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Vagus Nerve Stimulation Activates Central Nervous System Structures In Epileptic Patients During PET H2(15)O Blood Flow Imaging.

D. Ko, C. Heck, Scott T. Grafton, M. Apuzzo, W. Couldwell, T. Chen, J. Day, V. Zelman, T. Smith, C. DeGiorgio
Published 1996 · Medicine

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OBJECTIVE To determine the central areas of activation by vagal nerve stimulation (VNS) in epilepsy. VNS is a promising neurosurgical method for treating patients with partial and secondary generalized epilepsy. The anti-epileptic mechanism of action from VNS is not well understood. METHODS We performed H2(15)O PET blood flow functional imaging on three patients with epilepsy in a vagal nerve stimulation study (E04 Protocol with Cyberonics). The three patients included two that had previous epilepsy surgery but continued to have frequent seizures. Seizure onset was frontal in two patients and bitemporal in the third patient. Twelve PET scans per subject were acquired every 10 minutes with a Siemens 953/A scanner. In 6 stimulus scans, VNS was activated for 60 seconds (2 mA, 30 Hz) commensurate with isotope injection. In 6 control scans no VNS was administered. No clinical seizures were present during any scan. Three way ANOVA with linear contrasts subject, task, repetition) of coregistered images identified significant treatment effects. RESULTS The difference between PET with VNS and without revealed that left VNS activated right thalamus (P < 0.0006), right posterior temporal cortex (P < 0.0003), left putamen (P < 0.0002), and left inferior cerebellum (P < 0.0009). CONCLUSIONS VNS causes activation of several central areas including contralateral thalamus. Localization to the thalamus suggests a possible mechanism to explain the therapeutic benefit, consistent with the role of the thalamus as a generator and modulator of cerebral activity.
This paper references
Regional Cerebral Blood Flow in Man Manipulated by Direct Vagal Stimulation
E. S. Garnett (1992)
Regional induction of fos immunoreactivity in the brain by anticonvulsant stimulation of the vagus nerve
D. Naritoku (1995)
Afferent vagal stimulation: neurographic correlates of induced EEG synchronization and desynchronization.
M. Chase (1967)
Anatomical, Physiological, and Theoretical Basis for the Antiepileptic Effect of Vagus Nerve Stimulation
P. Rutecki (1990)
A Noninvasive Approach to Quantitative Functional Brain Mapping with H215O and Positron Emission Tomography
P. Fox (1984)
Vagal Stimulation Reduces the Severity of Maximal Electroshock Seizures in Intact Rats: Use of a Cuff Electrode for Stimulating and Recording
J. W. Woodbury (1991)
Firing patterns of epileptic and normal neurons in the chronic alumina focus in undrugged monkeys during different behavioral states
A. Wyler (1975)
Applied Linear Statistical Models
V. Barnett (1975)
Electrical Stimulation of the Centromedian Thalamic Nucleus in the Treatment of Convulsive Seizures: A Preliminary Report
F. Velasco (1987)
Rapid Automated Algorithm for Aligning and Reslicing PET Images
R. Woods (1992)
An Implantable Neurocybernetic Prosthesis System
R. Terry (1990)
Placebo‐Controlled Pilot Study of Centromedian Thalamic Stimulation in Treatment of Intractable Seizures
R. Fisher (1992)
A double-blind trial of chronic cerebellar stimulation in twelve patients with severe epilepsy.
G. D. Wright (1984)
Effects of hypnogenic vagal stimulation on thalamic neuronal activity in cats
G. Juhász (1985)
Preliminary evaluation of cerebellar stimulation by double-blind stimulation and biological criteria in the treatment of epilepsy.
J. V. Van Buren (1978)
Projection of cardiovascular afferents to the lateral nodulus-uvula of the cerebellum in rabbits
N. Nisimaru (1995)
Epileptic patterns of local cerebral metabolism and perfusion in humans determined by emission computed tomography of 18FDG and 13NH3
D. Kuhl (1980)
A Noninvasive Positron Computed Tomography Technique Using Oxygen-15-Labeled Water for the Evaluation of Neurobehavioral Task Batteries
J. Mazziotta (1985)
The nucleus of the solitary tract in the monkey: Projections to the thalamus and brain stem nuclei
R. Beckstead (1980)
A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures
Lippincott Williams Wilkins (1995)
Vagus Nerve Stimulation for Treatment of Partial Seizures: 3. Long‐Term Follow‐Up on First 67 Patients Exiting a Controlled Study
R. George (1994)
Automated image registration
R. Woods (1993)
Surgical Technique for Implantation of the Neurocybernetic Prosthesis
S. A. Reid (1990)
Peptides in the parabrachial nucleus modulate visceral input to the thalamus.
T. Saleh (1993)
Suppression of Interictal Spikes and Seizures by Stimulation of the Vagus Nerve
R. Mclachlan (1993)

