Probing circuit of Papez with stimulation of anterior nucleus of the thalamus and hippocampal evoked potentials
Language English Country Netherlands Media print-electronic
Document type Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
Grant support
UH2 NS095495
NINDS NIH HHS - United States
R01 NS092882
NINDS NIH HHS - United States
PubMed
31841958
DOI
10.1016/j.eplepsyres.2019.106248
PII: S0920-1211(19)30545-5
Knihovny.cz E-resources
- Keywords
- Anterior nucleus of thalamus, Deep brain stimulation, Epilepsy, Evoked potentials, Mesial temporal sclerosis,
- MeSH
- Adult MeSH
- Electric Stimulation MeSH
- Epilepsy, Temporal Lobe physiopathology MeSH
- Evoked Potentials physiology MeSH
- Hippocampus physiopathology MeSH
- Humans MeSH
- Neural Pathways physiopathology MeSH
- Anterior Thalamic Nuclei physiopathology MeSH
- Pilot Projects MeSH
- Seizures physiopathology MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Research Support, N.I.H., Extramural MeSH
PURPOSE: Despite documented clinical effectiveness, deep brain stimulation (DBS) therapy for drug-resistant epilepsy rarely yields long-term seizure free outcomes. METHODS: This pilot study in five patients investigated circuit of Papez evoked potentials (EPs) using hippocampal sensing during anterior nucleus of the thalamus (ANT) electrical stimulation. We hypothesize that hippocampal EP is a potential biomarker that could be useful for ANT electrode targeting and improving seizure reduction. We obtained bilateral circuit of Papez EPs in five patients with bilateral temporal lobe epilepsy (TLE). The circuit of Papez EPs were measured and assessed by signal amplitude. Volumetric analysis of relevant mesial temporal structures and ANT stimulation analysis was performed on immediate post-implantation images. RESULTS: The patient with the most favorable seizure outcome, which meant long-term seizure reduction greater than 50 % compared to baseline, had strong bilateral EPs and normal hippocampal structure. Conversely, those without clinical benefit with ANT DBS had absent or weak bilateral EPs as well as MRI findings consistent with mesial temporal sclerosis (MTS). CONCLUSION: The data support the hypothesis that hippocampal EPs with ANT stimulation may be used to as a surrogate marker to probe circuit of Papez and predict ANT DBS efficacy.
Department of Neurosurgery Mayo Clinic Jacksonville Florida USA
Department of Neurosurgery Mayo Clinic Rochester Minnesota USA
Graduate Institute of Biomedical Engineering Chang Gung University Taiwan
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