Deep brain stimulation for patients with refractory epilepsy: nuclei selection and surgical outcome.

Objective: By studying the surgical outcome of deep brain stimulation (DBS) of different target nuclei for patients with refractory epilepsy, we aimed to explore a clinically feasible target nucleus selection strategy.

Methods: We selected patients with refractory epilepsy who were not eligible for resective surgery. For each patient, we performed DBS on a thalamic nucleus [anterior nucleus of the thalamus (ANT), subthalamic nucleus (STN), centromedian nucleus (CMN), or pulvinar nucleus (PN)] selected based on the location of the patient's epileptogenic zone (EZ) and the possible epileptic network involved.

The anterior nucleus of the thalamus plays a role in the epileptic network.

Objectives: We investigated both the metabolic differences and interictal/ictal discharges of the anterior nucleus of the thalamus (ANT) in patients with epilepsy to clarify the relationship between the ANT and the epileptic network.

Methods: Nineteen patients with drug-resistant epilepsy who underwent stereoelectroencephalography were studied. Metabolic differences in ANT were analyzed using [18F] fluorodeoxyglucose-positron emission tomography with three-dimensional (3D) visual and quantitative analyses.

Deep brain stimulation of the subthalamic nucleus for epilepsy.

Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a promising palliative option for patients with refractory epilepsy. However, crucial questions remain unanswered: Which patients are the optimal candidates? How, where, and when to stimulate the STN? And what is the mechanism of STN-DBS action on epilepsy? Thus, we reviewed the clinical evidence on the antiepileptic effects of STN-DBS and its possible mechanisms on drug-resistant epilepsy, its safety, and the factors influencing stimulation outcomes. This information may guide clinical decision-making.

Transformative neural representations support long-term episodic memory.

Memory is often conceived as a dynamic process that involves substantial transformations of mental representations. However, the neural mechanisms underlying these transformations and their role in memory formation and retrieval have only started to be elucidated. Combining intracranial EEG recordings with deep neural network models, we provide a detailed picture of the representational transformations from encoding to short-term memory maintenance and long-term memory retrieval that underlie successful episodic memory.

Characterizing the hyper- and hypometabolism in temporal lobe epilepsy using multivariate machine learning.

Mesial temporal lobe epilepsy (MTLE) is the most common type of focal epilepsy, presenting both structural and metabolic abnormalities in the ipsilateral mesial temporal lobe. While it has been demonstrated that the metabolic abnormalities in MTLE actually extend beyond the epileptogenic zone, how such multidimensional information is associated with the diagnosis of MTLE remains to be tested. Here, we explore the whole-brain metabolic patterns in 23 patients with MTLE and 24 healthy controls using [ F]fluorodeoxyglucose PET imaging.

Anterior thalamic stimulation improves working memory precision judgments.

Background: The anterior nucleus of thalamus (ANT) has been suggested as an extended hippocampal system. The circuit of ANT and hippocampus has been widely demonstrated to be associated with memory function. Both lesions to each region and disrupting inter-regional information flow can induce working memory impairment.

Stable maintenance of multiple representational formats in human visual short-term memory.

Visual short-term memory (VSTM) enables humans to form a stable and coherent representation of the external world. However, the nature and temporal dynamics of the neural representations in VSTM that support this stability are barely understood. Here we combined human intracranial electroencephalography (iEEG) recordings with analyses using deep neural networks and semantic models to probe the representational format and temporal dynamics of information in VSTM.

Subthalamic Nucleus Stimulation Modulates Motor Epileptic Activity in Humans.

Objective: Pharmaco-refractory focal motor epileptic seizures pose a significant challenge. Deep brain stimulation (DBS) is a recently recognized therapeutic option for the treatment of refractory epilepsy. To identify the specific target for focal motor seizures, we evaluate the modulatory effects of the subthalamic nucleus (STN) stimulation because of the critical role of STN in cortico-subcortical motor processing.

Long-term outcome of unilateral deep brain stimulation of the subthalamic nucleus for a patient with drug-resistant focal myoclonic seizure.

It remains an unsolved problem in the treatment of patients with refractory focal epilepsy originating from the motor cortex since resection surgery can result in significant morbidity. Neurostimulation has emerged as an effective method for treating patients who are not suitable for conventional surgical procedures due to its relative safety, reversibility, and lower risk of complications. The subthalamic nucleus (STN) has been shown to be a potential target for treating refractory motor seizures.

The localizing and lateralizing value of palpitation aura in patients with focal epilepsy.

The semiology of auras is essential to presurgical evaluation of patients with focal epilepsy. To assess the localizing and lateralizing value of palpitation aura in focal epilepsy, we retrospectively analyzed the demography, electroclinical, neuroimaging, surgical, pathology data, and outcomes of 114 patients with focal epilepsy and the palpitation aura occurrence in relation to epileptogenic (temporal vs extratemporal, left vs right) origin. Out of 114 patients (mean age, 23.

The role of magnetoencephalography in the presurgical evaluation of patients with MRI-negative operculo-insular epilepsy.

Purpose: Magnetoencephalography (MEG) is considered to be a useful clinical tool to provide additional information for localising the epileptogenic zone or planning intracranial electrode implantation. This study aimed to evaluate the value of MEG in the presurgical localisation of the operculo-insular epileptogenic zone in patients with negative magnetic resonance imaging (MRI).

Methods: Thirteen patients with operculo-insular epilepsy and negative MRI who were identified by presurgical evaluation and underwent resective surgery from January 2011 to June 2015 were included and analysed in the study.

High-frequency stimulation of anterior nucleus of thalamus desynchronizes epileptic network in humans.

Epilepsy has been classically seen as a brain disorder resulting from abnormally enhanced neuronal excitability and synchronization. Although it has been described since antiquity, there are still significant challenges achieving the therapeutic goal of seizure freedom. Deep brain stimulation of the anterior nucleus of the thalamus has emerged as a promising therapy for focal drug-resistant epilepsy; the basic mechanism of action, however, remains unclear.

The surgical outcome of patients with bilateral temporal lobe epilepsy.

Objectives: The purpose of this study is to explore the surgical outcome of unilateral anterior temporal lobectomy (ATL) for patients with bilateral temporal lobe epilepsy (BTLE).

Methods: We retrospectively reviewed the data of patients who were diagnosed with BTLE by scalp electroencephalogram (EEG) and underwent ATL from 2001 to 2015. In addition, 80 patients were randomly selected as a control group.

Focal epilepsy with paroxysmal pain due to somatic injury.

We present two cases with paroxysmal pain that developed after a somatic injury to the trunk. The main characteristic of the episodes was paroxysmal severe pain, mainly located in the original region of somatic injury, with ipsilateral tonic or dystonic behaviour. The clinical characteristics supported a diagnosis of focal epilepsy.

Surgical treatment for patients with symptomatic generalised seizures due to brain lesions.

Object: To study the role of epilepsy surgery for patients with focal lesions who exhibited the semiology of clinically generalised seizures.

Methods: From our epilepsy surgery series, we identified 29 patients who underwent surgery for seizures, including certain types of generalised seizures, according to their ictal semiology. We systematically reviewed the brain imaging, video-EEG, surgical operation, and pathological findings data of these patients.