Title
Thalamic and limbic involvement in the mechanism of action of vagus nerve stimulation, a SPECT study Thalamic and limbic involvement in the mechanism of action of vagus nerve stimulation, a SPECT study
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
London ,
Subject
Human medicine
Source (journal)
Seizure: European journal of epilepsy. - London
Volume/pages
17(2008) :8 , p. 699-706
ISSN
1059-1311
ISI
000261815700006
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
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 (99m)Tc-ECD (ethyl cystein dimer) SPECT activation study at the time the first stimulation train was administered. 12 patients underwent an additional (99m)Tc-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. (C) 2008 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
E-info
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