EEG Reactivity Predicts Individual Efficacy of Vagal Nerve
Stimulation in Intractable Epileptics

J 2019

EEG Reactivity Predicts Individual Efficacy of Vagal Nerve Stimulation in Intractable Epileptics

BRÁZDIL, Milan, Irena DOLEŽALOVÁ, Eva KORIŤÁKOVÁ, Jan CHLÁDEK, Robert ROMAN et. al.

Basic information

Original name

EEG Reactivity Predicts Individual Efficacy of Vagal Nerve Stimulation in Intractable Epileptics

Authors

BRÁZDIL, Milan (203 Czech Republic, guarantor, belonging to the institution), Irena DOLEŽALOVÁ (203 Czech Republic, belonging to the institution), Eva KORIŤÁKOVÁ (203 Czech Republic, belonging to the institution), Jan CHLÁDEK (203 Czech Republic, belonging to the institution), Robert ROMAN (203 Czech Republic, belonging to the institution), Martin PAIL (203 Czech Republic, belonging to the institution), Pavel JURAK (203 Czech Republic), Daniel Joel SHAW (826 United Kingdom of Great Britain and Northern Ireland, belonging to the institution) and Jan CHRASTINA (203 Czech Republic, belonging to the institution)

Edition

FRONTIERS IN NEUROLOGY, LAUSANNE, FRONTIERS MEDIA SA, 2019, 1664-2295

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 2.889

RIV identification code

RIV/00216224:14110/19:00108497

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.3389/fneur.2019.00392

UT WoS

000466518800001

Keywords in English

vagal nerve stimulation; neurostimulation; epilepsy; efficacy prediction; EEG reactivity; epilepsy treatment

Abstract

V originále

Background: Chronic vagal nerve stimulation (VNS) is a well-established non-pharmacological treatment option for drug-resistant epilepsy. This study sought to develop a statistical model for prediction of VNS efficacy. We hypothesized that reactivity of the electroencephalogram (EEG) to external stimuli measured during routine preoperative evaluation differs between VNS responders and non-responders. Materials and Methods: Power spectral analyses were computed retrospectively on pre-operative EEG recordings from 60 epileptic patients with VNS. Thirty five responders and 25 non-responders were compared on the relative power values in four standard frequency bands and eight conditions of clinical assessment-eyes opening/closing, photic stimulation, and hyperventilation. Using logistic regression, groups of electrodes within anatomical areas identified as maximally discriminative by n leave-one-out iterations were used to classify patients. The reliability of the predictive model was verified with an independent data-set from 22 additional patients. Results: Power spectral analyses revealed significant differences in EEG reactivity between responders and non-responders; specifically, the dynamics of alpha and gamma activity strongly reflected VNS efficacy. Using individual EEG reactivity to develop and validate a predictive model, we discriminated between responders and non-responders with 86% accuracy, 83% sensitivity, and 90% specificity. Conclusion: We present a new statistical model with which EEG reactivity to external stimuli during routine presurgical evaluation can be seen as a promising avenue for the identification of patients with favorable VNS outcome. This novel method for the prediction of VNS efficacy might represent a breakthrough in the management of drug-resistant epilepsy, with wide-reaching medical and economic implications.

Links

LQ1601, research and development project

Name: CEITEC 2020 (Acronym: CEITEC2020)

Investor: Ministry of Education, Youth and Sports of the CR

NV19-04-00343, research and development project

Name: Predikce Efektu Stimulace u pacientů s Epilepsií (PRESEnCE) (Acronym: PRESEnCE)

Investor: Ministry of Health of the CR

Citovat

BRÁZDIL, Milan, Irena DOLEŽALOVÁ, Eva KORIŤÁKOVÁ, Jan CHLÁDEK, Robert ROMAN, Martin PAIL, Pavel JURAK, Daniel Joel SHAW and Jan CHRASTINA. EEG Reactivity Predicts Individual Efficacy of Vagal Nerve Stimulation in Intractable Epileptics. FRONTIERS IN NEUROLOGY. LAUSANNE: FRONTIERS MEDIA SA, 2019, vol. 10, No 392, p. 1-11. ISSN 1664-2295. Available from: https://dx.doi.org/10.3389/fneur.2019.00392.

