We hypothesized that local/regional properties of stimulated structure/circuitry contribute to the effect of deep brain stimulation (DBS). We analyzed intracerebral electroencephalographic (EEG) recordings from externalized DBS electrodes targeted bilaterally in the anterior nuclei of the thalamus (ANT) in 12 patients (six responders, six nonresponders) with more than 1 year of follow-up care. In the bipolar local field potentials of the EEG, spectral power (PW) and power spectral entropy (PSE) were calculated in the passbands 1-4, 4-8, 8-12, 12-20, 20-45, 65-80, 80-200 and 200-500 Hz. The most significant differences between responders and nonresponders were observed in the BRIDGE area (bipolar recordings with one contact within the ANT and the second contact in adjacent tissue). In responders, PW was significantly decreased in the frequency bands of 65-80, 80-200, and 200-500 Hz (p < .05); PSE was significantly increased in all frequency bands (p < .05) except for 200-500 Hz (p = .06). The local EEG characteristics of ANT recorded after implantation may play a significant role in DBS response prediction.

• Klíčová slova
• anterior thalamic nucleus, deep brain stimulation, oscillations, prediction,
• MeSH
• elektroencefalografie metody   MeSH
• hluboká mozková stimulace metody   MeSH
• lidé MeSH
• nuclei anteriores thalami patofyziologie   chirurgie   MeSH
• refrakterní epilepsie patofyziologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: To review the therapeutic effects of deep brain stimulation of the anterior nuclei of the thalamus (ANT-DBS) and the predictors of its effectiveness, safety, and adverse effects. METHODS: A comprehensive search of the medical literature (PubMed) was conducted to identify relevant articles investigating ANT-DBS therapy for epilepsy. Out of 332 references, 77 focused on focal epilepsies were reviewed. RESULTS: The DBS effect is probably due to decreased synchronization of epileptic activity in the cortex. The potential mechanisms from cellular to brain network levels are presented. The ANT might participate actively in the network elaborating focal seizures. The effects of ANT-DBS differed in various studies; ANT-DBS was linked with a 41% seizure frequency reduction at 1 year, 69% at 5 years, and 75% at 7 years. The most frequently reported adverse effects, depression and memory impairment, were considered non-serious in the long-term follow-up view. ANT-DBS also has been used in a few cases to treat status epilepticus. CONCLUSIONS: We reviewed the clinical literature and identified several factors that may predict seizure outcome following DBS therapy. More large-scale trials are required since there is a need to explore stimulation settings, apply patient-tailored therapy, and identify the presurgical predictors of patient response. SIGNIFICANCE: A critical review of the published literature on ANT-DBS in focal epilepsy is presented. ANT-DBS mechanisms are not fully understood; possible explanations are provided. Biomarkers of ANT-DBS effectiveness may lead to patient-tailored therapy.

• Klíčová slova
• Anterior thalamic nuclei, Deep brain stimulation, Focal epilepsy,
• MeSH
• epilepsie parciální * terapie   MeSH
• epilepsie * terapie   MeSH
• hluboká mozková stimulace * MeSH
• lidé MeSH
• nuclei anteriores thalami * MeSH
• záchvaty terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

In the article, we describe a rare case: a 52-year-old male patient with an isolated lesion of the anterior thalamic nuclei in the dominant hemisphere due to an ischemic stroke. The patient's syndrome of disordered verbal fluency, working memory, learning and executive functions is seen as a part of a lesion in the dorsolateral complex circuit. During the following 6 months, we observed significant improvement in visual learning, recent memory and categorisation of subjects, while verbal learning and visuospatial planning remained insufficient. In this context, the preservation of thalamic structures in different types of cognitive deterioration is discussed.

• MeSH
• afekt MeSH
• cévní mozková příhoda patologie   patofyziologie   psychologie   MeSH
• funkční lateralita fyziologie   MeSH
• ischemie mozku patologie   psychologie   MeSH
• krátkodobá paměť MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mozkový krevní oběh MeSH
• nemoci thalamu patologie   psychologie   MeSH
• neuropsychologické testy MeSH
• nuclei anteriores thalami krevní zásobení   patologie   MeSH
• poruchy paměti etiologie   psychologie   MeSH
• poruchy učení etiologie   psychologie   MeSH
• pozornost fyziologie   MeSH
• psychomotorický výkon fyziologie   MeSH
• verbální chování fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVE: To study the involvement of the anterior nuclei of the thalamus (ANT) as compared to the involvement of the hippocampus in the processes of encoding and recognition during visual and verbal memory tasks. METHODS: We studied intracerebral recordings in patients with pharmacoresistent epilepsy who underwent deep brain stimulation (DBS) of the ANT with depth electrodes implanted bilaterally in the ANT and compared the results with epilepsy surgery candidates with depth electrodes implanted bilaterally in the hippocampus. We recorded the event-related potentials (ERPs) elicited by the visual and verbal memory encoding and recognition tasks. RESULTS: P300-like potentials were recorded in the hippocampus by visual and verbal memory encoding and recognition tasks and in the ANT by the visual encoding and visual and verbal recognition tasks. No significant ERPs were recorded during the verbal encoding task in the ANT. In the visual and verbal recognition tasks, the P300-like potentials in the ANT preceded the P300-like potentials in the hippocampus. CONCLUSIONS: The ANT is a structure in the memory pathway that processes memory information before the hippocampus. We suggest that the ANT has a specific role in memory processes, especially memory recognition, and that memory disturbance should be considered in patients with ANT-DBS and in patients with ANT lesions. ANT is well positioned to serve as a subcortical gate for memory processing in cortical structures.

