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Neurophysiological investigations of drug resistant epilepsy patients treated with vagus nerve stimulation to differentiate responders from non-responders

Stephanie Hödl (UGent) , Sofie Carrette (UGent) , Alfred Meurs (UGent) , Evelien Carrette (UGent) , Ann Mertens (UGent) , Stefanie Gadeyne (UGent) , Lutgart Goossens (UGent) , Frank Dewaele (UGent) , Charlotte Bouckaert (UGent) , Ine Dauwe (UGent) , et al.
(2020) EUROPEAN JOURNAL OF NEUROLOGY. 27(7). p.1178-1189
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Abstract
Background and purpose In patients treated with vagus nerve stimulation (VNS) for drug resistant epilepsy (DRE), up to a third of patients will eventually not respond to the therapy. As VNS therapy requires surgery for device implantation, prediction of response prior to surgery is desirable. It is hypothesized that neurophysiological investigations related to the mechanisms of action of VNS may help to differentiate VNS responders from non-responders prior to the initiation of therapy. Methods In a prospective series of DRE patients, polysomnography, heart rate variability (HRV) and cognitive event related potentials were recorded. Polysomnography and HRV were repeated after 1 year of treatment with VNS. Polysomnography, HRV and cognitive event related potentials were compared between VNS responders (>= 50% reduction in seizure frequency) and non-responders. Results Fifteen out of 30 patients became VNS responders after 1 year of VNS treatment. Prior to treatment with VNS, the amount of deep sleep (NREM 3), the HRV high frequency (HF) power and the P3b amplitude were significantly different in responders compared to non-responders (P = 0.007; P = 0.001; P = 0.03). Conclusion Three neurophysiological parameters, NREM 3, HRV HF and P3b amplitude, were found to be significantly different in DRE patients who became responders to VNS treatment prior to initiation of their treatment with VNS. These non-invasive recordings may be used as characteristics for response in future studies and help avoid unsuccessful implantations. Mechanistically these findings may be related to changes in brain regions involved in the so-called vagal afferent network.
Keywords
heart rate variability, neurostimulation, P3 evoked potential, polysomnography, HEART-RATE-VARIABILITY, FUNCTIONAL CONNECTIVITY, SLEEP, EFFICACY, PREDICTORS, METAANALYSIS, BIOMARKER, LESIONS, VNS, P3

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MLA
Hödl, Stephanie, et al. “Neurophysiological Investigations of Drug Resistant Epilepsy Patients Treated with Vagus Nerve Stimulation to Differentiate Responders from Non-Responders.” EUROPEAN JOURNAL OF NEUROLOGY, vol. 27, no. 7, 2020, pp. 1178–89, doi:10.1111/ene.14270.
APA
Hödl, S., Carrette, S., Meurs, A., Carrette, E., Mertens, A., Gadeyne, S., … Vonck, K. (2020). Neurophysiological investigations of drug resistant epilepsy patients treated with vagus nerve stimulation to differentiate responders from non-responders. EUROPEAN JOURNAL OF NEUROLOGY, 27(7), 1178–1189. https://doi.org/10.1111/ene.14270
Chicago author-date
Hödl, Stephanie, Sofie Carrette, Alfred Meurs, Evelien Carrette, Ann Mertens, Stefanie Gadeyne, Lutgart Goossens, et al. 2020. “Neurophysiological Investigations of Drug Resistant Epilepsy Patients Treated with Vagus Nerve Stimulation to Differentiate Responders from Non-Responders.” EUROPEAN JOURNAL OF NEUROLOGY 27 (7): 1178–89. https://doi.org/10.1111/ene.14270.
Chicago author-date (all authors)
Hödl, Stephanie, Sofie Carrette, Alfred Meurs, Evelien Carrette, Ann Mertens, Stefanie Gadeyne, Lutgart Goossens, Frank Dewaele, Charlotte Bouckaert, Ine Dauwe, Silke Proesmans, Robrecht Raedt, Paul Boon, and Kristl Vonck. 2020. “Neurophysiological Investigations of Drug Resistant Epilepsy Patients Treated with Vagus Nerve Stimulation to Differentiate Responders from Non-Responders.” EUROPEAN JOURNAL OF NEUROLOGY 27 (7): 1178–1189. doi:10.1111/ene.14270.
Vancouver
1.
Hödl S, Carrette S, Meurs A, Carrette E, Mertens A, Gadeyne S, et al. Neurophysiological investigations of drug resistant epilepsy patients treated with vagus nerve stimulation to differentiate responders from non-responders. EUROPEAN JOURNAL OF NEUROLOGY. 2020;27(7):1178–89.
IEEE
[1]
S. Hödl et al., “Neurophysiological investigations of drug resistant epilepsy patients treated with vagus nerve stimulation to differentiate responders from non-responders,” EUROPEAN JOURNAL OF NEUROLOGY, vol. 27, no. 7, pp. 1178–1189, 2020.
@article{8659963,
  abstract     = {Background and purpose In patients treated with vagus nerve stimulation (VNS) for drug resistant epilepsy (DRE), up to a third of patients will eventually not respond to the therapy. As VNS therapy requires surgery for device implantation, prediction of response prior to surgery is desirable. It is hypothesized that neurophysiological investigations related to the mechanisms of action of VNS may help to differentiate VNS responders from non-responders prior to the initiation of therapy.

Methods In a prospective series of DRE patients, polysomnography, heart rate variability (HRV) and cognitive event related potentials were recorded. Polysomnography and HRV were repeated after 1 year of treatment with VNS. Polysomnography, HRV and cognitive event related potentials were compared between VNS responders (>= 50% reduction in seizure frequency) and non-responders.

Results Fifteen out of 30 patients became VNS responders after 1 year of VNS treatment. Prior to treatment with VNS, the amount of deep sleep (NREM 3), the HRV high frequency (HF) power and the P3b amplitude were significantly different in responders compared to non-responders (P = 0.007; P = 0.001; P = 0.03).

Conclusion Three neurophysiological parameters, NREM 3, HRV HF and P3b amplitude, were found to be significantly different in DRE patients who became responders to VNS treatment prior to initiation of their treatment with VNS. These non-invasive recordings may be used as characteristics for response in future studies and help avoid unsuccessful implantations. Mechanistically these findings may be related to changes in brain regions involved in the so-called vagal afferent network.},
  author       = {Hödl, Stephanie and Carrette, Sofie and Meurs, Alfred and Carrette, Evelien and Mertens, Ann and Gadeyne, Stefanie and Goossens, Lutgart and Dewaele, Frank and Bouckaert, Charlotte and Dauwe, Ine and Proesmans, Silke and Raedt, Robrecht and Boon, Paul and Vonck, Kristl},
  issn         = {1351-5101},
  journal      = {EUROPEAN JOURNAL OF NEUROLOGY},
  keywords     = {heart rate variability,neurostimulation,P3 evoked potential,polysomnography,HEART-RATE-VARIABILITY,FUNCTIONAL CONNECTIVITY,SLEEP,EFFICACY,PREDICTORS,METAANALYSIS,BIOMARKER,LESIONS,VNS,P3},
  language     = {eng},
  number       = {7},
  pages        = {1178--1189},
  title        = {Neurophysiological investigations of drug resistant epilepsy patients treated with vagus nerve stimulation to differentiate responders from non-responders},
  url          = {http://dx.doi.org/10.1111/ene.14270},
  volume       = {27},
  year         = {2020},
}

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