Thalamic interictal epileptiform discharges in deep brain stimulated epilepsy patients

Sweeney‐Reed, Catherine M.; Lee, Harim; Rampp, Stefan; Zaehle, Tino; Buentjen, Lars; Voges, J.; Holtkamp, Martin; Hinrichs, Hermann; Heinze, Hans‐Jochen; Schmitt, Friedhelm C.

doi:10.1007/s00415-016-8246-5

Cited by 24 publications

(35 citation statements)

References 33 publications

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“…Additional nonrandomized studies have demonstrated a 44% to 100% seizure response rate. 1,5,11,16,19,25,29,30,32,34,[37][38][39]48,54,55 Recent innovations in implantation technique, such as the posterior inferior parietal electrode trajectory and concomitant hippocampal electrode placement, warrant additional research and consideration for widespread implementation. 25,32,54 CMT DBS has also demonstrated promising results in the treatment of patients with generalized epilepsy.…”

Section: Discussionmentioning

confidence: 99%

“…Over the past decade, 20 studies have been published, reporting on 220 patients who underwent ANT DBS for the treatment of epilepsy. 1,5,11,15,16,19,25,29,30,32,34,[37][38][39][40]48,49,[53][54][55] These studies have reported responder rates ranging from 44% to 100%. Patients from the largest series (n = 110) were reported to have median seizure reduction rates of 56% at 2 years 15 and 69% at 5 years.…”

Section: Seizure Outcomesmentioning

confidence: 99%

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Open-loop deep brain stimulation for the treatment of epilepsy: a systematic review of clinical outcomes over the past decade (2008–present)

Zhou¹,

Chen²,

Farber³

et al. 2018

Neurosurgical Focus

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OBJECTIVEThe field of deep brain stimulation (DBS) for epilepsy has grown tremendously since its inception in the 1970s and 1980s. The goal of this review is to identify and evaluate all studies published on the topic of open-loop DBS for epilepsy over the past decade (2008 to present).METHODSA PubMed search was conducted to identify all articles reporting clinical outcomes of open-loop DBS for the treatment of epilepsy published since January 1, 2008. The following composite search terms were used: (“epilepsy” [MeSH] OR “seizures” [MeSH] OR “kindling, neurologic” [MeSH] OR epilep* OR seizure* OR convuls*) AND (“deep brain stimulation” [MeSH] OR “deep brain stimulation” OR “DBS”) OR (“electric stimulation therapy” [MeSH] OR “electric stimulation therapy” OR “implantable neurostimulators” [MeSH]).RESULTSThe authors identified 41 studies that met the criteria for inclusion. The anterior nucleus of the thalamus, centromedian nucleus of the thalamus, and hippocampus were the most frequently evaluated targets. Among the 41 articles, 19 reported on stimulation of the anterior nucleus of the thalamus, 6 evaluated stimulation of the centromedian nucleus of the thalamus, and 9 evaluated stimulation of the hippocampus. The remaining 7 articles reported on the evaluation of alternative DBS targets, including the posterior hypothalamus, subthalamic nucleus, ventral intermediate nucleus of the thalamus, nucleus accumbens, caudal zone incerta, mammillothalamic tract, and fornix. The authors evaluated each study for overall epilepsy response rates as well as adverse events and other significant, nonepilepsy outcomes.CONCLUSIONSLevel I evidence supports the safety and efficacy of stimulating the anterior nucleus of the thalamus and the hippocampus for the treatment of medically refractory epilepsy. Level III and IV evidence supports stimulation of other targets for epilepsy. Ongoing research into the efficacy, adverse effects, and mechanisms of open-loop DBS continues to expand the knowledge supporting the use of these treatment modalities in patients with refractory epilepsy.

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Section: Discussionmentioning

confidence: 99%

Section: Seizure Outcomesmentioning

confidence: 99%

Open-loop deep brain stimulation for the treatment of epilepsy: a systematic review of clinical outcomes over the past decade (2008–present)

Zhou¹,

Chen²,

Farber³

et al. 2018

Neurosurgical Focus

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“…Epileptic discharges were recorded by stereotaxic electroencephalography in the PuN during the ictal phase as well as in the ATN and MDN during the interictal phase in patients with TLE. In addition, stimulation of the medial PuN could induce cortical‐evoked potentials in different cortical regions .…”

