AI Article Synopsis
- ANT DBS is a neuromodulation therapy for patients with difficult-to-treat focal seizures that progress to bilateral tonic-clonic seizures when other treatments fail.
- In a study of 10 adults, most patients (9 out of 10) experienced over 50% reduction in seizure frequency within 3 months post-surgery, with an average seizure reduction of 73.3% at the last follow-up.
- The findings suggest that ANT DBS can effectively reduce seizures in patients, particularly those with temporal lobe epilepsy, though the exact optimal lead location for best outcomes remains unclear.
Article Abstract
Background: Deep brain stimulation of the anterior nucleus of the thalamus (ANT DBS) is a neuromodulation therapy for patients with refractory focal seizures evolving into bilateral tonic-clonic seizures when pharmacotherapy as well other neuromodulation techniques including vagus nerve stimulation or responsive neurostimulation have failed.
Objective: We performed a prospective single-center study investigating the clinical efficacy and exact ANT DBS lead location in patients with DRE.
Methods: The primary outcome measure was the proportion of patients with more than 50 % reduction in diary-recorded seizures when compared to three preoperative months (baseline seizure frequency). The close postoperative follow-up was performed every 3 months. The seizure frequency, stimulation settings and adverse events were closely monitored during follow-up visits. We also analyzed the seizure outcome with location of ANT DBS active contacts.
Results: Between May 2020 and October 2022, 10 adult patients with a mean age of 38.5 years (range, 30-48 years) underwent bilateral ANT DBS surgery (mean duration of DRE 28.6 years, range 16-41 years). The median seizure count in three months period preceding surgery (baseline seizure count) was 43.2 (range, 4-150). Nine patients achieved more than 50 % seizure reduction at the last follow-up (mean range 3-33 13.6 months, months). ANT DBS caused seizure reduction 3 months after procedure as well as at last follow-up by 60.4 % and 73.3 %, respectively. Due to relatively small number of studying individuals we cannot precisely locate the area within ANT associated with good clinical outcome. Patients with temporal lobe epilepsy had a remarkable reduction of seizure frequency. No patient suffered transient or permanent neurological deficits.
Conclusions: Clinical efficacy of ANT DBS may support more widespread utilization of this neuromodulation technique especially for seizures originating from temporal lobes.
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| http://dx.doi.org/10.1016/j.eplepsyres.2023.107199 | DOI Listing |
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Objective: Stereotactic neuromodulation, such as deep brain stimulation (DBS) and responsive neurostimulation (RNS), have emerged as some of the more promising means for managing drug-resistant epilepsy. This study serves as a comprehensive analysis of DBS of the anterior nucleus of the thalamus (ANT), centromedian thalamic nucleus (CMT), and hippocampus and RNS for seizure reduction in adult intractable epilepsy.
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Background And Objectives: Deep brain stimulation (DBS) targeting the anterior nucleus of the thalamus (ANT) has been shown to be effective in treating some patients with medically refractory epilepsy. However, it remains unknown how seizures spread through the ANT relative to other thalamic nuclei. This study aimed to investigate, through simultaneous recordings from both ANT and pulvinar (PLV) nucleus, their roles in seizure propagation.
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Purpose: Anterior nucleus of the thalamus (ANT) is the only deep brain stimulation (DBS) target that is approved by the FDA for treatment of drug-resistant epilepsy (DRE). Hippocampus (HC) and centromedian nucleus (CMN) have been reported as potential DBS targets for DRE. This study aimed to assess the effectiveness and predictors of response among DRE patients treated with DBS in general and among ANT, HC and CMN DBS-targets.
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- Traumatic brain injury (TBI) can lead to long-term deficits in attention and memory, and deep brain stimulation (DBS) is being explored as a potential therapy for improving these cognitive impairments.* -
- The study tested whether early DBS after TBI in male rats can prevent memory decline and promote neuroprotection by evaluating behavioral tests and measuring brain cell health and neurotrophic factors.* -
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