@article{1546030,
   author = {Brázdil, Milan and Doležalová, Irena and Koriťáková, Eva and Chládek, Jan and Roman, Robert and Pail, Martin and Jurak, Pavel and Shaw, Daniel Joel and Chrastina, Jan},
   article_location = {LAUSANNE},
   article_number = {392},
   doi = {http://dx.doi.org/10.3389/fneur.2019.00392},
   keywords = {vagal nerve stimulation; neurostimulation; epilepsy; efficacy prediction; EEG reactivity; epilepsy treatment},
   language = {eng},
   issn = {1664-2295},
   journal = {FRONTIERS IN NEUROLOGY},
   title = {EEG Reactivity Predicts Individual Efficacy of Vagal Nerve Stimulation in Intractable Epileptics},
   url = {https://www.frontiersin.org/articles/10.3389/fneur.2019.00392/full},
   volume = {10},
   year = {2019}
}

TY  - JOUR
ID  - 1546030
AU  - Brázdil, Milan - Doležalová, Irena - Koriťáková, Eva - Chládek, Jan - Roman, Robert - Pail, Martin - Jurak, Pavel - Shaw, Daniel Joel - Chrastina, Jan
PY  - 2019
TI  - EEG Reactivity Predicts Individual Efficacy of Vagal Nerve Stimulation in Intractable Epileptics
JF  - FRONTIERS IN NEUROLOGY
VL  - 10
IS  - 392
SP  - 1-11
EP  - 1-11
PB  - FRONTIERS MEDIA SA
SN  - 16642295
KW  - vagal nerve stimulation
KW  - neurostimulation
KW  - epilepsy
KW  - efficacy prediction
KW  - EEG reactivity
KW  - epilepsy treatment
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2019.00392/full
L2  - https://www.frontiersin.org/articles/10.3389/fneur.2019.00392/full
N2  - Background: Chronic vagal nerve stimulation (VNS) is a well-established non-pharmacological treatment option for drug-resistant epilepsy. This study sought to develop a statistical model for prediction of VNS efficacy. We hypothesized that reactivity of the electroencephalogram (EEG) to external stimuli measured during routine preoperative evaluation differs between VNS responders and non-responders. Materials and Methods: Power spectral analyses were computed retrospectively on pre-operative EEG recordings from 60 epileptic patients with VNS. Thirty five responders and 25 non-responders were compared on the relative power values in four standard frequency bands and eight conditions of clinical assessment-eyes opening/closing, photic stimulation, and hyperventilation. Using logistic regression, groups of electrodes within anatomical areas identified as maximally discriminative by n leave-one-out iterations were used to classify patients. The reliability of the predictive model was verified with an independent data-set from 22 additional patients. Results: Power spectral analyses revealed significant differences in EEG reactivity between responders and non-responders; specifically, the dynamics of alpha and gamma activity strongly reflected VNS efficacy. Using individual EEG reactivity to develop and validate a predictive model, we discriminated between responders and non-responders with 86% accuracy, 83% sensitivity, and 90% specificity. Conclusion: We present a new statistical model with which EEG reactivity to external stimuli during routine presurgical evaluation can be seen as a promising avenue for the identification of patients with favorable VNS outcome. This novel method for the prediction of VNS efficacy might represent a breakthrough in the management of drug-resistant epilepsy, with wide-reaching medical and economic implications.
ER  -

BRÁZDIL, Milan, Irena DOLEŽALOVÁ, Eva KORIŤÁKOVÁ, Jan CHLÁDEK, Robert ROMAN, Martin PAIL, Pavel JURAK, Daniel Joel SHAW and Jan CHRASTINA. EEG Reactivity Predicts Individual Efficacy of Vagal Nerve Stimulation in Intractable Epileptics. \textit{FRONTIERS IN NEUROLOGY}. LAUSANNE: FRONTIERS MEDIA SA, 2019, vol.~10, No~392, p.~1-11. ISSN~1664-2295. Available from: https://dx.doi.org/10.3389/fneur.2019.00392.

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