Section: Discussionmentioning

confidence: 99%

Alterations in the hippocampal‐thalamic pathway underlying secondarily generalized tonic–clonic seizures in mesial temporal lobe epilepsy: A diffusion tensor imaging study

Chen

Ding

et al. 2018

Epilepsia

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Objective: The epileptogenic network underlying secondarily generalized tonicclonic seizures (sGTCS) in mesial temporal lobe epilepsy (mTLE) is not well understood. Here, we investigated alterations in the probabilistic hippocampal-thalamic pathway (pHTP) underlying sGTCS using diffusion tensor imaging and resting-state functional magnetic resonance imaging in a cohort of TLE patients with hippocampal sclerosis (HS). Methods: We consecutively recruited 51 unilateral TLE-HS patients (26 with and 25 without sGTCS) and 22 healthy controls. Probabilistic tractography was used to track the pHTP. Raw fractional anisotropy (FA) and mean diffusivity (MD) of the pHTP were corrected by the FA/MD of the hemispheric white matter on the same side. The volume of the thalamic subregion connected to the hippocampus (TSCH) was investigated. Fractional amplitude of low-frequency fluctuations of the hippocampus, the TSCH, and the thalamic subregion unconnected to the hippocampus in resting-state functional magnetic resonance imaging were also calculated. Results: After correction, the sGTCS group showed lower FA than the non-sGTCS group (P = 0.03), and lower FA as well as higher MD than controls in the ipsilateral pHTP. The non-sGTCS group only showed higher corrected MD in the ipsilateral pHTP relative to controls. Corrected FA or MD in the contralateral pHTP did not differ among groups. The TSCH was located in the mesial aspect of the thalamus, and it was atrophied in the sGTCS group compared to the non-sGTCS group and controls. The sGTCS group had lower fractional amplitude of low-frequency fluctuations in the ipsilateral hippocampus and TSCH compared to controls. Significance: In TLE-HS, sGTCS was associated with impaired integrity of the pHTP as well as structural and functional abnormalities in the medial thalamus.The medial thalamus is important in seizure generalization in mTLE. K E Y W O R D Shippocampal sclerosis, MRI, secondarily generalized tonic-clonic seizures, temporal lobe epilepsy, thalamus

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“…ANT represents a promising target because of their widespread projections to various cortical and subcortical structures and involvement in the process of generation and spreading of epileptic activity. [ 32 45 ]…”

Section: Introductionmentioning

confidence: 99%

Bilateral stereotactic lesions and chronic stimulation of the anterior thalamic nuclei for treatment of pharmacoresistant epilepsy

2018

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Background:The use of the anterior nucleus of thalamus (ANT) as a target for treatment of pharmacoresistant epilepsy is based on its crucial role in seizure propagation. We describe results of chronic bilateral ANT stimulation and bilateral ANT lesions in 31 patients with refractory epilepsy.Methods:ANT DBS was performed in 12 patients (group I) and bilateral stereotactic radiofrequency lesions of ANT were performed in 19 patients (group II). Targeting was based on stereotactic atlas information with correction of the final coordinates according to the location of anatomical landmarks and intraoperative microelectrode recording data.Results:Both groups were similar in age, gender, seizures frequency, and duration of disease. The median x, y, and z coordinates of ANT were found to be 2.9, 5, and 11 mm anterior, lateral, and superior to the mid-commissural point, respectively. Mean seizures reduction reached 80.3% in group of patients with ANT DBS with two nonresponders and 91.2% in group of patients with lesions. Five patients from group I and three patients from group II became seizure-free. The morbidity rate was low in both groups.Conclusions:Stereotactic anterior thalamotomy and chronic ANT stimulation are both effective for seizure control in epilepsy originated from frontal and temporal lobes. ANT lesions and stimulation were more effective for secondary-generalized seizures compared to simple partial seizures.

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Thalamic interictal epileptiform discharges in deep brain stimulated epilepsy patients

Cited by 24 publications

References 33 publications

Open-loop deep brain stimulation for the treatment of epilepsy: a systematic review of clinical outcomes over the past decade (2008–present)

Open-loop deep brain stimulation for the treatment of epilepsy: a systematic review of clinical outcomes over the past decade (2008–present)

Alterations in the hippocampal‐thalamic pathway underlying secondarily generalized tonic–clonic seizures in mesial temporal lobe epilepsy: A diffusion tensor imaging study

Bilateral stereotactic lesions and chronic stimulation of the anterior thalamic nuclei for treatment of pharmacoresistant epilepsy

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