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

Authors
 Rita Yu  ;  Hae‐Jeong Park  ;  Hojin Cho  ;  Ara Ko  ;  Chongwon Pae  ;  Maeng‐Keun Oh  ;  Hoon‐Chul Kang  ;  Heung Dong Kim  ;  Eun‐Kyung Park  ;  Kyu‐Won Shim  ;  Dong Suk Kim  ;  Joon Soo Lee 
Citation
 Epilepsia, Vol.59(12) : 2249-2259, 2018 
Journal Title
 Epilepsia 
ISSN
 0013-9580 
Issue Date
2018
Keywords
2-deoxy-2[18F]fluoro-D-glucose (FDG) PET ; epilepsy ; metabolic connectivity ; vagus nerve stimulation
Abstract
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[18 F]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% reduction) and compared metabolic connectivity differences between groups using a permutation test. RESULTS: Thirty-four (55.7%) patients showed >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 <50% seizure control after VNS. SIGNIFICANCE: This study shows that seizure outcome of VNS may be influenced by metabolic connectivity, which can be obtained from preoperative PET imaging. This study of metabolic connectivity analysis may contribute in further understanding of the mechanism of VNS in intractable seizures.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/epi.14590
DOI
10.1111/epi.14590
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
강훈철(Kang, Hoon Chul) ORCID logo https://orcid.org/0000-0002-3659-8847
김동석(Kim, Dong Seok)
김흥동(Kim, Heung Dong) ORCID logo https://orcid.org/0000-0002-8031-7336
박은경(Park, Eun Kyung)
박해정(Park, Hae Jeong) ORCID logo https://orcid.org/0000-0002-4633-0756
심규원(Shim, Kyu Won) ORCID logo https://orcid.org/0000-0002-9441-7354
오맹근(Oh, Maeng Keun)
이준수(Lee, Joon Soo) ORCID logo https://orcid.org/0000-0001-9036-9343
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166773
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