The P3 Event-Related Potential is a Biomarker for the Efficacy of Vagus Nerve Stimulation in Patients with Epilepsy

被引：71

作者：

De Taeye, Leen ^{[1
]}

Vonck, Kristl ^{[1
]}

van Bochove, Marlies ^{[2
]}

Boon, Paul ^{[1
]}

Van Roost, Dirk ^{[3
]}

Mollet, Lies ^{[1
]}

Meurs, Alfred ^{[1
]}

De Herdt, Veerle ^{[1
]}

Carrette, Evelien ^{[1
]}

Dauwe, Ine ^{[1
]}

Gadeyne, Stefanie ^{[1
]}

van Mierlo, Pieter ^{[4
]}

Verguts, Tom ^{[2
]}

Raedt, Robrecht ^{[1
]}

机构：

[1] Univ Ghent, Dept Neurol, LCEN3, B-9000 Ghent, Belgium

[2] Univ Ghent, Dept Expt Psychol, B-9000 Ghent, Belgium

[3] Ghent Univ Hosp, Dept Neurosurg, Ghent, Belgium

[4] Univ Ghent, Dept Elect & Informat Syst, MEDISIP, B-9000 Ghent, Belgium

来源：

NEUROTHERAPEUTICS | 2014年 / 11卷 / 03期

关键词：

Vagus nerve stimulation; epilepsy; event-related potentials; P3; biomarker; norepinephrine; LOCUS-COERULEUS LESIONS; LONG-TERM; REFRACTORY EPILEPSY; INTEGRATIVE THEORY; NOREPINEPHRINE; DEPRESSION; COGNITION; CHILDREN; RAT; VNS;

D O I：

10.1007/s13311-014-0272-3

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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 (a parts per thousand currency sign50 %). 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.

引用

页码：612 / 622

页数：11

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