{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:56Z","timestamp":1792471136536,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["MR\/T04294X\/1"],"award-info":[{"award-number":["MR\/T04294X\/1"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["MR\/V026569\/1"],"award-info":[{"award-number":["MR\/V026569\/1"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Vagus nerve stimulation (VNS) is a commonly used treatment for drug\u2010resistant epilepsy. However, response to VNS is variable, while understanding of this response variability is limited. The vagus afferent network (VagAN), the neural circuits thought to be involved in response to vagal afferents, has been implicated in response prediction in modalities such as diffusion\u2010weighted imaging, functional imaging, and neurophysiology. Structural abnormality in the VagAN from T1w MRI has not yet been studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We assessed if VagAN abnormalities, derived from pre\u2010implantation T1w MRI, were associated with VNS response in 92 individuals with epilepsy two years post\u2010implantation (42 responders, 50 non\u2010responders). We used the first principal component (PC1) from a robust principal component analysis for a variety of region sets trained using 100 healthy controls. We investigated two primary hypotheses. (i) If VagAN regions' PC1 differentiates response groups, (ii) if other region sets did not differentiate response groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Non\u2010responders had significantly higher VagAN PC1 abnormality scores than both responders (, ) and controls (, ). By contrast, non\u2010VagAN PC1 showed no discriminatory value (, ). VagAN outperformed all other region sets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Structural abnormality of VagAN was associated with non\u2010response to VNS. This suggests that volume abnormalities in key VNS regions correlate negatively with reduction of seizures. Abnormalities in other regions, such as the non\u2010VagAN region set, were not associated with VNS response. This metric, when combined with other modalities, may be a useful measure to improve the selection of individuals with drug\u2010resistant epilepsy for VNS therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Vagus nerve stimulation (VNS) is a common treatment for drug\u2010resistant epilepsy; however, it is not always effective. We tested whether volumes of brain regions related to VNS efficacy and found that abnormality within a set of regions known to be affected by VNS related to non\u2010response. No other set of regions showed this effect implying that this set of regions is uniquely placed to determine if someone may respond to VNS. This work supports the idea that VNS efficacy is limited by an individual's brain abnormality and should be considered in further studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70339","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:52:05Z","timestamp":1788169925000},"page":"1755-1763","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Structural morphometry distinguishes vagus nerve stimulation outcomes in individuals with epilepsy"],"prefix":"10.1002","volume":"11","author":[{"given":"Harry J.","family":"Clifford","sequence":"first","affiliation":[{"name":"CNNP Lab (www.cnnp\u2010lab.com), Computational Medicine Group School of Computing, Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Fenske","sequence":"additional","affiliation":[{"name":"CNNP Lab (www.cnnp\u2010lab.com), Computational Medicine Group School of Computing, Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4847-6273","authenticated-orcid":false,"given":"Yujiang","family":"Wang","sequence":"additional","affiliation":[{"name":"CNNP Lab (www.cnnp\u2010lab.com), Computational Medicine Group School of Computing, Newcastle University  Newcastle upon Tyne UK"},{"name":"Faculty of Medical Sciences Newcastle University  Newcastle upon Tyne UK"},{"name":"UCL Queen Square Institute of Neurology, Queen Square  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiago","family":"da Silva Costa","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences Newcastle University  Newcastle upon Tyne UK"},{"name":"Northern Centre for Mood Disorders Newcastle University; Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust  Newcastle upon Tyne 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A.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3849-4168","authenticated-orcid":false,"given":"Davide","family":"Giampiccolo","sequence":"additional","affiliation":[{"name":"UCL Queen Square Institute of Neurology, Queen Square  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Duncan","sequence":"additional","affiliation":[{"name":"UCL Queen Square Institute of Neurology, Queen Square  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2144-9838","authenticated-orcid":false,"given":"Peter N.","family":"Taylor","sequence":"additional","affiliation":[{"name":"CNNP Lab (www.cnnp\u2010lab.com), Computational Medicine Group School of Computing, Newcastle University  Newcastle upon 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