Establishment of a risk nomogram model for predicting the excitatory response of vagus nerve in patients with functional epilepsy after radiofrequency thermocoagulation_Journal of Epilepsy

Authors：

 LIN Yaoxin , WANG Fu , ZHONG Xuguang , LUO Jinqi

Department of Functional Neurosurgery, Foshan First People's Hospital, Foshan 528300, China;

Corresponding?author：

LIN Yaoxin, Email: lxyjhgo@163.com

Keywords：

Functional area epilepsy; Radiofrequency thermocoagulation; Vagal excitatory response; Risk model

DOI：

10.7507/2096-0247.20210047

Video：

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Objective To investigate the establishment of a risk nomogram model for predicting vagus excitatory response in patients with functional epilepsy after radiofrequency thermocoagulation.Methods A total of 106 patients with epilepsy admitted to the neurosurgery department of our hospital from January 2016 to June 2020 were selected and divided into the Vagus excitatory response (VER) group and the non-VER group according to their occurrence or absence. Logistic regression analysis was used to screen out the risk factors of VER during SEEG-guided Percutaneous radiofrequency thermocoagulation (PRFT) in patients with functional epilepsy, and R software was used to establish a histogram model affecting VER in SEEG-guided PRFT. Bootstrap method was used for internal verification. C-index, correction curve and ROC curve were used to evaluate the prediction ability of the model.Results Logistic regression analysis showed that age [OR=0.235, 95%CI (0.564, 3.076)], preoperative fugl-meyer score [OR=4.356, 95%CI (1.537, 6.621)], depression [OR=0.995, 95%CI (1.068, 7.404)], and lesion range [OR=1.512, 95%CI (0.073, 3.453)] were independent risk factors for the occurrence of VER in PRFT under the guidance of SEEG (P<0.05), and were highly correlated with the occurrence of VER in PRFT. Based on the above six indicators, a SEEG-guided colograph model of VER risk in PRFT was established, and the model was validated internally. The results showed that the C-index of the modeling set and validation set were 0.779 [95%CI (0.689, 0.869)] and 0.782 [95%CI (0.692, 0.872)], respectively. The calibration curves of the two groups fit well with the standard curves. The areas under the ROC curve (AUC) of the two groups were 0.779 and 0.782 respectively, which proved that the model had good prediction accuracy.Conclusion For patients with functional epilepsy requiring seeg-guided PRFT therapy, age, preoperative Fugl-meyer score, depression and lesion range should be taken into full consideration to comprehensively assess the incidence of VER, and early intervention measures should be taken to reduce and reduce the incidence, which has good clinical application value.

Citation： LIN Yaoxin, WANG Fu, ZHONG Xuguang, LUO Jinqi. Establishment of a risk nomogram model for predicting the excitatory response of vagus nerve in patients with functional epilepsy after radiofrequency thermocoagulation. Journal of Epilepsy, 2021, 7(4): 296-301. doi: 10.7507/2096-0247.20210047 Copy

1.	易愛玲, 杜光, 楊希. 抗癲癇藥物個體化用藥的使用情況分析. 中國臨床藥理學雜志, 2019, 35(15): 1674-1676.
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5.	Liu P, Zhong W, Liao C, et al. The role of percutaneous radiofrequency thermocoagulation for persistent or recurrent trigeminal neuralgia after surgery. J Craniofac Surg, 2016, 27(8): e752-e755.
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9.	Xue TQ, Zhang QX, Bian H, et al. Radiofrequency thermocoagulation through foramen rotundum versus foramen ovale for the treatment of V2 trigeminal neuralgia. pain physician, 2019, 22(6): E609-E614.
10.	董思斯, 李金梅. 人文關懷護理對依達拉奉聯合丙戊酸鈉治療腦卒中繼發癲癇患者負性情緒的影響. 實用臨床護理學電子雜志, 2018, 3(35): 20-21.
11.	鐘旭光, 王國福, 林耀新, 等. 藥物難治性癲癇患者應用SEEG引導下射頻熱凝毀損術治療的效果探析. 中國醫藥科學, 2018, 8(14): 246-249.
12.	周曉平, 姜秀峰, 胡小吾, 等. 帕金森病立體定向手術并發腦出血的原因分析. 功能性和立體定向神經外科雜志, 2004, 17(3): 133-135.
13.	賈和平, 金瑞林, 郭英俊, 等. 三叉神經半月節射頻熱凝術中迷走神經興奮反應及其危險因素. 中國疼痛醫學雜志, 2014, 20(1): 56-57.
14.	Ding W, Chen S, Wang R, et al. Percutaneous radiofrequency thermocoagulation for trigeminal neuralgia using neuronavigation-guided puncture from a mandibular angle. Medicine (Baltimore), 2016, 95(40): e4940.
15.	陶振玉. 體內外射頻熱凝毀損灶體積的相關性及近紅外光學參數的應用. 東南大學, 碩士學位論文, 2010.
16.	劉超, 王中琳. 柴胡加龍骨牡蠣湯治療腦卒中后癲癇的隨機單盲對照研究. 世界中醫藥, 2018, 13(9): 164-167.
17.	Nakamura T, Hirayama M, Hara T, et al. Role of cardiac sympathetic nerves in preventing orthostatic hypotension in Parkinson's disease. Parkinsonism Relat Disord, 2014, 20(4): 409-414.
18.	Shanks J, Xia Z, Lisco SJ, et al. Sympatho-excitatory response to pulmonary chemosensitive spinal afferent activation in anesthetized, vagotomized rats. Physiol Rep, 2018, 6(12): e13742.
19.	Takeo Fujii, Takahiro Kogawa, Jimin Wu, et al. Nomogram to predict pathologic complete response in HER2-positive breast cancer treated with neoadjuvant systemic therapy. Br J Cancer, 2017, 116(4): 509-514.