This paper is referenced by
Vagus nerve stimulation: current status and clinical applications.
S. Schachter (1997)
Progress report on new antiepileptic drugs: a summary of the fourth Eilat conference (EILAT IV)
M. Bialer (1999)
Sacral Neuromodulation for Fecal Incontinence: A Review of the Central Mechanisms of Action
Paul T. J. Janssen (2017)
Reassessment: Vagus nerve stimulation for epilepsy
R. Fisher (1999)
Vagus Nerve Stimulation for Treatment of Seizures?: Yes
E. Ben-Menachem (1998)
Investigation into the mechanisms of vagus nerve stimulation for the treatment of intractable epilepsy, using 99mTc-HMPAO SPET brain images
A. Barnes (2002)
Vagus Nerve Stimulation Therapy after Failed Cranial Surgery for Intractable Epilepsy: Results from the Vagus Nerve Stimulation Therapy Patient Outcome Registry
A. Amar (2004)
Vagus nerve stimulation in refractory epilepsy: SPECT activation study.
K. V. Van Laere (2000)
Advances in Neurostimulation for Depression: Electroconvulsive Therapy, Transcranial Magnetic Stimulation, Vagus Nerve Stimulation, and Deep Brain Stimulation
Linda L Carpenter (2009)
[Vagal stimulation in the treatment of epilepsy].
J. Iriarte (2002)
Phenytoin carried by silica core iron oxide nanoparticles reduces the expression of pharmacoresistant seizures in rats.
Argelia Rosillo-de la Torre (2015)
Suppression of harmaline‐induced tremor in rats by vagus nerve stimulation
A. Handforth (2001)
Vagus nerve stimulation activates central nervous system structures in epileptic patients during PET H2(15)O blood flow imaging.
Carter Lp (1998)
Neuer Behandlungsweg therapieresistenter Epilepsien und Depressionen
J. Scherrmann (2001)
Vagus nerve stimulation in pediatric epilepsy: a review.
I. Valencia (2001)
Diffusion-weighted imaging and status epilepticus during vagus nerve stimulation
IV W.O.Tatum (2004)
Reassessment: vagus nerve stimulation for epilepsy.
D. Wilkins (2000)
Vagus nerve stimulation for refractory epilepsy.
P. Boon (2001)
Positron emission tomography (PET) scan in epilepsy
C. Locharernkul (2008)
A SPECT study of the effect of vagal nerve stimulation on thalamic activity in patients with epilepsy
H. Ring (2000)
VNS induced desynchronization in gamma bands correlates with positive clinical outcome in temporal lobe pharmacoresistant epilepsy
M. Fraschini (2013)
An institutional experience with cervical vagus nerve trunk stimulation for medically refractory epilepsy: rationale, technique, and outcome.
A. Amar (1998)
Chapter 113 – Treatment of Intractable Epilepsy by Electrical Stimulation of the Vagus Nerve
Joseph R. Madsen (2012)
Deep Brain and Vagal Nerve Stimulation
S. A. Song (2020)
14 – The Epilepsies
J. Duncan (2000)
Acute vagus nerve stimulation using different pulse widths produces varying brain effects
Qiwen Mu (2004)
Vagus Nerve Stimulation
Matthew M. Troester (2010)
Vagus Nerve Stimulation: Clinical Experience in a Large Patient Series
J. Scherrmann (2001)
The Mechanism of Action of Vagus Nerve Stimulation for Refractory Epilepsy: The Current Status
K. Vonck (2001)
Vagus Nerve Stimulation. Authors' reply
I. Ross (2008)
Thalamic and limbic involvement in the mechanism of action of vagus nerve stimulation, a SPECT study
K. Vonck (2008)
Astroglial Networks and Implications for Therapeutic Neuromodulation of Epilepsy
Mark R. Witcher (2012)
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