Connectomic Profiling Identifies Responders to Vagus Nerve Stimulation

Annals of Neurology
Karim MithaniGeorge M Ibrahim

Abstract

Vagus nerve stimulation (VNS) is a common treatment for medically intractable epilepsy, but response rates are highly variable, with no preoperative means of identifying good candidates. This study aimed to predict VNS response using structural and functional connectomic profiling. Fifty-six children, comprising discovery (n = 38) and validation (n = 18) cohorts, were recruited from 3 separate institutions. Diffusion tensor imaging was used to identify group differences in white matter microstructure, which in turn informed beamforming of resting-state magnetoencephalography recordings. The results were used to generate a support vector machine learning classifier, which was independently validated. This algorithm was compared to a second classifier generated using 31 clinical covariates. Treatment responders demonstrated greater fractional anisotropy in left thalamocortical, limbic, and association fibers, as well as greater connectivity in a functional network encompassing left thalamic, insular, and temporal nodes (p < 0.05). The resulting classifier demonstrated 89.5% accuracy and area under the receiver operating characteristic (ROC) curve of 0.93 on 10-fold cross-validation. In the external validation cohort, this model d...Continue Reading

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Citations

Jan 9, 2020·The International Journal of Neuroscience·Jinbiao XiongQing Yu
Aug 31, 2020·Epilepsia·Adriana M WorkewychGeorge M Ibrahim
Oct 8, 2020·Brain Sciences·Niels Alexander FoitNeda Ladbon-Bernasconi
Nov 26, 2020·Epilepsia·Sara LarivièreBoris C Bernhardt
Dec 31, 2020·Neuromodulation : Journal of the International Neuromodulation Society·Jordan LamDarrin J Lee
Jan 11, 2021·Brain Stimulation·Marius KeuteAlireza Gharabaghi
Feb 17, 2021·Regional Anesthesia and Pain Medicine·Tina L Doshi, Peter S Staats
Feb 27, 2021·Seizure : the Journal of the British Epilepsy Association·Stephanie HödlKristl Vonck
Mar 19, 2021·Acta Neurologica Scandinavica·Dong Ah LeeKang Min Park
Mar 30, 2021·Expert Review of Neurotherapeutics·Hiroshi OtsuboElysa Widjaja
Apr 10, 2020·Seizure : the Journal of the British Epilepsy Association·Hitten P ZaveriKlaus Lehnertz
May 21, 2021·Cortex; a Journal Devoted to the Study of the Nervous System and Behavior·Marius KeuteTino Zaehle
Jul 10, 2021·Frontiers in Neuroscience·Daichi Sone, Iman Beheshti
Aug 11, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Dong Ah LeeKang Min Park
Oct 14, 2021·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Caren Armstrong, Eric D Marsh

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