Long-term effects of vagus nerve stimulation on EEG aperiodic components in patients with drug-resistant epilepsy

Autor: Yujiao Yang, Jing Wang, Xiongfei Wang, Chongyang Tang, Jiahui Deng, Zhaofen Yan, Qinqin Deng, Dong Chen, Jian Zhou, Yuguang Guan, Mengyang Wang, Tianfu Li, Guoming Luan
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Therapeutic Advances in Neurological Disorders, Vol 17 (2024)
Druh dokumentu: article
ISSN: 1756-2864
17562864
DOI: 10.1177/17562864241279124
Popis: Background: Drug-resistant epilepsy (DRE) affects approximately one-third of epilepsy patients who do not achieve adequate seizure control with medication. Vagus nerve stimulation (VNS) is an adjunctive therapy for DRE, but its long-term effects on cortical excitability remain unclear. Objectives: This study aims to elucidate the long-term effects of VNS on electroencephalography (EEG) aperiodic components in patients with DRE. Our objective is to identify biomarkers that can serve as indicators of therapeutic efficacy and provide mechanistic insights into the underlying neural processes. Design: This longitudinal observational study focused on patients with DRE undergoing VNS therapy at Sanbo Brain Hospital. The reduction in seizure frequency rates was quantified over short-term (⩽1 year), medium-term (1–3 years), and long-term (⩾3 years) intervals to assess the therapeutic efficacy of VNS. Both the periodic and aperiodic components of EEG data were analyzed. Methods: Advanced signal processing techniques were utilized to parameterize the periodic and aperiodic components of EEG data, focusing particularly on “offset” and “exponent.” These measures were compared before and after VNS therapy. Correlation analyses were conducted to explore the relationship between these EEG parameters and clinical outcomes. Results: In all, 18 patients with DRE participated in this study. During the long-term follow-up period, the responder rate was 55.56%. Significant decreases were observed in aperiodic offset ( p = 0.022) and exponent ( p = 0.039) among responders. The impact of age on these results was not significant. Correlation analyses revealed a negative association between therapeutic efficacy and a decrease in offset ( R = −0.546, p = 0.019) and exponent ( R = −0.636, p = 0.019). Conclusion: EEG aperiodic parameters, including offset and exponent, have the potential to serve as promising biomarkers for evaluating the efficacy of VNS. An understanding of the regulatory influence of VNS on cortical excitability through these aperiodic parameters could provide a basis for the development of more effective stimulation parameters and therapeutic strategies.
Databáze: Directory of Open Access Journals
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