no discernible spatial pattern could be detected, which points to a rather unspecific and generalized modification of brain activity. Assessing functional brain network characteristics can provide additional information for differentiating between focal and generalized epilepsy. TaVNS-related modifications of global network characteristics clearly differ between epilepsy types. Impact of such a non-pharmaceutical intervention on clinical decision-making in the treatment of different epilepsy types needs to be assessed in future studies.

摘要

癫痫类型因病理生理学和预后而异。经皮耳迷走神经刺激(taVNS)是癫痫的一种非侵入性治疗选择。然而,其作用方式以及对不同类型癫痫的影响仍不清楚。我们研究了短期taVNS是否会对不同类型癫痫中脑电图衍生的功能性脑网络的局部和全局特征产生不同影响。30名受试者(9名局灶性癫痫患者、11名全身性癫痫患者以及10名无癫痫或发作的个体)接受了3小时的连续脑电图记录(刺激前1小时、taVNS刺激1小时、刺激后1小时),我们从中得出不断演变的功能性脑网络。我们以时间分辨的方式评估了重要的全局(拓扑、鲁棒性和稳定性属性)和局部(顶点和边的中心性)网络特征。与局灶性癫痫患者和无癫痫患者相比,全身性癫痫患者在静息状态下其功能性脑网络的拓扑属性就明显不同。此外,局灶性和全身性癫痫患者对刺激的反应不同,表现为taVNS诱导的全局网络特征的即时和持久重组不同。在局部网络层面,未检测到明显的空间模式,这表明大脑活动的改变相当非特异性且具有普遍性。评估功能性脑网络特征可为区分局灶性和全身性癫痫提供额外信息。taVNS相关的全局网络特征改变在癫痫类型之间明显不同。这种非药物干预对不同癫痫类型治疗中临床决策的影响需要在未来研究中进行评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8050/9260140/a9cf64a284aa/fnhum-16-867563-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8050/9260140/2109e2518bc7/fnhum-16-867563-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8050/9260140/cb9ae9de9ba0/fnhum-16-867563-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8050/9260140/aeb2bc17ebe9/fnhum-16-867563-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8050/9260140/a9cf64a284aa/fnhum-16-867563-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8050/9260140/2109e2518bc7/fnhum-16-867563-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8050/9260140/cb9ae9de9ba0/fnhum-16-867563-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8050/9260140/aeb2bc17ebe9/fnhum-16-867563-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8050/9260140/a9cf64a284aa/fnhum-16-867563-g004.jpg

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本文引用的文献

[1]
Impact of Transcutaneous Auricular Vagus Nerve Stimulation on Large-Scale Functional Brain Networks: From Local to Global.

Front Physiol. 2021-8-20

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Seizure. 2021-10

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International Consensus Based Review and Recommendations for Minimum Reporting Standards in Research on Transcutaneous Vagus Nerve Stimulation (Version 2020).

Front Hum Neurosci. 2021-3-23

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Transcutaneous auricular vagus nerve stimulation induces stabilizing modifications in large-scale functional brain networks: towards understanding the effects of taVNS in subjects with epilepsy.

Sci Rep. 2021-4-12

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Lancet. 2021-4-10

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Responsive Vagus Nerve Stimulation for Drug Resistant Epilepsy: A Review of New Features and Practical Guidance for Advanced Practice Providers.

Front Neurol. 2021-1-15

[7]
Biomarkers of seizure response to vagus nerve stimulation: A scoping review.

Epilepsia. 2020-10

[8]
Functional brain network characteristics are associated with epilepsy severity in childhood absence epilepsy.

Neuroimage Clin. 2020

[9]
Sustained seizure freedom with transcutaneous vagal nerve stimulation in drug-resistant epilepsy caused by subcortical band heterotopias.

Seizure. 2019-8

[10]
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Lancet Neurol. 2019-2-14

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