Ooi Qian Yi, Qin Xiaoya, Yuan Yuan, Zhang Xiaobin, Yao Yi, Hao Hongwei, Li Luming
National Engineering Research Center of Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing 100084, China.
Precision Medicine and Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen 518071, China.
Brain Sci. 2023 Jun 21;13(7):976. doi: 10.3390/brainsci13070976.
An imbalance between excitation (E) and inhibition (I) in the brain has been identified as a key pathophysiology of epilepsy over the years. The hippocampus and amygdala in the limbic system play a crucial role in the initiation and conduction of epileptic seizures and are often referred to as the transfer station and amplifier of seizure activities. Existing animal and imaging studies reveal that the hippocampus and amygdala, which are significant parts of the vagal afferent network, can be modulated in order to generate an antiepileptic effect. Using stereo-electroencephalography (SEEG) data, we examined the E/I imbalance in the hippocampus and amygdala of ten drug-resistant epilepsy children treated with acute vagus nerve stimulation (VNS) by estimating the 1/f power slope of hippocampal and amygdala signals in the range of 1-80 Hz. While the change in the 1/f power slope from VNS-BASE varied between different stimulation amplitudes and brain regions, it was more prominent in the hippocampal region. In the hippocampal region, we found a flatter 1/f power slope during VNS-ON in patients with good responsiveness to VNS under the optimal stimulation amplitude, indicating that the E/I imbalance in the region was improved. There was no obvious change in 1/f power slope for VNS poor responders. For VNS non-responders, the 1/f power slope slightly increased when the stimulation was applied. Overall, this study implies that the regulation of E/I imbalance in the epileptic brain, especially in the hippocampal region, may be an acute intracranial effect of VNS.
多年来,大脑中兴奋(E)与抑制(I)之间的失衡已被确认为癫痫的关键病理生理学特征。边缘系统中的海马体和杏仁核在癫痫发作的起始和传导中起着至关重要的作用,常被称为癫痫活动的中转站和放大器。现有的动物和影像学研究表明,作为迷走神经传入网络重要组成部分的海马体和杏仁核可通过调节来产生抗癫痫作用。我们利用立体脑电图(SEEG)数据,通过估计1 - 80Hz范围内海马体和杏仁核信号的1/f功率斜率,研究了10例接受急性迷走神经刺激(VNS)治疗的耐药性癫痫儿童海马体和杏仁核中的E/I失衡情况。虽然VNS - BASE的1/f功率斜率变化在不同刺激幅度和脑区之间有所不同,但在海马体区域更为显著。在海马体区域,我们发现,在最佳刺激幅度下对VNS反应良好的患者,VNS开启时1/f功率斜率更平缓,这表明该区域的E/I失衡得到改善。VNS反应较差的患者,其1/f功率斜率没有明显变化。对于VNS无反应者,施加刺激时1/f功率斜率略有增加。总体而言,本研究表明,调节癫痫大脑中的E/I失衡,尤其是海马体区域的失衡,可能是VNS的一种急性颅内效应。
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