Page 91 - 南京医科大学学报自然科学版

第43卷第12期 南京医科大学学报（自然科学版）
2023年12月 Journal of Nanjing Medical University（Natural Sciences） ·1707 ·

·临床研究·

迷走神经刺激对难治性癫痫脑功能连接的即时效应

陈芳卿 ，李跃军 ，朱海涛 ，张 锐 ，陈奇琦 1，2*
1
1
1
1，2
南京医科大学附属脑科医院功能神经外科，脑磁图科，江苏 南京 210029
1 2
［摘 要］ 目的：研究迷走神经刺激（vagal nerve stimulation，VNS）对药物难治性癫痫（drug⁃resistant epilepsy，DRE）患者脑功能
连接的即时效应，探讨VNS抑制癫痫发作的作用机制。方法：采集14例正常被试静息态和14例DRE患者静息态和刺激态的
脑磁图数据，分6个频段分析即时VNS引起的DRE患者脑功能连接的改变。结果：在静息态，DRE患者相对正常被试，功能连
接显著增强。当VNS发生时，DRE患者有显著降低的功能连接，包括theta频段的左侧额中回⁃右侧嗅皮质和左侧丘脑⁃右侧距
状裂周围皮层，alpha频段的左侧丘脑⁃左侧颞极颞中回之间的连接。结论：即时VNS可以降低DRE患者脑功能连接，即降低患
者脑网络对发作的易损性，这可能是VNS调节DRE患者神经系统抑制癫痫发作的重要机制。
［关键词］ 迷走神经刺激；脑网络；功能连接；难治性癫痫；脑磁图
［中图分类号］ R742.1 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）12⁃1707⁃07
doi：10.7655/NYDXBNS20231214

Immediate effects of vagal nerve stimulation in brain functional connectivity in refractory
epilepsy

1
1，2
1
1
CHEN Fangqing ，LI Yuejun ，ZHU Haitao ，ZHANG Rui ，CHEN Qiqi 1，2*
Department of Functional Neurosurgery，Department of Magnetoencephalography，Nanjing Brain Hospital Affiliated
1 2
to Nanjing Medical University，Nanjing 210029，China
［Abstract］ Objective：To investigate the immediate effects of vagal nerve stimulation（VNS）on the brain functional connectivity of
patients with drug ⁃ resistant epilepsy（DRE）and explore the mechanism by whichVNS inhibits epileptic seizures. Methods：

Magnetoencephalography（MEG）data were collected from 14 healthy subjects in a resting state and from 14 DRE patients in both
resting and stimulated states. The changes in brain functional connectivity induced by immediate VNS were analyzed in six frequency
bands. Results：In the resting state，DRE patients showed significantly enhanced functional connectivity compared to healthy subjects.
When VNS occurred，DRE patients exhibited significantly reduced functional connectivity，including the connections between the left
middle frontal gyrus and the right olfactory cortex and the connections between the left thalamus and the surrounding cortex of the right
calcarine fissure in the theta frequency band，and the connections between the left thalamus and the left temporal polar middle
temporal gyrus in the alpha frequency band. Conclusion：Immediate VNS can reduce the brain functional connectivity of DRE
patients，thereby reducing the vulnerability of the brain network to seizures. This might be an important mechanism by which VNS
modulates the inhibition of epileptic seizures in DRE patients.
［Key words］ vagal nerve stimulation；brain network；functional connectivity；drug⁃refractory epilepsy；magnetoencephalography
［J Nanjing Med Univ，2023，43（12）：1707⁃1713］

迷走神经刺激（vagal nerve stimulation，VNS）作 展应用20多年，每年有数以万计的药物难治性癫痫
为一种治疗癫痫的神经调节方法，在临床上已经开 （drug⁃refractory epilepsy，DRE）患者接受VNS手术治
［1］
疗 。研究报道 26%~40%的 DRE 患者在接受 VNS
［2］
［基金项目］ 南京市卫健委项目（YKK22143，YKK21111） 治疗后，癫痫发作的频数能减少 50%以上 。而
∗ 且，接受 VNS 治疗的 DRE 患者认知功能也能得到
通信作者（Corresponding author），E⁃mail：chenqiqi@njmu.edu.cn