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High‐frequency electrical stimulation of the anterior thalamic nuclei increases vigilance in epilepsy patients during relaxed and drowsy wakefulness
Author(s) -
Bucurenciu Iancu,
Staack Anke Maren,
Gharabaghi Alireza,
Steinhoff Bernhard J.
Publication year - 2020
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.16514
Subject(s) - wakefulness , vigilance (psychology) , epilepsy , stimulation , medicine , psychology , audiology , deep brain stimulation , neuroscience , electroencephalography , anesthesia , disease , parkinson's disease
Objective High‐frequency deep brain stimulation (DBS) of anterior thalamic nuclei (ANT) reduces the frequency and intensity of focal and focal to bilateral tonic‐clonic epileptic seizures. We investigated the impact of high‐frequency ANT‐DBS on vigilance in epilepsy patients during relaxed and drowsy wakefulness, to better understand the effects and the mechanisms of action of this intervention in humans. Methods Four patients with different structural epileptic pathologies were included in this retrospective case‐cohort study. Short‐ and long‐term electroencephalography (EEG) was used to determine states of relaxed or drowsy wakefulness and the vigilance changes during stimulation‐on and stimulation‐off intervals. Results In relaxed, wakeful patients with eyes closed, the eyelid artifact rate increased acutely and reproducibly during stimulation‐on intervals, suggesting an enhanced vigilance. This effect was accompanied by a slight acceleration of the alpha rhythm. In drowsy patients with eyes closed, stimulation generated acutely and reproducibly alpha rhythms, similar to the paradoxical alpha activation during eyes opening. The occurrence of the alpha rhythms reflected an increase in the vigilance of the drowsy subjects during ANT‐DBS. Significance This is the first demonstration that ANT‐DBS increases the vigilance of wakeful epilepsy patients. Our results deliver circumstantial evidence that high‐frequency ANT‐DBS activates thalamocortical connections that promote wakefulness.