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Thalamic and limbic involvement in the mechanism of action of vagus nerve stimulation, a SPECT study

Kristl Vonck UGent, Veerle De Herdt UGent, Tommy Bosman, Stefanie Dedeurwaerdere, Koen Van Laere and Paul Boon UGent (2008) Seizure - European Journal of Epilepsy. 17(8). p.699-706
abstract
Purpose: To unravel the mechanism of action of neurostimulation as a treatment for seizures, functional neuroimaging toots allow minimally invasive research in humans. We performed single-photon emission computed tomography (SPECT) in patients with epilepsy, treated with vagus nerve stimulation (VNS). Changes in regional cerebral blood flow (rCBF) at the time of initial stimulation as well as after chronic treatment were correlated with tong-term clinical efficacy. Methods: In this pilot study, 27 patients (14 female and 13 mate) who were treated with VNS at Ghent University Hospital for refractory epilepsy underwent a Tc-99m-ECD (ethyl cystein dimer) SPECT activation study at the time the first stimulation train was administered. 12 patients underwent an additional Tc-99m-ECD SPECT activation study 6 months later. Image acquisition was performed on a high-resolution triple-headed gamma camera. Significant rCBF changes were correlated with prospectively assessed clinical efficacy data. Results: Significant rCBF changes were found in the thalamus, the hippocampus and the parahippocampal gyrus. Acute limbic hyper-perfusion and chronic thalamic hypo-perfusion correlate with positive clinical efficacy. Conclusions: Acute and chronic electrical stimulation of the vagus nerve induces rCBF changes that can be measured by SPECT on a group-basis. The thalamus and the limbic system are thought to play a key role in the mechanism of action of VNS.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Vagus nerve stimulation, Thalamus, SPECT, Refractory epilepsy, Limbic system
journal title
Seizure - European Journal of Epilepsy
Seizure
volume
17
issue
8
pages
699 - 706
publisher
W B SAUNDERS CO LTD
place of publication
London UK
Web of Science type
Article
Web of Science id
000261815700006
JCR category
CLINICAL NEUROLOGY
JCR impact factor
2.179 (2008)
JCR rank
77/156 (2008)
JCR quartile
2 (2008)
ISSN
1059-1311
DOI
10.1016/j.seizure.2008.05.001
language
English
UGent publication?
yes
classification
A1
id
609982
handle
http://hdl.handle.net/1854/LU-609982
date created
2009-05-07 16:04:13
date last changed
2009-06-22 12:24:58
@article{609982,
  abstract     = {Purpose: To unravel the mechanism of action of neurostimulation as a treatment for seizures, functional neuroimaging toots allow minimally invasive research in humans. We performed single-photon emission computed tomography (SPECT) in patients with epilepsy, treated with vagus nerve stimulation (VNS). Changes in regional cerebral blood flow (rCBF) at the time of initial stimulation as well as after chronic treatment were correlated with tong-term clinical efficacy.
Methods: In this pilot study, 27 patients (14 female and 13 mate) who were treated with VNS at Ghent University Hospital for refractory epilepsy underwent a Tc-99m-ECD (ethyl cystein dimer) SPECT activation study at the time the first stimulation train was administered. 12 patients underwent an additional Tc-99m-ECD SPECT activation study 6 months later. Image acquisition was performed on a high-resolution triple-headed gamma camera. Significant rCBF changes were correlated with prospectively assessed clinical efficacy data.

Results: Significant rCBF changes were found in the thalamus, the hippocampus and the parahippocampal gyrus. Acute limbic hyper-perfusion and chronic thalamic hypo-perfusion correlate with positive clinical efficacy.

Conclusions: Acute and chronic electrical stimulation of the vagus nerve induces rCBF changes that can be measured by SPECT on a group-basis. The thalamus and the limbic system are thought to play a key role in the mechanism of action of VNS.},
  author       = {Vonck, Kristl and De Herdt, Veerle and Bosman, Tommy and Dedeurwaerdere, Stefanie and Van Laere, Koen and Boon, Paul},
  issn         = {1059-1311},
  journal      = {Seizure - European Journal of Epilepsy},
  keyword      = {Vagus nerve stimulation,Thalamus,SPECT,Refractory epilepsy,Limbic system},
  language     = {eng},
  number       = {8},
  pages        = {699--706},
  publisher    = {W B SAUNDERS CO LTD},
  title        = {Thalamic and limbic involvement in the mechanism of action of vagus nerve stimulation, a SPECT study},
  url          = {http://dx.doi.org/10.1016/j.seizure.2008.05.001},
  volume       = {17},
  year         = {2008},
}

Chicago
Vonck, Kristl, VEERLE DE HERDT, Tommy Bosman, Stefanie Dedeurwaerdere, Koen Van Laere, and Paul Boon. 2008. “Thalamic and Limbic Involvement in the Mechanism of Action of Vagus Nerve Stimulation, a SPECT Study.” Seizure - European Journal of Epilepsy 17 (8): 699–706.
APA
Vonck, K., DE HERDT, V., Bosman, T., Dedeurwaerdere, S., Van Laere, K., & Boon, P. (2008). Thalamic and limbic involvement in the mechanism of action of vagus nerve stimulation, a SPECT study. Seizure - European Journal of Epilepsy, 17(8), 699–706.
Vancouver
1.
Vonck K, DE HERDT V, Bosman T, Dedeurwaerdere S, Van Laere K, Boon P. Thalamic and limbic involvement in the mechanism of action of vagus nerve stimulation, a SPECT study. Seizure - European Journal of Epilepsy. London UK: W B SAUNDERS CO LTD; 2008;17(8):699–706.
MLA
Vonck, Kristl, VEERLE DE HERDT, Tommy Bosman, et al. “Thalamic and Limbic Involvement in the Mechanism of Action of Vagus Nerve Stimulation, a SPECT Study.” Seizure - European Journal of Epilepsy 17.8 (2008): 699–706. Print.