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Deep brain stimulation of anterior nucleus thalami disrupts sleep in epilepsy patients
Author(s) -
Voges Berthold R.,
Schmitt Friedhelm C.,
Hamel Wolfgang,
House Patrick M.,
Kluge Christian,
Moll Christian K. E.,
Stodieck Stefan R.
Publication year - 2015
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13045
Subject(s) - deep brain stimulation , polysomnography , epilepsy , anesthesia , stimulation , thalamus , cohort , medicine , psychology , neuroscience , apnea , parkinson's disease , disease
Summary In view of the regulatory function of the thalamus in the sleep‐wake cycle, the impact of deep brain stimulation ( DBS ) of the anterior nucleus thalami ( ANT ) on sleep was assessed in a small consecutive cohort of epilepsy patients with standardized polysomnography ( PSG ). In nine patients treated with ANT ‐ DBS (voltage 5 V, frequency 145 Hz, cyclic mode), the number of arousals during stimulation and nonstimulation periods, neuropsychiatric symptoms (npS), and seizure frequency were determined. Electroclinical arousals were triggered in 14.0 to 67.0% (mean 42.4 ± SD 16.8%) of all deep brain stimuli. Six patients reported npS. Nocturnal DBS voltages were reduced in eight patients (one patient without npS refused) and PSG s were repeated. Electroclinical arousals occurred between 1.4 and 6.7 (mean 3.3 ± 1.7) times more frequently during stimulation periods compared to nonstimulation periods; the number of arousals positively correlated with the level of DBS voltage (range 1 V to 5 V) (Spearman′s rank coefficient 0.53121; p < 0.05). No patient experienced seizure deterioration and four patients reported remission of npS. This case‐cohort study provides evidence that ANT ‐ DBS interrupts sleep in a voltage‐dependent manner, thus putatively resulting in an increase of npS. Reduction of nocturnal DBS voltage seems to lead to improvement of npS without hampering efficacy of ANT ‐ DBS .