Optimized microburst VNS elicits fMRI responses beyond thalamic‐specific response from standard VNS

Objective In parallel to standard vagus nerve stimulation (VNS), microburst stimulation delivery has been developed. We evaluated the fMRI‐related signal changes associated with standard and optimized microburst stimulation in a proof‐of‐concept study (NCT03446664). Methods Twenty‐nine drug‐resistan...

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Bibliographic Details
Published in:Annals of clinical and translational neurology 2024-05, Vol.11 (5), p.1135-1147
Main Authors: Szaflarski, Jerzy P., Allendorfer, Jane B., Begnaud, Jason, Ranuzzi, Giovanni, Shamshiri, Elhum, Verner, Ryan, McDermott, Danielle, Brown, Mesha Gay, Macken, Michael, Bellinski, Irena, Cunningham, Elizabeth, O'Dwyer, Rebecca, Lynn, Fiona, Tatum, William O., Benbadis, Selim R., Jaisani, Zeenat, Zafar, Muhammad, Newman, Blake, Aydemir, Seyhmus, Vonck, Kristl, Mertens, Ann, Drees, Cornelia, Afra, Pegah, Kaye, Leslie, Gordon, Charles, Keith, Amy, Fetzer, Steffen, Jiang, Mei, Giannicola, Gaia, Van Grunderbeek, Wim
Format: Article
Language:English
Subjects:
Adolescent
Adult
Brain
Convulsions & seizures
Drug resistance
Drug Resistant Epilepsy - diagnostic imaging
Drug Resistant Epilepsy - physiopathology
Drug Resistant Epilepsy - therapy
Epilepsy
Female
Functional Neuroimaging - methods
Functional Neuroimaging - standards
Hispanic Americans
Humans
Magnetic Resonance Imaging
Male
Medical imaging
Middle Aged
Monkeys & apes
Neuroimaging
Proof of Concept Study
Prospective Studies
Thalamus - diagnostic imaging
Vagus Nerve Stimulation - methods
Young Adult
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Summary:Objective In parallel to standard vagus nerve stimulation (VNS), microburst stimulation delivery has been developed. We evaluated the fMRI‐related signal changes associated with standard and optimized microburst stimulation in a proof‐of‐concept study (NCT03446664). Methods Twenty‐nine drug‐resistant epilepsy patients were prospectively implanted with VNS. Three 3T fMRI scans were collected 2 weeks postimplantation. The maximum tolerated VNS intensity was determined prior to each scan starting at 0.125 mA with 0.125 mA increments. FMRI scans were block‐design with alternating 30 sec stimulation [ON] and 30 sec no stimulation [OFF]: Scan 1 utilized standard VNS and Scan 3 optimized microburst parameters to determine target settings. Semi‐automated on‐site fMRI data processing utilized ON–OFF block modeling to determine VNS‐related fMRI activation per stimulation setting. Anatomical thalamic mask was used to derive highest mean thalamic t‐value for determination of microburst stimulation parameters. Paired t‐tests corrected at P 
ISSN:2328-9503
2328-9503
DOI:10.1002/acn3.52029