• MeSH
• dospělí MeSH
• elektroencefalografie MeSH
• epilepsie patofyziologie   MeSH
• evokované potenciály MeSH
• hipokampus patofyziologie   MeSH
• hluboká mozková stimulace MeSH
• implantované elektrody MeSH
• lidé středního věku MeSH
• lidé MeSH
• nuclei anteriores thalami patofyziologie   MeSH
• paměť * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Reciprocal interactions between intralaminar thalamic nuclei (ncl. centralis lateralis, CL, and ncl. parafascicularis, Pf), the pretectal area (Pt) and lateral thalamic nuclei (ventrobasal complex, VB, ncl. anterior ventralis, AV, and ncl. ventralis anterior, VA) have been observed in ketamine-anaesthetized rats. Extracellular single unit activity has been recorded after single electrical stimuli. Electrical stimulation of the VB evoked a short latency orthodromic response followed by a pause in spontaneous activity in neurones of medial thalamic nuclei. Lateral thalamic neurones responded to electrical stimulation of the intralaminar nuclei or the pretectal area with the same pattern of response. Striatal, sensorimotor cortical or peripheral electrical stimulation also evoked similar responses. The pauses in spontaneous activity were shown to be the result of inhibition since the responsiveness of the intralaminar nuclei or the lateral thalamic neurones to all inputs was abolished or reduced after a conditioning electrical single-shock stimulation in the VB or in the intralaminar nuclei, respectively. The two components of the response were of a different origin, since most of the short latency responses disappeared after medullary, upper cervical sections or large decortications, while the inhibitions persisted. These inhibitions were shown to be of thalamic origin since their duration was decreased after extensive decortications increased after medullary section. It is concluded that the neuroneal properties studied in this report are probably broadly represented throughout the thalamus and that thalamic neurones are under inhibitory control elicited by afferent volleys. This inhibitory control includes a relay in the nucleus reticularis thalami (nRT). The mechanisms of sensory interaction can be purely thalamic, but they can be modulated by suprathalamic and/or mesencephalic loops.

• MeSH
• elektrická stimulace MeSH
• evokované potenciály MeSH
• jádra thalamu fyziologie   MeSH
• krysa rodu Rattus MeSH
• potkani Sprague-Dawley MeSH
• reakční čas MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

In acute experiments on adult rats we studied cortical responses to stimulation of two thalamic nuclei--a specific somatosensory relay nucleus (the ventral dorsomedial nucleus, VDM) and a nucleus without specific cortical projection (the lateral anterior nucleus, LA). The responses evoked from the two nuclei by various stimuli have the same basic form--an initial positive phase (inconstant in stimulation of the LA) is followed by dominant negativity and a late slow negative wave; the response ends with a rhythmic afterdischarge. Rhythmic stimulation of the thalamic nuclei produces incremental responses in the cortex and both the positive and the negative phase of the evoked potential participate in the amplitude changes. Hippocampocortical responses (which were compared with thalamocortical responses) have neither a late negative wave nor a distinct rhythmic afterdischarge; in rhythmic stimulation the amplitude of the responses seldom waxes and wanes. Study of the given cortical responses failed to explain the basic difference in the ability of the two thalamic nuclei to produce a self-sustained afterdischarge after rhythmic stimulation, when a spike-and wave rhythm was always elicited from the VDM, while in most cases a "hippocampal" type of self-sustained afterdischarge was evoked from the LA.

• MeSH
• dominance mozková fyziologie   MeSH
• elektrická stimulace MeSH
• evokované potenciály MeSH
• hipokampus fyziologie   MeSH
• jádra thalamu fyziologie   MeSH
• krysa rodu Rattus MeSH
• motorické korové centrum fyziologie   MeSH
• mozková kůra fyziologie   MeSH
• nervové dráhy fyziologie   MeSH
• neurony fyziologie   MeSH
• somatosenzorické korové centrum fyziologie   MeSH
• temenní lalok fyziologie   MeSH
• týlní lalok fyziologie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

