Effects of anterior thalamic nuclei stimulation on hippocampal activity: Chronic recording in a patient with drug-resistant focal epilepsy
Alexander B. Silva,Ankit N. Khambhati,Benjamin Speidel,Edward F. Chang,Vikram R. Rao +4 more
- Vol. 16, pp 100467
TLDR
In this article, the authors describe a patient with drug-resistant temporal lobe epilepsy who was implanted with a responsive neurostimulation device (RNS System), involving hippocampal and ipsilateral temporal neocortical leads, and subsequently received ANT DBS.Abstract:
Implanted neurostimulation devices are gaining traction as palliative treatment options for certain forms of drug-resistant epilepsy, but clinical utility of these devices is hindered by incomplete mechanistic understanding of their therapeutic effects. Approved devices for anterior thalamic nuclei deep brain stimulation (ANT DBS) are thought to work at a network level, but limited sensing capability precludes characterization of neurophysiological effects outside the thalamus. Here, we describe a patient with drug-resistant temporal lobe epilepsy who was implanted with a responsive neurostimulation device (RNS System), involving hippocampal and ipsilateral temporal neocortical leads, and subsequently received ANT DBS. Over 1.5 years, RNS System electrocorticography enabled multiscale characterization of neurophysiological effects of thalamic stimulation. In brain regions sampled by the RNS System, ANT DBS produced acute, phasic, frequency-dependent responses, including suppression of hippocampal low frequency local field potentials. ANT DBS modulated functional connectivity between hippocampus and neocortex. Finally, ANT DBS progressively suppressed hippocampal epileptiform activity in relation to the extent of hippocampal theta suppression, which informs stimulation parameter selection for ANT DBS. Taken together, this unique clinical scenario, involving hippocampal recordings of unprecedented chronicity alongside ANT DBS, sheds light on the therapeutic mechanism of thalamic stimulation and highlights capabilities needed in next-generation devicesread more
Citations
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Journal ArticleDOI
Towards network-guided neuromodulation for epilepsy
Rory J Piper,Robert M. Richardson,Gregory A. Worrell,David W. Carmichael,Torsten Baldeweg,Brian Litt,Timothy J. Denison,Martin Tisdall +7 more
TL;DR: The modulation of key ‘propagation points’ in the epileptogenic network are discussed, focusing primarily on thalamic nuclei targeted in current clinical practice, and the continuing evolution of network-guided neuromodulation for epilepsy is reviewed.
Journal ArticleDOI
Evidence supporting deep brain stimulation of the medial septum in the treatment of temporal lobe epilepsy
Eric R. Cole,Dayton P. Grogan,Nealen G. Laxpati,Alejandra Fernandez,Henry Skelton,Faical Isbaine,Claire-Anne Gutekunst,Robert E. Gross +7 more
TL;DR: It is argued that deep brain stimulation of the medial septum holds potential to provide an effective neuromodulation treatment for mesial temporal lobe epilepsy, and the considerations necessary for further evaluating this treatment paradigm with a clinical trial are discussed.
Journal ArticleDOI
Chronic electroencephalography in epilepsy with a responsive neurostimulation device: current status and future prospects.
TL;DR: The NeuroPace RNS System is a vanguard device whose diagnostic utility rivals its therapeutic benefits, but emerging minimally invasive devices, including those with subscalp recording electrodes, promise to be more applicable within a broad population of people with epilepsy as discussed by the authors.
Journal ArticleDOI
Concurrent brain-responsive and vagus nerve stimulation for treatment of drug-resistant focal epilepsy
Mesha-Gay Brown,Stefan Sillau,Danielle McDermott,Lia D. Ernst,David C. Spencer,Dario J. Englot,Hernán F J González,Proleta Datta,Ioannis Karakis,Danielle A. Becker,John D. Rolston,Amir Arain,Vikram R. Rao,Michael Doherty,A.E. Urban,Cornelia Drees +15 more
TL;DR: In this paper , the authors evaluated seizure outcomes and safety of concurrent RNS and VNS stimulation in adults with drug-resistant focal-onset seizures, and found that concurrent treatment with VNS and RNS is safe and that the addition of RNS to VNS can further reduce seizure frequency.
