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Abstract
Vagus nerve stimulation (VNS) is an adjunctive treatment for drug-resistant epilepsy (DRE). However, it is still difficult to predict which patients will respond to VNS treatment and to what extent. We aim to explore the relationship between preoperative heart rate variability (HRV) and VNS outcome. 50 healthy control subjects and 63 DRE patients who had received VNS implants and had at least one year of follow up were included. The preoperative HRV were analyzed by traditional linear methods and heart rhythm complexity analyses with multiscale entropy (MSE). DRE patients had significantly lower complexity indices (CI) as well as traditional linear HRV measurements than healthy controls. We also found that non-responders0 had significantly lower preoperative CI including Area 1–5, Area 6–15 and Area 6–20 than those in the responders0 while those of the non-responders50 had significantly lower RMSSD, pNN50, VLF, LF, HF, TP and LF/HF than the responders50. In receiver operating characteristic (ROC) curve analysis, Area 6–20 and RMSSD had the greatest discriminatory power for the responders0 and non-responders0, responders50 and non-responders50, respectively. Our results suggest that preoperative assessment of HRV by linear and MSE analysis can help in predicting VNS outcomes in patients with DRE.
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Details
1 National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China; Department of Biomedical Engineering, Chinese PLA General Hospital, Fuxing Road, Beijing, China
2 National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China
3 Beijing Neurosurgical Institute, Beijing, China; Neurosurgery, Beijing Tian Tan Hospital Capital Medical University, Beijing, China
4 Neurosurgery, Sanbo Brain Hospital Capital Medical University, Beijing, China
5 Neurosurgery, Peking University First Hospital FengTai Hospital, Beijing, China
6 Neurosurgery, Chinese PLA General Hospital, Fuxing Road, Beijing, China
7 Neurosurgery, TsingHua University YuQuan Hospital, Beijing, China
8 Neurosurgery, Navy General Hospital, Beijing, China
9 Neurosurgery, Beijing Tian Tan Hospital Capital Medical University, Beijing, China
10 National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China; Man-Machine-Environment Engineering Institute, School of Aerospace Engineering, Tsinghua University, Beijing, China; Precision Medicine & Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, Shenzhen, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing, China