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Neurotherapeutics

, Volume 11, Issue 3, pp 612–622 | Cite as

The P3 Event-Related Potential is a Biomarker for the Efficacy of Vagus Nerve Stimulation in Patients with Epilepsy

  • Leen De Taeye
  • Kristl Vonck
  • Marlies van Bochove
  • Paul Boon
  • Dirk Van Roost
  • Lies Mollet
  • Alfred Meurs
  • Veerle De Herdt
  • Evelien Carrette
  • Ine Dauwe
  • Stefanie Gadeyne
  • Pieter van Mierlo
  • Tom Verguts
  • Robrecht Raedt
Original Article

Abstract

Currently, the mechanism of action of vagus nerve stimulation (VNS) is not fully understood, and it is unclear which factors determine a patient’s response to treatment. Recent preclinical experiments indicate that activation of the locus coeruleus noradrenergic system is critical for the antiepileptic effect of VNS. This study aims to evaluate the effect of VNS on noradrenergic signaling in the human brain through a noninvasive marker of locus coeruleus noradrenergic activity: the P3 component of the event-related potential. We investigated whether VNS differentially modulates the P3 component in VNS responders versus VNS nonresponders. For this purpose, we recruited 20 patients with refractory epilepsy who had been treated with VNS for at least 18 months. Patients were divided into 2 groups with regard to their reduction in mean monthly seizure frequency: 10 responders (>50 %) and 10 nonresponders (≤50 %). Two stimulation conditions were compared: VNS OFF and VNS ON. In each condition, the P3 component was measured during an auditory oddball paradigm. VNS induced a significant increase of the P3 amplitude at the parietal midline electrode, in VNS responders only. In addition, logistic regression analysis showed that the increase of P3 amplitude can be used as a noninvasive indicator for VNS responders. These results support the hypothesis that activation of the locus coeruleus noradrenergic system is associated with the antiepileptic effect of VNS. Modulation of the P3 amplitude should be further investigated as a noninvasive biomarker for the therapeutic efficacy of VNS in patients with refractory epilepsy.

Keywords

Vagus nerve stimulation epilepsy event-related potentials P3 biomarker norepinephrine. 

Notes

Acknowledgments

L. De Taeye is supported by a Fonds Wetenschappelijk Onderzoek (FWO) aspirant grant. K. Vonck is supported by a Bijzonder Onderzoeksfonds (BOF) grant from Ghent University Hospital. P. Boon is supported by grants from FWO, grants from BOF, and by the Clinical Epilepsy Grant from Ghent University Hospital. M. van Bochove, L. Mollet, and T. Verguts are supported by grants from FWO. R. Raedt is supported by a BOF Tenure Track grant from Ghent University.

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Supplementary material

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Copyright information

© The American Society for Experimental NeuroTherapeutics, Inc. 2014

Authors and Affiliations

  • Leen De Taeye
    • 1
  • Kristl Vonck
    • 1
  • Marlies van Bochove
    • 2
  • Paul Boon
    • 1
  • Dirk Van Roost
    • 3
  • Lies Mollet
    • 1
  • Alfred Meurs
    • 1
  • Veerle De Herdt
    • 1
  • Evelien Carrette
    • 1
  • Ine Dauwe
    • 1
  • Stefanie Gadeyne
    • 1
  • Pieter van Mierlo
    • 4
  • Tom Verguts
    • 2
  • Robrecht Raedt
    • 1
  1. 1.LCEN3, Department of NeurologyGhent UniversityGhentBelgium
  2. 2.Department of Experimental PsychologyGhent UniversityGhentBelgium
  3. 3.Department of NeurosurgeryGhent University HospitalGhentBelgium
  4. 4.MEDISIP, Department of Electronics and Information SystemsGhent UniversityGhentBelgium

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