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The P3 event-related potential is a biomarker for the efficacy of vagus nerve stimulation in patients with epilepsy

Leen De Taeye (UGent) , Kristl Vonck (UGent) , Marlies van Bochove (UGent) , Paul Boon (UGent) , Dirk Van Roost (UGent) , Lies Mollet (UGent) , Alfred Meurs (UGent) , Veerle De Herdt (UGent) , Evelien Carrette (UGent) , Ine Dauwe (UGent) , et al.
(2014) NEUROTHERAPEUTICS. 11(3). p.612-622
Author
Organization
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The integrative neuroscience of behavioral control (Neuroscience)
Abstract
Currently, the mechanism of action of vagus nerve stimulation (VNS) is not fully understood, and it is unclear which factors determine a patient’s response to treatment. Recent preclinical experiments indicate that activation of the locus coeruleus noradrenergic system is critical for the antiepileptic effect of VNS. This study aims to evaluate the effect of VNS on noradrenergic signaling in the human brain through a noninvasive marker of locus coeruleus noradrenergic activity: the P3 component of the event-related potential. We investigated whether VNS differentially modulates the P3 component in VNS responders versus VNS nonresponders. For this purpose, we recruited 20 patients with refractory epilepsy who had been treated with VNS for at least 18 months. Patients were divided into 2 groups with regard to their reduction in mean monthly seizure frequency: 10 responders (>50 %) and 10 nonresponders (≤50 %). Two stimulation conditions were compared: VNS OFF and VNS ON. In each condition, the P3 component was measured during an auditory oddball paradigm. VNS induced a significant increase of the P3 amplitude at the parietal midline electrode, in VNS responders only. In addition, logistic regression analysis showed that the increase of P3 amplitude can be used as a noninvasive indicator for VNS responders. These results support the hypothesis that activation of the locus coeruleus noradrenergic system is associated with the antiepileptic effect of VNS. Modulation of the P3 amplitude should be further investigated as a noninvasive biomarker for the therapeutic efficacy of VNS in patients with refractory epilepsy.
Keywords
epilepsy, event-related potentials, P3, biomarker, CHILDREN, SEIZURES, Vagus nerve stimulation, INTEGRATIVE THEORY, LONG-TERM, LOCUS-COERULEUS LESIONS, REFRACTORY EPILEPSY, TREATMENT-RESISTANT DEPRESSION, RAT-BRAIN, NOREPINEPHRINE, COGNITION, norepinephrine

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Citation

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Chicago
De Taeye, Leen, Kristl Vonck, Marlies van Bochove, Paul Boon, Dirk Van Roost, Lies Mollet, Alfred Meurs, et al. 2014. “The P3 Event-related Potential Is a Biomarker for the Efficacy of Vagus Nerve Stimulation in Patients with Epilepsy.” Neurotherapeutics 11 (3): 612–622.
APA
De Taeye, L., Vonck, K., van Bochove, M., Boon, P., Van Roost, D., Mollet, L., Meurs, A., et al. (2014). The P3 event-related potential is a biomarker for the efficacy of vagus nerve stimulation in patients with epilepsy. NEUROTHERAPEUTICS, 11(3), 612–622.
Vancouver
1.
De Taeye L, Vonck K, van Bochove M, Boon P, Van Roost D, Mollet L, et al. The P3 event-related potential is a biomarker for the efficacy of vagus nerve stimulation in patients with epilepsy. NEUROTHERAPEUTICS. 2014;11(3):612–22.
MLA
De Taeye, Leen, Kristl Vonck, Marlies van Bochove, et al. “The P3 Event-related Potential Is a Biomarker for the Efficacy of Vagus Nerve Stimulation in Patients with Epilepsy.” NEUROTHERAPEUTICS 11.3 (2014): 612–622. Print.
@article{4358315,
  abstract     = {Currently, the mechanism of action of vagus nerve stimulation (VNS) is not fully understood, and it is unclear which factors determine a patient{\textquoteright}s response to treatment. Recent preclinical experiments indicate that activation of the locus coeruleus noradrenergic system is critical for the antiepileptic effect of VNS. This study aims to evaluate the effect of VNS on noradrenergic signaling in the human brain through a noninvasive marker of locus coeruleus noradrenergic activity: the P3 component of the event-related potential. We investigated whether VNS differentially modulates the P3 component in VNS responders versus VNS nonresponders. For this purpose, we recruited 20 patients with refractory epilepsy who had been treated with VNS for at least 18 months. Patients were divided into 2 groups with regard to their reduction in mean monthly seizure frequency: 10 responders ({\textrangle}50 \%) and 10 nonresponders (\ensuremath{\leq}50 \%). Two stimulation conditions were compared: VNS OFF and VNS ON. In each condition, the P3 component was measured during an auditory oddball paradigm. VNS induced a significant increase of the P3 amplitude at the parietal midline electrode, in VNS responders only. In addition, logistic regression analysis showed that the increase of P3 amplitude can be used as a noninvasive indicator for VNS responders. These results support the hypothesis that activation of the locus coeruleus noradrenergic system is associated with the antiepileptic effect of VNS. Modulation of the P3 amplitude should be further investigated as a noninvasive biomarker for the therapeutic efficacy of VNS in patients with refractory epilepsy.},
  author       = {De Taeye, Leen and Vonck, Kristl and van Bochove, Marlies and Boon, Paul and Van Roost, Dirk and Mollet, Lies and Meurs, Alfred and De Herdt, Veerle and Carrette, Evelien and Dauwe, Ine and Gadeyne, Stefanie and van Mierlo, Pieter and Verguts, Tom and Raedt, Robrecht},
  issn         = {1933-7213},
  journal      = {NEUROTHERAPEUTICS},
  language     = {eng},
  number       = {3},
  pages        = {612--622},
  title        = {The P3 event-related potential is a biomarker for the efficacy of vagus nerve stimulation in patients with epilepsy},
  url          = {http://dx.doi.org/10.1007/s13311-014-0272-3},
  volume       = {11},
  year         = {2014},
}

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