Frontiers in Neurology (Feb 2022)
Brainstem Associated Somatosensory Evoked Potentials and Response to Vagus Nerve Stimulation: An Investigation of the Vagus Afferent Network
- Hrishikesh Suresh,
- Hrishikesh Suresh,
- Hrishikesh Suresh,
- Karim Mithani,
- Karim Mithani,
- Karanbir Brar,
- Han Yan,
- Han Yan,
- Han Yan,
- Samuel Strantzas,
- Mike Vandenberk,
- Roy Sharma,
- Ivanna Yau,
- Christina Go,
- Elizabeth Pang,
- Elizabeth Pang,
- Elizabeth Kerr,
- Elizabeth Kerr,
- Ayako Ochi,
- Hiroshi Otsubo,
- Puneet Jain,
- Elizabeth Donner,
- O. Carter Snead,
- O. Carter Snead,
- O. Carter Snead,
- George M. Ibrahim,
- George M. Ibrahim,
- George M. Ibrahim,
- George M. Ibrahim
Affiliations
- Hrishikesh Suresh
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Hrishikesh Suresh
- Program in Neuroscience and Mental Health, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Hrishikesh Suresh
- Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Karim Mithani
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Karim Mithani
- Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Karanbir Brar
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
- Han Yan
- Program in Neuroscience and Mental Health, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Han Yan
- Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Han Yan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Samuel Strantzas
- Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Mike Vandenberk
- Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Roy Sharma
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- Ivanna Yau
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- Christina Go
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- Elizabeth Pang
- Program in Neuroscience and Mental Health, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Elizabeth Pang
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- Elizabeth Kerr
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- Elizabeth Kerr
- Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
- Ayako Ochi
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- Hiroshi Otsubo
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- Puneet Jain
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- Elizabeth Donner
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- O. Carter Snead
- Program in Neuroscience and Mental Health, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- O. Carter Snead
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- O. Carter Snead
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- George M. Ibrahim
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- George M. Ibrahim
- Program in Neuroscience and Mental Health, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- George M. Ibrahim
- Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- George M. Ibrahim
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- DOI
- https://doi.org/10.3389/fneur.2021.768539
- Journal volume & issue
-
Vol. 12
Abstract
Despite decades of clinical usage, selection of patients with drug resistant epilepsy who are most likely to benefit from vagus nerve stimulation (VNS) remains a challenge. The mechanism of action of VNS is dependent upon afferent brainstem circuitry, which comprises a critical component of the Vagus Afferent Network (VagAN). To evaluate the association between brainstem afferent circuitry and seizure response, we retrospectively collected intraoperative data from sub-cortical recordings of somatosensory evoked potentials (SSEP) in 7 children with focal drug resistant epilepsy who had failed epilepsy surgery and subsequently underwent VNS. Using multivariate linear regression, we demonstrate a robust negative association between SSEP amplitude (p < 0.01), and seizure reduction. There was no association between SSEP latency and seizure outcomes. Our findings provide novel insights into the mechanism of VNS and inform our understanding of the importance of brainstem afferent circuitry within the VagAN for seizure responsiveness following VNS.
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