Epilepsia open
Transcutaneous auricular vagus nerve stimulation in drug-resistant epilepsy: A randomized, sham-controlled crossover trial with exploratory EEG and MRI response phenotyping
By Hong SJ, Yang SY, Bok EK and 4 others.
Abstract
Objective
Transcutaneous auricular vagus nerve stimulation (taVNS) is a noninvasive neuromodulation strategy for drug-resistant epilepsy, but clinical response is heterogeneous. We examined whether electroencephalographic (EEG) and structural magnetic resonance imaging (MRI) phenotypes were associated with active-specific clinical benefit from taVNS.
Methods
In this single-center, randomized, double-blind, sham-controlled crossover exploratory pilot trial, 14 patients with drug-resistant focal epilepsy received 8 weeks of active taVNS and 8 weeks of sham stimulation, separated by a 4-week washout, in randomized sequence. The primary clinical outcome was seizure reduction ratio (SRR) during active versus sham stimulation. Active-specific clinical benefit was defined as ΔSRR = SRR_active - SRR_sham. Resting-state EEG was obtained at baseline and at the end of the protocol. Changes in regional relative band power were correlated with ΔSRR, with a focus on the β band based on prior evidence of vagal stimulation-related desynchronization. Baseline structural MRI findings were explored by active-phase responder status.