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

Rita Yu, Hae Jeong Park, Hojin Cho, Ara Ko, Chongwon Pae, Maeng Keun Oh, hoonchul kang, HeungDong Kim, Eun Kyung Park, Kyu Won Shim, Dong Suk Kim, Joon Soo Lee

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)2249-2259
Number of pages11
JournalEpilepsia
Volume59
Issue number12
DOIs
Publication statusPublished - 2018 Dec 1

Fingerprint

Vagus Nerve Stimulation
Positron-Emission Tomography
Epilepsy
Cross-Sectional Studies
Pediatrics
Glucose
Seizures
Putamen
Gyrus Cinguli
Metabolic Networks and Pathways
Cerebellum
Brain Stem

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Yu, Rita ; Park, Hae Jeong ; Cho, Hojin ; Ko, Ara ; Pae, Chongwon ; Oh, Maeng Keun ; kang, hoonchul ; Kim, HeungDong ; Park, Eun Kyung ; Shim, Kyu Won ; Kim, Dong Suk ; Lee, Joon Soo. / 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. In: Epilepsia. 2018 ; Vol. 59, No. 12. pp. 2249-2259.
@article{cd5e19ed280f4dfeb91a03c429bcfd22,
title = "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",
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.",
author = "Rita Yu and Park, {Hae Jeong} and Hojin Cho and Ara Ko and Chongwon Pae and Oh, {Maeng Keun} and hoonchul kang and HeungDong Kim and Park, {Eun Kyung} and Shim, {Kyu Won} and Kim, {Dong Suk} and Lee, {Joon Soo}",
year = "2018",
month = "12",
day = "1",
doi = "10.1111/epi.14590",
language = "English",
volume = "59",
pages = "2249--2259",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "12",

}

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. / Yu, Rita; Park, Hae Jeong; Cho, Hojin; Ko, Ara; Pae, Chongwon; Oh, Maeng Keun; kang, hoonchul; Kim, HeungDong; Park, Eun Kyung; Shim, Kyu Won; Kim, Dong Suk; Lee, Joon Soo.

In: Epilepsia, Vol. 59, No. 12, 01.12.2018, p. 2249-2259.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Interregional metabolic connectivity of 2-deoxy-2[ 18 F]fluoro-D-glucose positron emission tomography in vagus nerve stimulation for pediatric patients with epilepsy

T2 - A retrospective cross-sectional study

AU - Yu, Rita

AU - Park, Hae Jeong

AU - Cho, Hojin

AU - Ko, Ara

AU - Pae, Chongwon

AU - Oh, Maeng Keun

AU - kang, hoonchul

AU - Kim, HeungDong

AU - Park, Eun Kyung

AU - Shim, Kyu Won

AU - Kim, Dong Suk

AU - Lee, Joon Soo

PY - 2018/12/1

Y1 - 2018/12/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85055881958&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055881958&partnerID=8YFLogxK

U2 - 10.1111/epi.14590

DO - 10.1111/epi.14590

M3 - Article

C2 - 30370541

AN - SCOPUS:85055881958

VL - 59

SP - 2249

EP - 2259

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 12

ER -