Interregional metabolic connectivity of 2‐deoxy‐2[18F]fluoro‐D‐glucose positron emission tomography in vagus nerve stimulation for pediatric patients with epilepsy: A retrospective cross‐sectional study

Summary Objective With the recognition of epilepsy as a network disease that disrupts the organizing ability of resting‐state brain networks, vagus nerve stimulation (VNS) may control epileptic seizures through modulation of functional connectivity. We evaluated preoperative 2‐deoxy‐2[18F]fluoro‐D‐g...

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Published in:Epilepsia (Copenhagen) 2018-12, Vol.59 (12), p.2249-2259
Main Authors: Yu, Rita, Park, Hae‐Jeong, Cho, Hojin, Ko, Ara, Pae, Chongwon, Oh, Maeng‐Keun, Kang, Hoon‐Chul, Kim, Heung Dong, Park, Eun‐Kyung, Shim, Kyu‐Won, Kim, Dong Suk, Lee, Joon Soo
Format: Article
Language:English
Subjects:
2‐deoxy‐2[18F]fluoro‐D‐glucose (FDG) PET
epilepsy
metabolic connectivity
vagus nerve stimulation
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Summary:Summary Objective With the recognition of epilepsy as a network disease that disrupts the organizing ability of resting‐state brain networks, vagus nerve stimulation (VNS) may control epileptic seizures through modulation of functional connectivity. We evaluated preoperative 2‐deoxy‐2[18F]fluoro‐D‐glucose (FDG) positron emission tomography (PET) in VNS‐implanted pediatric patients with refractory epilepsy to analyze the metabolic connectivity of patients and its prognostic role in seizure control. Methods Preoperative PET data of 66 VNS pediatric patients who were followed up for a minimum of 1 year after the procedure were collected for the study. Retrospective review of the patients’ charts was performed, and five patients with inappropriate PET data or major health issues were excluded. We conducted an independent component analysis of FDG‐PET to extract spatial metabolic components and their activities, which were used to perform cross‐sectional metabolic network analysis. We divided the patients into VNS‐effective and VNS‐ineffective groups (VNS‐effective group, ≥50% seizure reduction; VNS‐ineffective group, 50% seizure reduction from baseline frequency 1 year after VNS. A significant difference in metabolic connectivity evaluated by preoperative FDG‐PET was noted between groups. Relative changes in glucose metabolism were strongly connected among the areas of brainstem, cingulate gyrus, cerebellum, bilateral insula, and putamen in patients with
ISSN:0013-9580
1528-1167
DOI:10.1111/epi.14590