Precision mapping of the epileptogenic network with low- and high-frequency stimulation of anterior nucleus of thalamus.
Anterior nucleus of thalamus
Epileptogenicity index
Excitability
Gamma band activation
Gamma band suppression
Stereo-encephalography
Target engagement
Journal
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
ISSN: 1872-8952
Titre abrégé: Clin Neurophysiol
Pays: Netherlands
ID NLM: 100883319
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
02
04
2020
revised:
18
05
2020
accepted:
27
05
2020
pubmed:
19
7
2020
medline:
26
5
2021
entrez:
19
7
2020
Statut:
ppublish
Résumé
The goal of thalamic deep brain stimulation in epilepsy is to engage and modulate the epileptogenic network. We demonstrate how the anterior nucleus of thalamus (ANT) stimulation engages the epileptogenic network using electrophysiological measures (gamma response and post-stimulation excitability). Five patients with suspected temporal lobe epilepsy syndrome, undergoing stereo-electroencephalography (SEEG), were enrolled in the IRB approved study to undergo recording and stimulation of the ANT. We analyzed the extent of gamma-band response (activation or suppression) and post-stimulation change in excitability in various cortical regions during low (10 Hz) and high (50 Hz) frequency stimulations. 10 Hz stimulation increased cortical gamma, whereas 50 Hz stimulation suppressed the gamma responses. The maximum response to stimuli was in the hippocampus. High epileptogenicity regions were more susceptible to stimulation. Both 10-and 50 Hz stimulations decreased post-stimulation cortical excitability. The greater the gamma-band activation with 10 Hz stimulation, the greater was the decrease in post-stimulation excitability. We define an EEG marker that delineates stimulation-specific nodal engagement. We proved that nodes that were engaged with the thalamus during stimulation were more likely to show a short term decrease in post-stimulation excitability. Patient-specific engagement patterns during stimulation can be mapped with SEEG that can be used to optimize stimulation parameters.
Identifiants
pubmed: 32682244
pii: S1388-2457(20)30382-5
doi: 10.1016/j.clinph.2020.05.036
pmc: PMC7434689
mid: NIHMS1608354
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
2158-2167Subventions
Organisme : NIMH NIH HHS
ID : RF1 MH117155
Pays : United States
Informations de copyright
Copyright © 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.
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