Vagus nerve stimulation is an add-on treatment for patients with refractory epilepsy. Despite its well-established use in clinical practice, mechanisms of action remain poorly understood and only one third of implanted patients respond to the treatment. No reliable biomarkers of therapeutic effect have been identified so far. Moreover, there are no standardized measures guiding the titration of VNS parameters. Synergia Medical has recently developed a new optoelectronic neurostimulator, which is the first Vagus Nerve Stimulation (VNS) device for epilepsy treatment with a full MRI compatibility. Using this neurostimulator, we will be able to study at a central level the brain functional changes induced by different VNS strategies. We intend to analyze the functional MRI (fMRI) responses to acute VNS, focusing on the “vagal afferent network” (Hachem et al. 2018 Neurosug Focus). At a peripheral level, Laryngeal Motor Evoked-Potentials (LMEPs) are peripheral muscular responses generated by the VNS-induced vocal fold contraction. LMEPs demonstrate the genuine activation of vagal fibers, providing insights on the conduction and activation properties of motor A-fibers (Vespa et al. 2019 Front Neurosci). The new Synergia Medical’s device allows the recording of LMEPs, through a laryngeal detection unit incorporated to the new Synergia Medical’s device. We will study prospectively LMEPs characteristics in patients implanted with VNS, determine possible immediate or late post-implant changes in LMEPs, and correlate these characteristics with the clinical efficacy of the therapy in terms of seizure control. The main objectives of this project are: i) to determine the key brain structures activated upon acute stimulation and to understand how these regions are affected when different stimulation paradigms are applied. ii) to establish the validity of LMEPs as a biomarker for the therapeutic effect of VNS
We are looking for a highly motivated medical doctor or biomedical scientist with excellent degrees and specific interest for Neurosciences, willing to integrate in a multidisciplinary team consisting of neurologists, neurophysiologists and engineers. Any prior experience in imaging/functional MRI and basic Matlab knowledge is a plus.
This project is financed by the Walloon region for a period of 3 years (“Doctorat en entreprise”). PhD can be prolonged through FNRS/FRIA application.
Start of the project: between October 2020 and March 2021
Fluent English and basic French are required.
Application: Interested candidates are requested to send their application, including a cover letter describing yourself, your interests and your resume to Pr. Riëm El Tahry (firstname.lastname@example.org ), Pascal Doguet, PhD, CEO Synergia Médical (Pascal Doguet (email@example.com ) and Dr. Jean Delbeke , MD, PhD (firstname.lastname@example.org ).
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