Vagus Nerve Stimulation Elicits Sleep EEG Desynchronization and Network Changes in Responder Patients in Epilepsy

Vespa, Simone; Heyse, Jolan; Stumpp, Lars; Liberati, Giulia; Santos, Susana Ferrão; Rooijakkers, Herbert; Nonclercq, Antoine; Mouraux, André; Mierlo, Pieter van; Tahry, Riëm El

doi:10.1007/s13311-021-01124-4

Cited by 16 publications

(39 citation statements)

References 80 publications

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“…However, no consistent changes in connectivity were detected in the stimulation-on state vs. the stimulation-off state. This result differed from that of the previous literature, which reported global desynchronization with PLI values when the stimulation was on in the responder group compared with those when the stimulation was off [16,23,24]. This finding may be attributed to a different time interval between surgery and the EEG study, or a different methodology of EEG analysis employed in the previous studies compared with ours.…”

Section: Discussioncontrasting

confidence: 99%

“…Moreover, DTF has been mainly used to demonstrate the propagation of seizures or the seizure onset zone [17,26,27]. One study that performed a network analysis using a directed connectivity measure, i.e., partial directed coherence, showed decreased network efficiency during sleep after acute VNS in responders, but not in nonresponders [16]. Enhanced synchronization in epileptic networks has been studied well in previous reports using EEG and MEG [28][29][30][31].…”

Section: Discussionmentioning

confidence: 97%

“…Functional connectivity is defined as the statistical dependencies among remote neurophysiological events, whereas effective connectivity refers explicitly to the effect that one neural system exerts over another, either at a synaptic or population level [15]. Biomarkers using functional connectivity analysis with electrophysiological activity have been applied to determine responsiveness to VNS treatment [10], and effective connectivity analysis was introduced on scalp EEG in a previous study using partial directed coherence [16]. Directed transfer function (DTF), as a type of function for effective connectivity analysis, is a multichannel parametric method based on an autoregressive model that is used to determine the patterns of neural information flow in PWEs [17].…”

Section: Introductionmentioning

confidence: 99%

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Prediction of the Responsiveness to Vagus-Nerve Stimulation in Patients with Drug-Resistant Epilepsy via Directed-Transfer-Function Analysis of Their Perioperative Scalp EEGs

Kim

Hwang

et al. 2022

JCM

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This study aims to compare directed transfer function (DTF), which is an effective connectivity analysis, derived from scalp EEGs between responder and nonresponder groups implanted with vagus-nerve stimulation (VNS). Twelve patients with drug-resistant epilepsy (six responders and six nonresponders) and ten controls were recruited. A good response to VNS was defined as a reduction of ≥50% in seizure frequency compared with the presurgical baseline. DTF was calculated in five frequency bands (delta, theta, alpha, beta, and broadband) and seven grouped electrode regions (left and right frontal, temporal, parieto-occipital, and midline) in three different states (presurgical, stimulation-on, and stimulation-off states). Responders showed presurgical nodal strength close to the control group in both inflow and outflow, whereas nonresponders exhibited increased inward and outward connectivity measures. Nonresponders also had increased inward and outward connectivity measures in the various brain regions and various frequency bands assessed compared with the control group when the stimulation was on or off. Our study demonstrated that the presurgical DTF profiles of responders were different from those of nonresponders. Moreover, a presurgical normal DTF profile may predict good responsiveness to VNS.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Prediction of the Responsiveness to Vagus-Nerve Stimulation in Patients with Drug-Resistant Epilepsy via Directed-Transfer-Function Analysis of Their Perioperative Scalp EEGs

Kim

Hwang

et al. 2022

JCM

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“…The correlation between VNS-induced interictal EEG time-series decrease in functional connectivity and decrease in seizure frequency suggested that the therapeutic effect of VNS may be related to changes in interictal functional connectivity. A recent study 87 investigated the effect of VNS on Fc during two states of vigilance (wakefulness vs stage-N2 sleep). Weighted PLI was computed as a connectivity measure of synchronization for VNS OFF and ON conditions in 24 patients.…”

Section: Brain Functional Connectivity Studiesmentioning

confidence: 99%

Latest Views on the Mechanisms of Action of Surgically Implanted Cervical Vagal Nerve Stimulation in Epilepsy

Carron¹,

Roncon²,

Lagarde³

et al. 2023

Neuromodulation: Technology at the Neural Interface

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“…Vagus nerve stimulation is also known to trigger sleep disordered breathing, dependent on stimulation settings ( Romero-Osorio et al, 2018 ; Salvadé et al, 2018 ; Vespa et al, 2021 ).…”

Section: Resultsmentioning

confidence: 99%

Sleep and Temporal Lobe Epilepsy – Associations, Mechanisms and Treatment Implications

Garg

Charlesworth

Shukla

2022

Front. Hum. Neurosci.

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In this systematic review, we aim to describe the association between temporal lobe epilepsy (TLE) and sleep, with bidirectional links in mechanisms and therapeutic aspects. Sleep stages may variably impact seizure occurrence, secondary generalization and the development, frequency and distribution of interictal epileptiform discharges. Conversely, epilepsy affects sleep micro- and macroarchitecture. TLE, the most frequent form of drug resistant epilepsy (DRE), shares an enduring relationship with sleep, with some intriguing potential mechanisms specific to anatomic localization, linking the two. Sleep characteristics of TLE may also inform localizing properties in persons with DRE, since seizures arising from the temporal lobe seem to be more common during wakefulness, compared to seizures of extratemporal origin. Polysomnographic studies indicate that persons with TLE may experience excessive daytime somnolence, disrupted sleep architecture, increased wake after sleep onset, frequent shifts in sleep stages, lower sleep efficiency, decreased rapid eye movement (REM) sleep, and possibly, increased incidence of sleep apnea. Limited literature suggests that effective epilepsy surgery may remedy many of these objective and subjective sleep-related concerns, via multipronged effects, apart from reduced seizure frequency. Additionally, sleep abnormalities also seem to influence memory, language and cognitive-executive function in both medically controlled and refractory TLE. Another aspect of the relationship pertains to anti-seizure medications (ASMs), which may contribute significantly to sleep characteristics and abnormalities in persons with TLE. Literature focused on specific aspects of TLE and sleep is limited, and heterogeneous. Future investigations are essential to understand the pathogenetic mechanisms linking sleep abnormalities on epilepsy outcomes in the important sub-population of TLE.

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Vagus Nerve Stimulation Elicits Sleep EEG Desynchronization and Network Changes in Responder Patients in Epilepsy

Cited by 16 publications

References 80 publications

Prediction of the Responsiveness to Vagus-Nerve Stimulation in Patients with Drug-Resistant Epilepsy via Directed-Transfer-Function Analysis of Their Perioperative Scalp EEGs

Prediction of the Responsiveness to Vagus-Nerve Stimulation in Patients with Drug-Resistant Epilepsy via Directed-Transfer-Function Analysis of Their Perioperative Scalp EEGs

Latest Views on the Mechanisms of Action of Surgically Implanted Cervical Vagal Nerve Stimulation in Epilepsy

Sleep and Temporal Lobe Epilepsy – Associations, Mechanisms and Treatment Implications

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