Elucidation of the effects of vagus nerve stimulation (VNS) on cerebral blood flow and neural function in refractory epilepsy

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K10786
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Neurosurgery
• Research Institution: Osaka University
• Principal Investigator: Maruo Tomoyuki 大阪大学, 医学系研究科, 招へい教員 (90533810)
• Co-Investigator(Kenkyū-buntansha): 貴島 晴彦 大阪大学, 医学系研究科, 教授 (10332743) ; 押野 悟 大阪大学, 医学系研究科, 准教授 (40403050) ; 中村 元 大阪大学, 医学系研究科, 助教 (80533794)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: てんかん / 迷走神経刺激 / 脳血流 / 脳波 / 脳代謝

Outline of Final Research Achievements

In the present study, we established the method for creating models of acute and chronic generalized epilepsy and analyzed data to elucidate the effects of left vagus nerve stimulation on EEG, cerebral blood flow, and brain function and metabolism. The transient increase in cerebral blood flow induced by vagus nerve stimulation and the subsequent decrease in cerebral blood flow and metabolism after continued stimulation, as well as the marked decrease in epileptic waves, were confirmed with good reproducibility. This suggests that left vagus nerve stimulation contributes to the inhibition of seizure wave firing as well as the suppression of cerebral blood flow associated with seizure wave propagation. The results of this study will lead to the conditions for effective vagal nerve stimulation of refractory epilepsy and to the selection of effective treatment targets.

Free Research Field

機能的脳神経外科

Academic Significance and Societal Importance of the Research Achievements

本研究の結果は、発作につながる脳波変化時の局所血流変化と、非発作性てんかん性放電時の局所血流変化を捉え発作のトリガーや発作発現機序の解明の手がかりとなるものと考えられる。難治性てんかん治療に携わっている医療者にとって、薬物治療や手術でも治療に難渋する発作を呈する患者を多数経験している。今研究により、難治性てんかんに関する病態解明や治療法のさらなる開発の一助となることが期待できる。