1. 易愛玲, 杜光, 楊希. 抗癲癇藥物個體化用藥的使用情況分析. 中國臨床藥理學雜志, 2019, 35(15): 1674-1676.
2. Balestrini S, Sisodiya SM. Pharmacogenomics in epilepsy. Neurosci Lett, 2018, 667: 27-39.
3. Liu J, Tong L, Song S, et al. Novel and de novo mutations in pediatric refractory epilepsy. Mol Brain, 2018, 11(1): 48.
4. Cossu M, Cardinale F, Casaceli G, et al. Stereo-EEG-guided radiofrequency thermocoagulations. Epilepsia, 2017, 58(Suppl 1): 66-72.
5. Liu P, Zhong W, Liao C, et al. The role of percutaneous radiofrequency thermocoagulation for persistent or recurrent trigeminal neuralgia after surgery. J Craniofac Surg, 2016, 27(8): e752-e755.
6. 吳昊澤. 立體定向腦電圖引導下射頻熱凝毀損術在難治性癲癇中的應用. 延安大學, 碩士學位論文, 2019.
7. Anderson SJ, Jamniczky HA, Krigolson OE, et al. Quantifying two-dimensional and three-dimensional stereoscopic learning in anatomy using electroencephalography. NPJ Sci Learn, 2019, 4: 10.
8. Zheng C, Yitong J, Zipu J, et al. The long-term outcome of 3-dimensional CT-guided percutaneous radiofrequency thermocoagulation for tumor-related trigeminal neuralgia. Pain Physician, 2019, 22(5): E467-E475.
9. Xue TQ, Zhang QX, Bian H, et al. Radiofrequency thermocoagulation through foramen rotundum versus foramen ovale for the treatment of V2 trigeminal neuralgia. pain physician, 2019, 22(6): E609-E614.
10. 董思斯, 李金梅. 人文關懷護理對依達拉奉聯合丙戊酸鈉治療腦卒中繼發癲癇患者負性情緒的影響. 實用臨床護理學電子雜志, 2018, 3(35): 20-21.
11. 鐘旭光, 王國福, 林耀新, 等. 藥物難治性癲癇患者應用SEEG引導下射頻熱凝毀損術治療的效果探析. 中國醫藥科學, 2018, 8(14): 246-249.
12. 周曉平, 姜秀峰, 胡小吾, 等. 帕金森病立體定向手術并發腦出血的原因分析. 功能性和立體定向神經外科雜志, 2004, 17(3): 133-135.
13. 賈和平, 金瑞林, 郭英俊, 等. 三叉神經半月節射頻熱凝術中迷走神經興奮反應及其危險因素. 中國疼痛醫學雜志, 2014, 20(1): 56-57.
14. Ding W, Chen S, Wang R, et al. Percutaneous radiofrequency thermocoagulation for trigeminal neuralgia using neuronavigation-guided puncture from a mandibular angle. Medicine (Baltimore), 2016, 95(40): e4940.
15. 陶振玉. 體內外射頻熱凝毀損灶體積的相關性及近紅外光學參數的應用. 東南大學, 碩士學位論文, 2010.
16. 劉超, 王中琳. 柴胡加龍骨牡蠣湯治療腦卒中后癲癇的隨機單盲對照研究. 世界中醫藥, 2018, 13(9): 164-167.
17. Nakamura T, Hirayama M, Hara T, et al. Role of cardiac sympathetic nerves in preventing orthostatic hypotension in Parkinson's disease. Parkinsonism Relat Disord, 2014, 20(4): 409-414.
18. Shanks J, Xia Z, Lisco SJ, et al. Sympatho-excitatory response to pulmonary chemosensitive spinal afferent activation in anesthetized, vagotomized rats. Physiol Rep, 2018, 6(12): e13742.
19. Takeo Fujii, Takahiro Kogawa, Jimin Wu, et al. Nomogram to predict pathologic complete response in HER2-positive breast cancer treated with neoadjuvant systemic therapy. Br J Cancer, 2017, 116(4): 509-514.

Journal of Epilepsy

Establishment of a risk nomogram model for predicting the excitatory response of vagus nerve in patients with functional epilepsy after radiofrequency thermocoagulation

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