Evidence map›Paper›PMID 34458713›Full record

ArticleEpilepsy & behavior reports2021

Effects of anterior thalamic nuclei stimulation on hippocampal activity: Chronic recording in a patient with drug-resistant focal epilepsy.

Alexander B Silva, Ankit N Khambhati, Benjamin A Speidel, Edward F Chang, Vikram R Rao

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsy & behavior reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Article
  6. Towards network-guided neuromodulation for epilepsy.Brain : a journal of neurology · 2022
    Review
  7. Article
  8. Article
  9. Article
  10. Emerging Trends in Neuromodulation for Treatment of Drug-Resistant Epilepsy.Frontiers in pain research (Lausanne, Switzerland) · 2022
    Review
  11. Article
  12. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alexander B SilvaMedical Scientist Training Program, University of California, San Francisco, USA.
Ankit N KhambhatiDepartment of Neurological Surgery and Weill Institute for Neurosciences, University of California, San Francisco, USA.
Benjamin A SpeidelDepartment of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, United States.
Edward F ChangDepartment of Neurological Surgery and Weill Institute for Neurosciences, University of California, San Francisco, USA.
Vikram R RaoDepartment of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, United States.

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007618 · NIGMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ANDERSON, MARK S · 1985 to 2020
$29.6M
NIGMS NIH HHS T32 GM007618
6 · The paper itself

Abstract

Implanted neurostimulation devices are gaining traction as palliative treatment options for certain forms of drug-resistant epilepsy, but clinical utility of these devices is hindered by incomplete mechanistic understanding of their therapeutic effects. Approved devices for anterior thalamic nuclei deep brain stimulation (ANT DBS) are thought to work at a network level, but limited sensing capability precludes characterization of neurophysiological effects outside the thalamus. Here, we describe a patient with drug-resistant temporal lobe epilepsy who was implanted with a responsive neurostimulation device (RNS System), involving hippocampal and ipsilateral temporal neocortical leads, and subsequently received ANT DBS. Over 1.5 years, RNS System electrocorticography enabled multiscale characterization of neurophysiological effects of thalamic stimulation. In brain regions sampled by the RNS System, ANT DBS produced acute, phasic, frequency-dependent responses, including suppression of hippocampal low frequency local field potentials. ANT DBS modulated functional connectivity between hippocampus and neocortex. Finally, ANT DBS progressively suppressed hippocampal epileptiform activity in relation to the extent of hippocampal theta suppression, which informs stimulation parameter selection for ANT DBS. Taken together, this unique clinical scenario, involving hippocampal recordings of unprecedented chronicity alongside ANT DBS, sheds light on the therapeutic mechanism of thalamic stimulation and highlights capabilities needed in next-generation devices.

Indexed as

Biomarkers of treatmentChronic electrocorticographyDeep brain stimulationEpilepsyFunctional connectivityHippocampus

Identifiers

PMID34458713
PMCPMC8379668

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.