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Epilepsy, Headache, Vertigo

開催日 2014/9/11
時間 16:00 - 17:00
会場 Poster / Exhibition(Event Hall B)

Slow cortical potential shift as a candidate marker for the efficacy of vagus nerve stimulation for seizure suppression

  • P1-358
  • バヤスガラン ボルギル / Borgil Bayasgalan:1 松橋 眞生 / Masao Matsuhashi:4,5 松本 理器 / Riki Matsumoto:2 中野 直樹 / Naoki Nakano:3 下竹 昭寛 / Akihiro Shimotake:1 文室 知之 / Tomoyuki Fumuro:5 國枝 武治 / Takeharu Kunieda:6 加藤 天美 / Amami Kato:3 高橋 良輔 / Ryousuke Takahashi:1 池田 昭夫 / Akio Ikeda:2 
  • 1:京都大院医脳病態生理 / Department of Neurology, Kyoto University Graduate School of Medicine 2:京都大院・医・てんかん・運動異常生理学講座 / Department of Epilepsy, Movement Disorders and Physiology 3:近畿大・医・脳神経外科 / Department of Neurosurgery, Kinki University School of Medicine 4:京都大院・脳機能総合研究センター / Human Brain Research Center, Kyoto University Graduate School of Medicine 5:京都大・学際融合教育研究推進センター・健康長寿社会の総合医療開発ユニット / Research and Educational Unit of Leaders for Integrated Medical System, Kyoto University 6:京都大・医・脳神経外科 / Department of Neurosurgery, Kyoto University Graduate School of Medicine 

Purpose: The purpose of this research is to study mechanism of vagus nerve stimulation (VNS) for seizure reduction by analyzing slow cortical potentials (SCP), and to evaluate plausibility of SCP as a biomarker for predicting good responders of VNS in advance.
Method: We analyzed clinical routine EEGs from 11 patients with intractable epilepsy treated with VNS. These EEGs were recorded by AC coupled amplifier with hardware time constant (TC) 10 sec in 7 patients and 2 sec in the remaining 4 patients.
5 patients with TC 10 sec recording had a seizure frequency reduction >50% and showed positive SCP during VNS on-time. The remaining 2 patients had seizure reduction <50%, and did not show significant positive or negative shift. Correlation between positive SCP and seizure reduction >50% was significant (Fisher's exact test =0.048)
In TC 2 sec recorded patient group, 1 patient with seizure reduction >50% showed SCP positivity. In another patient with seizure reduction >50%, SCP showed negative shift. The remaining 2 patients had seizure reduction <50%, and no significant SCP shift to positivity or negativity was observed. As the number of patients in this group was small, statistical analysis was not performed.
Conclusion: Positive polarity of SCP associated with VNS could represent the inhibitory activity induced by VNS on the seizure control. SCP could be a biomarker to predict the good responders before VNS surgery if we would apply transient, noninvasive methods such as transcutaneous VNS before surgery. Recording with TC 10 sec may show more informative SCP than recording with TC 2 sec. Initial large potential due to polarized electrodes may distort biological slow activity and this should be taken into account.

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