期刊
EPILEPSY RESEARCH
卷 92, 期 2-3, 页码 231-239出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.eplepsyres.2010.10.007
关键词
Vagus nerve stimulation; Epilepsy; Compound action potentials
资金
- Ghent University (BOF)
- FWO
- BOF
- Ghent University Hospital
- Neurotech Belgium
Purpose: Vagus nerve stimulation (VNS) is an established treatment for refractory epilepsy. The ADNS-300 is a new system for VNS that includes a rechargeable stimulus generator and an electrode for combined stimulation and recording. In this feasibility study, three patients were implanted with ADNS-300 for therapeutic VNS. In addition, compound action potentials (CAPs) were recorded to evaluate activation of the vagus nerve in response to VNS. Methods: Three patients were implanted with a cuff-electrode around the left vagus nerve, that was connected to a rechargeable pulse generator under the left clavicula. Two weeks after surgery, therapeutic VNS (0.25-1.25 mA, 500 mu s, 30s on, 10 min off and 30 Hz) was initiated and stimulus-induced CAPs were recorded. Results: The ADNS-300 system was successfully implanted in all three patients and patients were appropriately stimulated during six months of follow-up. A reduction in seizure frequency was demonstrated in two patients (43% and 40% in patients 1 and 3, respectively), while in patient 2 seizure frequency remained unchanged. CAPs could be recorded in patients 1 and 2, proving stimulation-induced activation of the vagus nerve. Conclusion: This feasibility study demonstrates that the ADNS-300 system can be used for combined therapeutic stimulation (in 3/3 patients) and recording of CAPs in response to VNS (in 2/3 patients) up to three weeks after surgery. Implantation in a larger number of patients will lead to a better understanding of the electrophysiology of the vagus nerve, which in turn could result in more adequate and individualized VNS parameter choice. (C) 2010 Elsevier B.V. All rights reserved.
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