Biomarker; Epilepsy; Magnetic resonance imaging; Support vector machine; Thalamocortical tracts; Vagus nerve stimulation; Pharmacology; Neurology (clinical); Pharmacology (medical)
Abstract :
[en] The mechanisms of action of Vagus Nerve Stimulation (VNS) and the biological prerequisites to respond to the treatment are currently under investigation. It is hypothesized that thalamocortical tracts play a central role in the antiseizure effects of VNS by disrupting the genesis of pathological activity in the brain. This pilot study explored whether in vivo microstructural features of thalamocortical tracts may differentiate Drug-Resistant Epilepsy (DRE) patients responding and not responding to VNS treatment. Eighteen patients with DRE (37.11 ± 10.13 years, 10 females), including 11 responders or partial responders and 7 non-responders to VNS, were recruited for this high-gradient multi-shell diffusion Magnetic Resonance Imaging (MRI) study. Using Diffusion Tensor Imaging (DTI) and multi-compartment models - Neurite Orientation Dispersion and Density Imaging (NODDI) and Microstructure Fingerprinting (MF), we extracted microstructural features in 12 subsegments of thalamocortical tracts. These characteristics were compared between responders/partial responders and non-responders. Subsequently, a Support Vector Machine (SVM) classifier was built, incorporating microstructural features and 12 clinical covariates (including age, sex, duration of VNS therapy, number of antiseizure medications, benzodiazepine intake, epilepsy duration, epilepsy onset age, epilepsy type - focal or generalized, presence of an epileptic syndrome - no syndrome or Lennox-Gastaut syndrome, etiology of epilepsy - structural, genetic, viral, or unknown, history of brain surgery, and presence of a brain lesion detected on structural MRI images). Multiple diffusion metrics consistently demonstrated significantly higher white matter fiber integrity in patients with a better response to VNS (pFDR < 0.05) in different subsegments of thalamocortical tracts. The SVM model achieved a classification accuracy of 94.12%. The inclusion of clinical covariates did not improve the classification performance. The results suggest that the structural integrity of thalamocortical tracts may be linked to therapeutic effectiveness of VNS. This study reveals the great potential of diffusion MRI in improving our understanding of the biological factors associated with the response to VNS therapy.
Research Center/Unit :
GIGA-SLEEP - GIGA CRC In vivo Imaging-Sleep and chronobiology - ULiège
Disciplines :
Neurology
Author, co-author :
Berger, Alexandre; Epilepsy and Neurostimulation Lab, Institute of Neuroscience (IoNS), Department of Clinical Neuroscience, Catholic University of Louvain, 1200, Brussels, Belgium, Synergia Medical SA, 1435, Mont-Saint-Guibert, Belgium, Sleep and Chronobiology Lab, GIGA-Cyclotron Research Center-In Vivo Imaging, University of Liège, 4000, Liège, Belgium. Electronic address: alexandre.berger@uclouvain.be
Cerra, Michele; Institute of Information and Communication Technologies, Electronics and Applied Mathematics (ICTEAM), Catholic University of Louvain, 1348, Louvain-la-Neuve, Belgium, Politecnico di Torino, Department of Control and Computer Engineering, Corso Duca Degli Abruzzi 24, 10129, Torino, Italy
Joris, Vincent; Epilepsy and Neurostimulation Lab, Institute of Neuroscience (IoNS), Department of Clinical Neuroscience, Catholic University of Louvain, 1200, Brussels, Belgium, Cliniques Universitaires Saint-Luc (CUSL), Department of Neurosurgery, 1200, Brussels, Belgium
Danthine, Venethia; Epilepsy and Neurostimulation Lab, Institute of Neuroscience (IoNS), Department of Clinical Neuroscience, Catholic University of Louvain, 1200, Brussels, Belgium
Macq, Benoit; Institute of Information and Communication Technologies, Electronics and Applied Mathematics (ICTEAM), Catholic University of Louvain, 1348, Louvain-la-Neuve, Belgium
Dricot, Laurence; Epilepsy and Neurostimulation Lab, Institute of Neuroscience (IoNS), Department of Clinical Neuroscience, Catholic University of Louvain, 1200, Brussels, Belgium
Vandewalle, Gilles ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques
Delinte, Nicolas; Epilepsy and Neurostimulation Lab, Institute of Neuroscience (IoNS), Department of Clinical Neuroscience, Catholic University of Louvain, 1200, Brussels, Belgium, Institute of Information and Communication Technologies, Electronics and Applied Mathematics (ICTEAM), Catholic University of Louvain, 1348, Louvain-la-Neuve, Belgium
El Tahry, Riëm; Epilepsy and Neurostimulation Lab, Institute of Neuroscience (IoNS), Department of Clinical Neuroscience, Catholic University of Louvain, 1200, Brussels, Belgium, Center for Refractory Epilepsy, Cliniques Universitaires Saint-Luc (CUSL), Department of Neurology, 1200, Brussels, Belgium
Language :
English
Title :
Identifying responders to vagus nerve stimulation based on microstructural features of thalamocortical tracts in drug-resistant epilepsy.
AB was supported by the Walloon Region and Synergia Medical SA (Industrial Doctorate Program, convention n\u00B08193). The firm was not involved in the study design, data collection and analysis, interpretation of the data, the writing of the article, or the decision to submit it for publication. RET is funded by the Queen Elisabeth Medical Foundation (QEMF) and Fonds pour la Recherche Clinique (FRC) \u2013 Saint-Luc University Hospital. GV was supported by the Fonds de la Recherche Scientifique \u2013 Fonds National de la Recherche Scientifique (FRS-FNRS).AB was supported by the Walloon Region and Synergia Medical SA (Industrial Doctorate Program, convention n\u00B08193). RET is funded by the Walloon Excellence in Life Sciences and Biotechnology (WELBIO) department of the WEL Research Institute (X.2001.22). GV was supported by the Fonds de la Recherche Scientifique \u2013 Fonds National de la Recherche Scientifique (FRS-FNRS).
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