SPECT imaging of cerebral blood flow changes induced by acute trigeminal nerve stimulation in drug-resistant epilepsy. A pilot study
Academic Article
Publication Date:
2021
Short description:
SPECT imaging of cerebral blood flow changes induced by acute trigeminal nerve stimulation in drug-resistant epilepsy. A pilot study / Mercante, B., Nuvoli, S., Sotgiu, M.A., Manca, A., Todesco, S., Melis, F., Spanu, A., Deriu, F.. - In: CLINICAL NEUROPHYSIOLOGY. - ISSN 1388-2457. - 132:Mar 24(2021), pp. 1274-1282. [10.1016/j.clinph.2021.01.033]
abstract:
Objective: To explore the cortical areas targeted by acute transcutaneous trigeminal nerve stimulation (TNS) in patients with drug-resistant epilepsy (DRE) using single photon emission computed tomography (SPECT).
Methods: Ten patients with DRE underwent brain SPECT at baseline and immediately after a 20-minute TNS (0.25 ms; 120 Hz; 30 s ON and 30 s OFF) applied bilaterally to the infraorbital nerve. The French Color Standard International Scale was used for qualitative analyses and z-scores were used to calculate the Odds Ratio (OR).
Results: At baseline global hypoperfusion (mainly in temporo-mesial, temporo-parietal and fronto-temporal and temporo-occipital areas) was detected in all patients. Following TNS, a global increase in cortical tracer uptake and a significant decrease in median hypoperfusion score were observed. A significant effect favoring a general TNS-induced increase in cortical perfusion (OR = 4.96; p = 0.0005) was detected in 70% of cases, with significant effects in the limbic (p = 0.003) and temporal (p = 0.003) lobes. Quantitative analyses of z-scores confirmed significant TNS-induced increases in perfusion in the temporal (+0.59 SDs; p = 0.001), and limbic (+0.43 SDs; p = 0.03) lobes.
Conclusion: Short-term TNS is followed a global increase in cortical perfusion, namely in the temporal and limbic lobes.
Significance: The TNS-induced perfusion increase may reflect neurons' activity changes in cortical areas implicated in the epilepsy network.
Methods: Ten patients with DRE underwent brain SPECT at baseline and immediately after a 20-minute TNS (0.25 ms; 120 Hz; 30 s ON and 30 s OFF) applied bilaterally to the infraorbital nerve. The French Color Standard International Scale was used for qualitative analyses and z-scores were used to calculate the Odds Ratio (OR).
Results: At baseline global hypoperfusion (mainly in temporo-mesial, temporo-parietal and fronto-temporal and temporo-occipital areas) was detected in all patients. Following TNS, a global increase in cortical tracer uptake and a significant decrease in median hypoperfusion score were observed. A significant effect favoring a general TNS-induced increase in cortical perfusion (OR = 4.96; p = 0.0005) was detected in 70% of cases, with significant effects in the limbic (p = 0.003) and temporal (p = 0.003) lobes. Quantitative analyses of z-scores confirmed significant TNS-induced increases in perfusion in the temporal (+0.59 SDs; p = 0.001), and limbic (+0.43 SDs; p = 0.03) lobes.
Conclusion: Short-term TNS is followed a global increase in cortical perfusion, namely in the temporal and limbic lobes.
Significance: The TNS-induced perfusion increase may reflect neurons' activity changes in cortical areas implicated in the epilepsy network.
Iris type:
1.1 Articolo in rivista
Keywords:
Brain SPECT; Cerebral blood flow; Cerebral perfusion; Drug-resistant epilepsy; Trigeminal nerve stimulation.
List of contributors:
Mercante, Beniamina; Nuvoli, Susanna; Sotgiu, Maria A.; Manca, Andrea; Todesco, Sara; Melis, Francesco; Spanu, Angela; Deriu, Franca
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