There is a paucity of data to guide anterior nucleus of the thalamus (ANT) deep brain stimulation (DBS) with brain sensing. The clinical Medtronic Percept DBS device provides constrained brain sensing power within a frequency band (power-in-band [PIB]), recorded in 10-min averaged increments. Here, four patients with temporal lobe epilepsy were implanted with an investigational device providing full bandwidth chronic intracranial electroencephalogram (cEEG) from bilateral ANT and hippocampus (Hc). ANT PIB-based seizure detection was assessed. Detection parameters were cEEG PIB center frequency, bandwidth, and epoch duration. Performance was evaluated against epileptologist-confirmed Hc seizures, and assessed by area under the precision-recall curve (PR-AUC). Data included 99 days of cEEG, and 20, 278, 3, and 18 Hc seizures for Subjects 1-4. The best detector had 7-Hz center frequency, 5-Hz band width, and 10-s epoch duration (group PR-AUC = .90), with 75% sensitivity and .38 false alarms per day for Subject 1, and 100% and .0 for Subjects 3 and 4. Hc seizures in Subject 2 did not propagate to ANT. The relative change of ANT PIB was maximal ipsilateral to seizure onset for all detected seizures. Chronic ANT and Hc recordings provide direct guidance for ANT DBS with brain sensing.

• Klíčová slova
• chronic brain recordings, deep brain stimulation, neuromodulation, seizure detection,
• MeSH
• epilepsie * terapie   MeSH
• hipokampus diagnostické zobrazování   MeSH
• hluboká mozková stimulace * MeSH
• lidé MeSH
• nuclei anteriores thalami * fyziologie   MeSH
• thalamus MeSH
• záchvaty diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

Rhythmic cortical phenomena were evoked by stimulation of hippocampus and/or thalamus in rats. Electrical stimulation of thalamic nuclei (nc. ventralis dorsomedialis VDM and nc. lateralis anterior--LA) by single pulses elicited rhythmic after-discharge ("spindle") as a late component of the cortical response, whereas identical stimulation of hippocampus did not trigger such an activity. Rhythmic stimulation of thalamic nuclei elicited cortical incremental responses more often than stimulation of hippocampus. Epileptic self-sustained after-discharges (AD) occurred after the endo of rhythmic stimulation in 66% of hippocampal stimulations, in 35% of VDM stimulations and in 30% of LA stimulations. AD evoked by stimulation of the hippocampus (long duration discharges of slow serrated waves) differed characteristically from AD following stimulation of the VMD (short duration spike and wave complexes). Stimulation of the LA in half of the cases led to the "hippocampal" pattern of serrated wave after-discharges, in the remaining cases spike-and-wave complexes or a combined AD pattern was recorded.

• MeSH
• elektrická stimulace MeSH
• elektroencefalografie * MeSH
• elektrofyziologie MeSH
• epilepsie patofyziologie   MeSH
• evokované potenciály MeSH
• hipokampus patofyziologie   MeSH
• jádra thalamu patofyziologie   MeSH
• krysa rodu Rattus MeSH
• somatosenzorické korové centrum patofyziologie   MeSH
• thalamus patofyziologie   MeSH
• týlní lalok patofyziologie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články 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.

• Klíčová slova
• Anterior nucleus of thalamus, Deep brain stimulation, Epilepsy, Evoked potentials, Mesial temporal sclerosis,
• MeSH
• dospělí MeSH
• elektrická stimulace MeSH
• epilepsie temporálního laloku patofyziologie   MeSH
• evokované potenciály fyziologie   MeSH
• hipokampus patofyziologie   MeSH
• lidé MeSH
• nervové dráhy patofyziologie   MeSH
• nuclei anteriores thalami patofyziologie   MeSH
• pilotní projekty MeSH
• záchvaty patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

Cognitive adverse effects were reported after the deep brain stimulation (DBS) of the anterior nucleus of the thalamus (AN) in epilepsy. As the AN may have an influence on widespread neocortical networks, we hypothesized that the AN, in addition to its participation in memory processing, may also participate in cognitive activities linked with the frontal neocortical structures. The aim of this study was to investigate whether the AN might participate in complex motor-cognitive activities. Three pharmacoresistant epilepsy patients implanted with AN-DBS electrodes performed two tasks involving the writing of single letters: (1) copying letters from a monitor; and (2) writing of any letter other than that appearing on the monitor. The cognitive load of the second task was increased. The task-related oscillatory changes and evoked potentials were assessed. Local event-related alpha and beta desynchronization were more expressed during the second task while the lower gamma synchronization decreased. The local field event-related potentials were elicited by the two tasks without any specific differences. The AN participates in cognitive networks processing complex motor-cognitive tasks. Attention should be paid to executive functions in subjects undergoing AN-DBS.

• MeSH
• alfa rytmus EEG MeSH
• beta rytmus EEG MeSH
• dospělí MeSH
• elektroencefalografie MeSH
• epilepsie patologie   patofyziologie   terapie   MeSH
• evokované potenciály MeSH
• gama rytmus EEG MeSH
• hluboká mozková stimulace MeSH
• kognice fyziologie   MeSH
• léková rezistence MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• motorické dovednosti fyziologie   MeSH
• nuclei anteriores thalami patologie   patofyziologie   MeSH
• psaní * MeSH
• reakční čas MeSH
• zraková percepce fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH