Electroencephalogram synchronization measure as a predictive biomarker of Vagus nerve stimulation response in refractory epilepsy: A retrospective study.
Biomarkers; Humans; Male; Female; Adult; Retrospective Studies; Young Adult; Sleep/physiology; Adolescent; Middle Aged; Electroencephalography Phase Synchronization; Treatment Outcome; Wakefulness/physiology; Vagus Nerve Stimulation/methods; Drug Resistant Epilepsy/therapy; Drug Resistant Epilepsy/physiopathology; Electroencephalography; Drug Resistant Epilepsy; Sleep; Vagus Nerve Stimulation; Wakefulness; Multidisciplinary
Abstract :
[en] There are currently no established biomarkers for predicting the therapeutic effectiveness of Vagus Nerve Stimulation (VNS). Given that neural desynchronization is a pivotal mechanism underlying VNS action, EEG synchronization measures could potentially serve as predictive biomarkers of VNS response. Notably, an increased brain synchronization in delta band has been observed during sleep-potentially due to an activation of thalamocortical circuitry, and interictal epileptiform discharges are more frequently observed during sleep. Therefore, investigation of EEG synchronization metrics during sleep could provide a valuable insight into the excitatory-inhibitory balance in a pro-epileptogenic state, that could be pathological in patients exhibiting a poor response to VNS. A 19-channel-standard EEG system was used to collect data from 38 individuals with Drug-Resistant Epilepsy (DRE) who were candidates for VNS implantation. An EEG synchronization metric-the Weighted Phase Lag Index (wPLI)-was extracted before VNS implantation and compared between sleep and wakefulness, and between responders (R) and non-responders (NR). In the delta band, a higher wPLI was found during wakefulness compared to sleep in NR only. However, in this band, no synchronization difference in any state was found between R and NR. During sleep and within the alpha band, a negative correlation was found between wPLI and the percentage of seizure reduction after VNS implantation. Overall, our results suggest that patients exhibiting a poor VNS efficacy may present a more pathological thalamocortical circuitry before VNS implantation. EEG synchronization measures could provide interesting insights into the prerequisites for responding to VNS, in order to avoid unnecessary implantations in patients showing a poor therapeutic efficacy.
Disciplines :
Neurology Neurosciences & behavior
Author, co-author :
Danthine, Venethia ; Institute of NeuroScience (IoNS), Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
Cottin, Lise ; Bio- Electro- And Mechanical Systems (BEAMS), Université Libre de Bruxelles, Brussels, Belgium
Berger, Alexandre ; Université de Liège - ULiège > GIGA > GIGA Neurosciences - Sleep and chronobiology ; Institute of NeuroScience (IoNS), Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
Germany Morrison, Enrique Ignacio; Institute of NeuroScience (IoNS), Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium ; Walloon Excellence in Life Sciences and Biotechnology (WELBIO) department, WEL Research Institute, Wavre, Belgium
Liberati, Giulia ; Institute of NeuroScience (IoNS), Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium ; Institute of Psychology (IPSY), Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
Ferrao Santos, Susana; Institute of NeuroScience (IoNS), Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium ; Department of Neurology, Cliniques Universitaires Saint Luc, Woluwe-Saint-Lambert, Belgium
Delbeke, Jean; Institute of NeuroScience (IoNS), Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
Nonclercq, Antoine ; Bio- Electro- And Mechanical Systems (BEAMS), Université Libre de Bruxelles, Brussels, Belgium
El Tahry, Riëm; Institute of NeuroScience (IoNS), Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium ; Department of Neurology, Cliniques Universitaires Saint Luc, Woluwe-Saint-Lambert, Belgium ; Walloon Excellence in Life Sciences and Biotechnology (WELBIO) department, WEL Research Institute, Wavre, Belgium
Language :
English
Title :
Electroencephalogram synchronization measure as a predictive biomarker of Vagus nerve stimulation response in refractory epilepsy: A retrospective study.
FRIA - Fonds pour la Formation à la Recherche dans l'Industrie et dans l'Agriculture WELBIO - Walloon Excellence in Life Sciences and Biotechnology QEMF - Queen Elisabeth Medical Foundation
Funding text :
Funding: VD is supported by a Fond de la Recherche Scientifique (F.R.S.-FNRS) with a FRIA grant. EIGM is funded by the Walloon Excellence in Life Sciences and Biotechnology (WELBIO) department of the WEL Research Institute (X.2001.22). RET is funded by the Walloon Excellence in Life Sciences and Biotechnology (WELBIO) department of the WEL Research Institute (X.2001.22) and the Queen Elisabeth Medical Foundation (QEMF). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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