The association between DTI-based thalamocortical structural connection and the efficacy of vagus nerve stimulation in patients with drug-resistant epilepsy

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior Pub Date : 2025-10-02 DOI:10.1016/j.yebeh.2025.110734

Zi-Ao Xu, Bohang Liu, Ming Shan, Xue-Fei Ji, Lei Ye, Hong-Wei Cheng

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引用次数: 0

Abstract

Aim

Vagus nerve stimulation (VNS) is an important treatment option for patients with drug-resistant epilepsy (DRE). However, there is a lack of effective indicators to predict the efficacy of VNS. We aimed to investigate the correlation between thalamocortical structural connection and efficacy of VNS treatment.

Method

A total of 31 DRE patients and 30 healthy individuals were recruited. All participants received cranial DTI scans. The thalamic subareas were segmented as the region of interest (ROI) by probabilistic tractography. Five pathways of the structural connection between thalamus ROI and corresponding cerebral cortex ROI were analyzed respectively, including thalamus-prefrontal cortex (thalamus-PFC), thalamus-motor and premotor cortex (thalamus-MC), thalamus-somatosensory cortex (thalamus-SC), thalamus- parietal and occipital cortex (POC) and thalamus-temporal cortex (thalamus-TC). The integrity of the thalamocortical structural connection was evaluated by 4 indices, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD). The correlation between thalamocortical structural connections and the response to VNS treatment were then analyzed.

Results

DRE patients exhibited significantly lower FA values in the thalamus-PFC, thalamus-MC, thalamus-SC, thalamus-POC, and thalamus-TC regions compared to controls, with increased MD and RD values in the thalamus-PFC, thalamus-SC and thalamus-MC regions. Within the DRE group, the FA values in the thalamus-PFC and thalamus-TC regions were significantly higher, while the RD values were significantly lower compared to the other three regions. DRE patients who had better response to VNS treatment had higher FA values in the thalamus-PFC and thalamus-TC regions.

Conclusion

there are damages of neural fiber integrity within the thalamo-cortical connection pathway in DRE patients, which is associated with demyelinating lesions. Those patients with relatively intact thalamo-cortical connections tend to achieve better response to VNS treatment.

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基于dti的丘脑皮质结构连接与耐药癫痫迷走神经刺激疗效的关系

迷走神经刺激（VNS）是治疗耐药癫痫（DRE）的重要方法。然而，目前还缺乏有效的指标来预测VNS的疗效。我们的目的是探讨丘脑皮质结构连接与VNS治疗效果之间的关系。方法共招募31例DRE患者和30例健康人。所有参与者都接受了颅脑DTI扫描。利用概率神经束成像技术将丘脑亚区分割为感兴趣区域（ROI）。分别分析了丘脑-前额叶皮质（thalamus- pfc）、丘脑-运动和前运动皮质（thalamus- mc）、丘脑-体感皮质（thalamus- sc）、丘脑-顶叶和枕叶皮质（POC）和丘脑-颞叶皮质（thalamus- tc）这5条丘脑- ROI与相应大脑皮层之间的结构连接通路。采用分数各向异性（FA）、平均扩散率（MD）、径向扩散率（RD）和轴向扩散率（AD） 4个指标评价丘脑皮质结构连接的完整性。然后分析丘脑皮质结构连接与VNS治疗反应之间的相关性。结果与对照组相比，dre患者在丘脑- pfc、丘脑- mc、丘脑- sc、丘脑- poc和丘脑- tc区域的FA值显著降低，而丘脑- pfc、丘脑- sc和丘脑- mc区域的MD和RD值升高。在DRE组中，丘脑- pfc和丘脑- tc区域的FA值显著高于其他三个区域，而RD值显著低于其他三个区域。对VNS治疗反应较好的DRE患者在丘脑- pfc和丘脑- tc区域的FA值较高。结论DRE患者丘脑-皮层连接通路内存在神经纤维完整性损伤，与脱髓鞘病变有关。丘脑-皮层连接相对完整的患者对VNS治疗的反应更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.