High frequency anterior nucleus of the thalamus deep brain stimulation (ANT DBS) is an established therapy for treatment resistant focal epilepsies. Although high frequency-ANT DBS is well tolerated, patients are rarely seizure free and the efficacy of other DBS parameters and their impact on comorbidities of epilepsy such as depression and memory dysfunction remain unclear. The purpose of this study was to assess the impact of low vs high frequency ANT DBS on verbal memory and self-reported anxiety and depression symptoms. Five patients with treatment resistant temporal lobe epilepsy were implanted with an investigational brain stimulation and sensing device capable of ANT DBS and ambulatory intracranial electroencephalographic (iEEG) monitoring, enabling long-term detection of electrographic seizures. While patients received therapeutic high frequency (100 and 145 Hz continuous and cycling) and low frequency (2 and 7 Hz continuous) stimulation, they completed weekly free recall verbal memory tasks and thrice weekly self-reports of anxiety and depression symptom severity. Mixed effects models were then used to evaluate associations between memory scores, anxiety and depression self-reports, seizure counts, and stimulation frequency. Memory score was significantly associated with stimulation frequency, with higher free recall verbal memory scores during low frequency ANT DBS. Self-reported anxiety and depression symptom severity was not significantly associated with stimulation frequency. These findings suggest the choice of ANT DBS stimulation parameter may impact patients' cognitive function, independently of its impact on seizure rates.

Biomedical Engineering and Physiology Graduate Program Mayo Clinic Graduate School of Biomedical Sciences Rochester MN United States

BioTechMed Center Brain and Mind Electrophysiology Lab Multimedia Systems Department Faculty of Electronics Telecommunication and Informatics Gdansk University of Technology 80 233 Gdansk Poland

Czech Institute of Informatics Robotics and Cybernetics Czech Technical University Prague Prague Czechia

Department of Biostatistics Mayo Clinic Rochester MN United States

Department of Neurology Bioelectronics Neurophysiology and Engineering Laboratory Mayo Clinic Rochester MN United States

Department of Neurosurgery Mayo Clinic Rochester MN United States

Department of Psychiatry and Psychology Mayo Clinic Rochester MN United States

Department of Radiology Mayo Clinic Rochester MN United States

Faculty of Biomedical Engineering Czech Technical University Prague Prague Czechia

Faculty of Electrical Engineering and Communication Department of Biomedical Engineering Brno University of Technology Brno Czechia

International Clinic Research Center St Anne's University Research Hospital Brno Czechia

Mayo Clinic Alix School of Medicine Rochester MN United States

Mayo Clinic Medical Scientist Training Program Rochester MN United States

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