Single-Cell Recordings to Target the Anterior Nucleus of the Thalamus in Deep Brain Stimulation for Patients with Refractory Epilepsy

Frederic L. W. V. J. Schaper, Yan Zhao, Marcus L. F. Janssen, G. Louis Wagner, Albert J. Colon, Danny M. W. Hilkman, Erik Gommer, Marielle C. G. Vlooswijk, Govert Hoogland, Linda Ackermans, Lo J. Bour, Richard J. A. Van Wezel, Paul Boon, Yasin Temel, Tjitske Heida, Vivianne H. J. M. Van Kranen-Mastenbroek, Rob P. W. Rouhl*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a promising treatment for patients with refractory epilepsy. However, therapy response varies and precise positioning of the DBS lead is potentially essential for maximizing therapeutic efficacy. We investigate if single-cell recordings acquired by microelectrode recordings can aid targeting of the ANT during surgery and hypothesize that the neuronal firing properties of the target region relate to clinical outcome. We prospectively included 10 refractory epilepsy patients and performed microelectrode recordings under general anesthesia to identify the change in neuronal signals when approaching and transecting the ANT. The neuronal firing properties of the target region, anatomical locations of microelectrode recordings and active contact positions of the DBS lead along the recorded trajectory were compared between responders and nonresponders to DBS. We obtained 19 sets of recordings from 10 patients (five responders and five nonresponders). Amongst the 403 neurons detected, 365 (90.6%) were classified as bursty. Entry into the ANT was characterized by an increase in firing rate while exit of the ANT was characterized by a decrease in firing rate. Comparing the trajectories of responders to nonresponders, we found differences neither in the neuronal firing properties themselves nor in their locations relative to the position of the active contact. Single-cell firing rate acquired by microelectrode recordings under general anesthesia can thus aid targeting of the ANT during surgery, but is not related to clinical outcome in DBS for patients with refractory epilepsy.

Original languageEnglish
Article number1850012
Number of pages12
JournalInternational Journal of Neural Systems
Volume29
Issue number4
DOIs
Publication statusPublished - May 2019

Keywords

  • Deep brain stimulation
  • anterior nucleus of the thalamus
  • epilepsy
  • microelectrode recordings
  • ELECTRICAL-STIMULATION
  • SUBTHALAMIC NUCLEUS
  • DBS

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