Using chronic recordings from a closed‐loop neurostimulation system to capture seizures across multiple thalamic nuclei

Kundu, Bornali; Arain, Amir; Davis, Tyler; Charlebois, Chantel M.; Rolston, John D.

doi:10.1002/acn3.51701

Cited by 4 publications

(4 citation statements)

References 38 publications

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“…Meanwhile, the ANT is part of Papez circuit which links medial frontal cortex with medial temporal lobe structures and is believed to underlie aspects of emotional and mnemonic function (34,35). Up until now, several case reports of ANT and CMN responsive neurostimulation have been published in the literature (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Reports on neuromodulation involving other thalamic nuclei, including the pulvinar, have been examined as well (36,37).…”

Section: Discussionmentioning

confidence: 99%

“…Of the patients with focal onset, 11 had greater than three foci, four had two foci, and five had a single focus. Onset zones on scalp were varied and as follows: Frontal (12), parietal (7), occipital (4), temporal (13), and mesial temporal (2). The majority had an intracranial EEG (20).…”

Section: Seizure Characteristicsmentioning

confidence: 99%

“…On the other hand, RNS is a closed-loop device activated by abnormal electrocorticography patterns in or near the seizure focus (1). Because epilepsy is thought to involve corticothalamic networks, DBS and RNS have been increasingly applied to the thalamus (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

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A multicenter retrospective study of patients treated in the thalamus with responsive neurostimulation

Fields,

Eka,

Schreckinger

et al. 2023

Front. Neurol.

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IntroductionFor drug resistant epilepsy patients who are either not candidates for resective surgery or have already failed resective surgery, neuromodulation is a promising option. Neuromodulatory approaches include responsive neurostimulation (RNS), deep brain stimulation (DBS), and vagal nerve stimulation (VNS). Thalamocortical circuits are involved in both generalized and focal onset seizures. This paper explores the use of RNS in the centromedian nucleus of the thalamus (CMN) and in the anterior thalamic nucleus (ANT) of patients with drug resistant epilepsy.MethodsThis is a retrospective multicenter study from seven different epilepsy centers in the United States. Patients that had unilateral or bilateral thalamic RNS leads implanted in the CMN or ANT for at least 6 months were included. Primary objectives were to describe the implant location and determine changes in the frequency of disabling seizures at 6 months, 1 year, 2 years, and > 2 years. Secondary objectives included documenting seizure free periods, anti-seizure medication regimen changes, stimulation side effects, and serious adverse events. In addition, the global clinical impression scale was completed.ResultsTwelve patients had at least one lead placed in the CMN, and 13 had at least one lead placed in the ANT. The median baseline seizure frequency was 15 per month. Overall, the median seizure reduction was 33% at 6 months, 55% at 1 year, 65% at 2 years, and 74% at >2 years. Seizure free intervals of at least 3 months occurred in nine patients. Most patients (60%, 15/25) did not have a change in anti-seizure medications post RNS placement. Two serious adverse events were recorded, one related to RNS implantation. Lastly, overall functioning seemed to improve with 88% showing improvement on the global clinical impression scale.DiscussionMeaningful seizure reduction was observed in patients who suffer from drug resistant epilepsy with unilateral or bilateral RNS in either the ANT or CMN of the thalamus. Most patients remained on their pre-operative anti-seizure medication regimen. The device was well tolerated with few side effects. There were rare serious adverse events. Most patients showed an improvement in global clinical impression scores.

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Section: Discussionmentioning

confidence: 99%

Section: Seizure Characteristicsmentioning

confidence: 99%

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A multicenter retrospective study of patients treated in the thalamus with responsive neurostimulation

Fields,

Eka,

Schreckinger

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

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“…Specific thalamic nuclei serve as neuromodulation targets for nervous system diseases (Whiting et al, 2018 ). For instance, deep brain stimulation of the ventral intermediate nucleus has proven effective in inhibiting essential tremors (Benabid et al, 1991 ), while the anterior thalamic nucleus is a targeted intervention for intractable epilepsy (Krishna et al, 2016 ; Kundu et al, 2022 ). The ventral posterolateral nucleus is a therapeutic target for alleviating neuropathic pain (Abreu et al, 2017 ), and the centromedian‐parafascicular‐complex is involved with consciousness recovery after severe traumatic brain injury (Schiff et al, 2007 ) and treatment of Tourette Syndrome (Baldermann et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Prior‐guided individualized thalamic parcellation based on local diffusion characteristics

Gao,

Wu,

Wang

et al. 2024

Human Brain Mapping

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Comprising numerous subnuclei, the thalamus intricately interconnects the cortex and subcortex, orchestrating various facets of brain functions. Extracting personalized parcellation patterns for these subnuclei is crucial, as different thalamic nuclei play varying roles in cognition and serve as therapeutic targets for neuromodulation. However, accurately delineating the thalamic nuclei boundary at the individual level is challenging due to intersubject variability. In this study, we proposed a prior‐guided parcellation (PG‐par) method to achieve robust individualized thalamic parcellation based on a central‐boundary prior. We first constructed probabilistic atlas of thalamic nuclei using high‐quality diffusion MRI datasets based on the local diffusion characteristics. Subsequently, high‐probability voxels in the probabilistic atlas were utilized as prior guidance to train unique multiple classification models for each subject based on a multilayer perceptron. Finally, we employed the trained model to predict the parcellation labels for thalamic voxels and construct individualized thalamic parcellation. Through a test–retest assessment, the proposed prior‐guided individualized thalamic parcellation exhibited excellent reproducibility and the capacity to detect individual variability. Compared with group atlas registration and individual clustering parcellation, the proposed PG‐par demonstrated superior parcellation performance under different scanning protocols and clinic settings. Furthermore, the prior‐guided individualized parcellation exhibited better correspondence with the histological staining atlas. The proposed prior‐guided individualized thalamic parcellation method contributes to the personalized modeling of brain parcellation.

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Advancing thalamic neuromodulation in epilepsy: Bridging adult data to pediatric care

Samanta,

Aungaroon,

Albert

et al. 2024

Epilepsy Research

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Using chronic recordings from a closed‐loop neurostimulation system to capture seizures across multiple thalamic nuclei

Cited by 4 publications

References 38 publications

A multicenter retrospective study of patients treated in the thalamus with responsive neurostimulation

A multicenter retrospective study of patients treated in the thalamus with responsive neurostimulation

Prior‐guided individualized thalamic parcellation based on local diffusion characteristics

Advancing thalamic neuromodulation in epilepsy: Bridging adult data to pediatric care

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