| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Departments of Neurology (Drs. Henry, Pennell, Epstein, Grafton, and Hoffman), Neurosurgery (Dr. Bakay), and Radiology (Drs. Votaw, Faber, Grafton, and Hoffman), Emory University School of Medicine, Atlanta, GA.
Address correspondence and reprint requests to Dr. Thomas R. Henry, Department of Neurology, Emory University, Woodruff Memorial Research Building, Suite 6000, 1639 Pierce Drive, Atlanta, GA 30322; e-mail: thenr01{at}emory.edu
OBJECTIVE: To determine possible sites of therapeutic action of vagus nerve stimulation (VNS), by correlating acute VNS-induced regional cerebral blood flow (rCBF) alterations and chronic therapeutic responses.
BACKGROUND: We previously found that VNS acutely induces rCBF alterations at sites that receive vagal afferents and higher-order projections, including dorsal medulla, somatosensory cortex (contralateral to stimulation), thalamus and cerebellum bilaterally, and several limbic structures (including hippocampus and amygdala bilaterally).
METHODS: VNS-induced rCBF changes were measured by subtracting resting rCBF from rCBF during VNS, using [O-15]water and PET, immediately before ongoing VNS began, in 11 partial epilepsy patients. T-statistical mapping established relative rCBF increases and decreases for each patient. Percent changes in frequency of complex partial seizures (with or without secondary generalization) during three months of VNS compared with pre-VNS baseline, and T-thresholded rCBF changes (for each of the 25 regions of previously observed significant CBF change), were rank ordered across patients. Spearman rank correlation coefficients assessed associations of seizure-frequency change and t-thresholded rCBF change.
RESULTS: Seizure-frequency changes ranged from 71% decrease to 12% increase during VNS. Only the right and left thalami showed significant associations of rCBF change with seizure-frequency change. Increased right and left thalamic CBF correlated with decreased seizures (p < 0.001).
CONCLUSIONS: Increased thalamic synaptic activities probably mediate some antiseizure effects of VNS. Future studies should examine neurotransmitter-receptor alterations in reticular and specific thalamic nuclei during VNS.
This article has been cited by other articles:
|
|
 |
|
  S.-I. Ito and A. D. Craig Vagal-Evoked Activity in the Parafascicular Nucleus of the Primate Thalamus J Neurophysiol, October 1, 2005; 94(4): 2976 - 2982. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Handforth, W. G. Ondo, S. Tatter, G. W. Mathern, R. K. Simpson Jr., F. Walker, J. P. Sutton, J. P. Hubble, and J. Jankovic Vagus nerve stimulation for essential tremor: A pilot efficacy and safety trial Neurology, November 25, 2003; 61(10): 1401 - 1405. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Buchhalter and R. G. Jarrar Therapeutics in Pediatric Epilepsy, Part 2: Epilepsy Surgery and Vagus Nerve Stimulation Mayo Clin. Proc., March 1, 2003; 78(3): 371 - 378. [Abstract] [PDF]
|
|
|
|
|
|
A. A. Cohen-Gadol, J. W. Britton, N. M. Wetjen, W. R. Marsh, F. B. Meyer, and C. Raffel Neurostimulation Therapy for Epilepsy: Current Modalities and Future Directions Mayo Clin. Proc., February 1, 2003; 78(2): 238 - 248. [Abstract] [PDF]
|
|
|
|
|
|
T. R. Henry Therapeutic mechanisms of vagus nerve stimulation Neurology, September 24, 2002; 59(90064): S3 - 14. [Abstract] [Full Text]
|
|
|
|
 |
|
 V. Bouilleret, M. P. Valenti, E. Hirsch, F. Semah, and I. J. Namer Correlation Between PET and SISCOM in Temporal Lobe Epilepsy J. Nucl. Med., August 1, 2002; 43(8): 991 - 998. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kirchner, H. Stefan, M. Schmelz, K. M. Haslbeck, and F. Birklein Influence of vagus nerve stimulation on histamine-induced itching Neurology, July 9, 2002; 59(1): 108 - 112. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Van Laere, K. Vonck, P. Boon, J. Versijpt, and R. Dierckx Perfusion SPECT Changes After Acute and Chronic Vagus Nerve Stimulation in Relation to Prestimulus Condition and Long-Term Clinical Efficacy J. Nucl. Med., June 1, 2002; 43(6): 733 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Lanska J.L. Corning and vagal nerve stimulation for seizures in the 1880s Neurology, February 12, 2002; 58(3): 452 - 459. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. E. Fanselow, A. P. Reid, and M. A. L. Nicolelis Reduction of Pentylenetetrazole-Induced Seizure Activity in Awake Rats by Seizure-Triggered Trigeminal Nerve Stimulation J. Neurosci., November 1, 2000; 20(21): 8160 - 8168. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. I. Sirven, M. Sperling, D. Naritoku, S. Schachter, D. Labar, M. Holmes, A. Wilensky, J. Cibula, D. M. Labiner, D. Bergen, et al. Vagus nerve stimulation therapy for epilepsy in older adults Neurology, March 14, 2000; 54(5): 1179 - 1182. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. P. Lesser Unexpected places Neurology, April 1, 1999; 52(6): 1117 - 1117. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
