Application of scalp electroencephalogram in treatment of refractory epilepsy with vagus nerve stimulation

被引：4

作者：

Qin X. ^{[1
,7
]}

Yuan Y. ^{[1
,7
]}

Chen Y. ^{[3
]}

Liao J. ^{[4
]}

Lin S. ^{[3
]}

Yang Z. ^{[6
]}

Li L. ^{[1
,7
]}

机构：

[1] Precision Medicine & Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen

[2] National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University

[3] Epilepsy Center, Shenzhen Children's Hospital, Shenzhen, 518038, Guangdong

[4] Epilepsy Center, Shenzhen Children's Hospital, Shenzhen

[5] Department of Neurology, Shenzhen Children's Hospital, Shenzhen

[6] National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, 100084, Beijing

[7] Precision Medicine & Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen

[8] National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University

[9] IDG/McGovern Institute for Brain Research at Tsinghua University

[10] Institute of Epilepsy, Beijing Institute for Brain Disorders

来源：

Shengwu Yixue Gongchengxue Zazhi/Journal of Biomedical Engineering | 2020年 / 37卷 / 04期

关键词：

curative effect evaluation; electroencephalogram; therapeutic effect prediction; treatment mechanism; vagus nerve stimulation;

D O I：

10.7507/1001-5515.201909002

中图分类号：

R96 [药理学]; R3 [基础医学]; R4 [临床医学];

学科分类号：

1001 ; 1002 ; 100602 ; 100706 ;

摘要：

癫痫发作是由于大脑神经元过度放电的扩散而引起的，因此半个世纪以来脑电图（EEG）一直是科学家研究癫痫以及评估癫痫治疗的重要工具。本文综述了近 30 年头皮 EEG 在迷走神经电刺激（VNS）治疗难治性癫痫的临床研究中的应用，重点从基于 EEG 特征预测 VNS 对药物难治性癫痫的疗效和 VNS 治疗对药物难治性癫痫患者的 EEG 影响两方面展开介绍，并阐述相关 VNS 治疗机制。其中，针对基于 EEG 特征预测 VNS 疗效方面，介绍了痫样放电变化、慢皮质电位变化极性、脑电对称性以及脑电功率谱变化等特征指标与疗效的关系；针对 VNS 治疗对患者 EEG 特征的影响方面，介绍了 VNS 治疗后痫样放电、功率谱、同步性、脑网络以及事件相关电位 P300 振幅的变化等影响。尽管目前的研究尚未确定具有代表性的、可用于临床推广的 EEG 标志物，本综述可为大宗案例的前瞻性研究奠定基础，有利于指导 EEG 应用于 VNS 的临床治疗，为预测、评估 VNS 疗效以及理解 VNS 治疗机制提供思路，具有重要的临床价值和科学意义。.; Electroencephalogram (EEG) has been an important tool for scientists to study epilepsy and evaluate the treatment of epilepsy for half a century, since epilepsy seizures are caused by the diffusion of excessive discharge of brain neurons. This paper reviews the clinical application of scalp EEG in the treatment of intractable epilepsy with vagus nerve stimulation (VNS) in the past 30 years. It mainly introduces the prediction of the therapeutic effect of VNS on intractable epilepsy based on EEG characteristics and the effect of VNS on EEG of patients with intractable epilepsy, and expounds some therapeutic mechanisms of VNS. For predicting the efficacy of VNS based on EEG characteristics, EEG characteristics such as epileptiform discharge, polarity of slow cortical potential changes, changes of EEG symmetry level and changes of EEG power spectrum are described. In view of the influence of VNS treatment on patients' EEG characteristics, the change of epileptiform discharge, power spectrum, synchrony, brain network and amplitude of event-related potential P300 are described. Although no representative EEG markers have been identified for clinical promotion, this review paves the way for prospective studies of larger patient populations in the future to better apply EEG to the clinical treatment of VNS, and provides ideas for predicting VNS efficacy, assessing VNS efficacy, and understanding VNS treatment mechanisms, with broad medical and scientific implications.

引用

页码：699 / 707

页数：8