Journal ArticleDOI
Patient‐specific structural connectivity informs outcomes of responsive neurostimulation for temporal lobe epilepsy
Chantel M. Charlebois,Daria Nesterovich Anderson,Kara A. Johnson,Brian Philip,Tyler S. Davis,Blake J. Newman,Angela Peters,Amir Arain,Alan D. Dorval,John D. Rolston,Christopher R. Butson +10 more
TL;DR: The aim of this study was to quantify responsive neurostimulation in the mesial temporal lobe, identify stimulation‐dependent networks associated with seizure reduction, and determine if stimulation location or stimulation‐ dependent networks inform outcomes.
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Robert S. Fisher,Vicenta Salanova,Thomas C. Witt,Robert M. Worth,Thomas R. Henry,Robert E. Gross,Kalarickal J. Oommen,Ivan Osorio,Jules M. Nazzaro,Douglas Labar,Michael G. Kaplitt,Michael R. Sperling,Evan Sandok,John H. Neal,Adrian Handforth,John M. Stern,Antonio DeSalles,Steve Chung,Andrew G. Shetter,Donna Bergen,Roy A.E. Bakay,Jaimie M. Henderson,Jacqueline A. French,Gordon H. Baltuch,William E. Rosenfeld,Andrew Youkilis,William J. Marks,Paul A. Garcia,Nicolas Barbaro,Nathan B. Fountain,Carl W. Bazil,Robert R. Goodman,Guy M. McKhann,K. Babu Krishnamurthy,Steven Papavassiliou,Charles M. Epstein,John R. Pollard,Lisa Tonder,Joan Grebin,Robert J. Coffey,Nina M. Graves,Marc A. Dichter,William Elias,Paul Francel,Robert C. Frysinger,Kevin Graber,John Grant,Gary Heit,Susan T. Herman,Padmaja Kandula,Andres M. Kanner,Jeanne Ann King,Eric Kobylarz,Karen Lapp,Suzette M. LaRoche,Susan Lippmann,Rama Maganti,Timothy Mapstone,Dragos Sabau,Lara M. Schrader,Ashwini Sharan,Mike Smith,David M. Treiman,Steve Wilkinson,Steven Wong,Andro Zangaladze,Shelley Adderley,Brian Bridges,Mimi Callanan,Dawn Cordero,Cecelia Fields,Megan Johnson,MaryAnn Kavalir,Patsy Kretschmar,Carol Macpherson,Kathy Mancl,Marsha Manley,Stephanie Marsh,Jean Montgomery,Pam Mundt,Phani Priya Nekkalapu,Bill Nikolov,Bruce Palmer,Linda Perdue,Alison Randall,David Smith,Linda Smith,Kristen Strybing,Leigh Stott,Robin Taylor,Stacy Thompson,Zornitza Timenova,Bree Vogelsong,Virginia Balbona,Donna K. Broshek,Deborah A. Cahn-Weiner,Lisa Clift,Mary Davidson,Evan Drake,Sally Frutiger,Lynette Featherstone,Chris Grote,Dan Han,Dianne Henry,Jessica Horsfall,Andrea Hovick,Jennifer Gray,David Kareken,Kristin Kirlin,Debbie Livingood,Michele Meyer,Nancy Minniti,Jeannine Morrone Strupinsky,William Schultz,James Scott,Joseph I. Tracy,Stuart Waltonen,Penelope Ziefert,Carla Van Amburg,Mark E Burdelle,Sandra Clements,Robert Cox,Raeleen Dolin,Michelle Fulk,Harinder R. Kaur,Lawrence J. Hirsch,Thomas J. Hoeppner,Andrea Hurt,Mary Komosa,Scott E. Krahl,Laura Ponticello,Mark Quigg,Helene Quinn,Marvin A. Rossi,Patty Schaefer,Christopher Skidmore,Diane Sundstrom,Patricia Trudeau,Monica Volz,Norman C. Wang,Lynette Will,Carol Young +141 more
TL;DR: A multicenter, double‐blind, randomized trial of bilateral stimulation of the anterior nuclei of the thalamus for localization‐related epilepsy is reported.