Network Reorganization of Anterograde Thalamic Connectivity During Non-Periodic Patterned Deep Brain Stimulation
Johnson, T. D.; Mohan, B.; Huang, H.; Cramer, J.; Drees, C.; Hoerth, M.; Crepeau, A.; Drazkowski, J.; Noe, K.; Baxter, L.; Mbonde, A.; Harris, C.; Ince, N.; Miller, K. J.; Hermes, D.; Worrell, G.; Parker, J. J.
Show abstract
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) can reduce seizures in patients with drug-resistant epilepsy. However, seizure freedom is rare, and there is no early response biomarker to predict long-term seizure suppression. To evaluate a short-term biomarker of therapeutic response to DBS, we studied 18-minute trials of ANT stimulation in patients with drug-resistant epilepsy undergoing intracranial electroencephalography. We compared a standard high-frequency periodic versus a non-periodic pulse pattern. We found that short-term ANT stimulation within the clinically used amplitude range preferentially altered the first 150 ms of anterograde ANT to anterior cingulate and superior frontal connectivity. Non-periodic ANT stimulation selectively modified early cortico-cortical evoked potentials more than periodic stimulation, and these changes were driven by the response phase. These pattern-specific changes in connectivity between the ANT and spatially restricted cortical areas suggest differing mechanisms and are a promising biomarker for patients being treated with ANT-DBS.
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