Evidence map›Paper›PMID 42119303›Full record

ArticleEBioMedicine2026

Thalamic interictal epileptic and non-epileptic events during NREM sleep in patients with focal epilepsy: a Stereo-EEG study.

Hongyi Ye, Kassem Jaber, Alyssa Ho, Lingqi Ye, John Thomas, Xiaowei Xu, Cong Chen, Yihe Chen, Guoping Ren, Matthew Moye and 9 more

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Article in EBioMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

19 authors.

Hongyi YeDepartment of Neurology and Epilepsy Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Neurology, Duke University, Durham, NC, USA.
Kassem JaberDepartment of Neurology, Duke University, Durham, NC, USA; Department of Biomedical Engineering, Duke University, Durham, NC, USA.
Alyssa HoDepartment of Neurology, Duke University, Durham, NC, USA.
Lingqi YeDepartment of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
John ThomasDepartment of Biomedical Engineering, Duke University, Durham, NC, USA; Department of Electrical and Computer Engineering Technology, Rochester Institute of Technology, Rochester, NY, USA.
Xiaowei XuDepartment of Neurology and Epilepsy Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Cong ChenDepartment of Neurology and Epilepsy Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yihe ChenDepartment of Neurology and Epilepsy Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Guoping RenDepartment of Neurology, Duke University, Durham, NC, USA; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Matthew MoyeDepartment of Neurology, Duke University, Durham, NC, USA.
Tamir AvigdorDepartment of Neurology, Duke University, Durham, NC, USA.
Irena DoležalováDepartment of Neurology, Duke University, Durham, NC, USA.
Petr KlimesDepartment of Neurology, Duke University, Durham, NC, USA.
Prachi ParikhDepartment of Neurology, Duke University, Durham, NC, USA.
Derek SouthwellDepartment of Neurosurgery, Duke University, Durham, NC, USA.
Zhe ZhengDepartment of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Junming ZhuDepartment of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Shuang WangDepartment of Neurology and Epilepsy Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Birgit FrauscherDepartment of Neurology, Duke University, Durham, NC, USA; Department of Biomedical Engineering, Duke University, Durham, NC, USA; Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada. Electronic address: birgit.frauscher@duke.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThalamic recordings are increasingly incorporated into stereo-electroencephalography (SEEG) evaluations of drug-resistant focal epilepsy to guide neuromodulation targeting. Human thalamic electrophysiology, however, is poorly defined, limiting the distinction between pathological and physiological activity. Here, we characterised interictal epileptic and non-epileptic events during non-rapid eye movement (NREM) sleep across multiple thalamic nuclei and examined their associations to seizure outcomes.

methodsWe analysed NREM sleep SEEG recordings from 64 patients with drug-resistant focal epilepsy. Electrodes sampled four thalamic nuclei: centromedian (CM), pulvinar (Pu), ventral lateral (VL), and ventral posterolateral (VPL). Patients were classified into three outcome groups: favourable, unfavourable, and surgically non-remediable. Rates of thalamic spikes, high-frequency oscillations (HFOs), spike-fast activity, and sleep spindles were analysed and compared across nuclei and outcomes.

findingsRecordings of the thalamus revealed both pathological and physiological interictal events. Interictal epileptic events were infrequent. Only ∼0.2% of seizure-onset zone spikes propagated to the thalamus. Thalamic spike-fast activity was indicative of unfavourable surgical outcomes (CM: p = 0.047, d = 0.46) or surgically non-remediable epilepsy (VL: p = 0.002, d = 0.84). In contrast, thalamic sleep spindles were ubiquitous but reduced in surgically non-remediable patients (CM: p = 0.031, d = -0.58; VL: p = 0.005, d = -0.79). Finally, unique thalamic SEEG patterns were identified, including spikes concomitant with spindles, isolated spikes, and physiological fast ripples.

interpretationThis study provides a comprehensive characterisation of thalamic interictal events during NREM sleep, enriching our understanding of thalamic pathophysiology and highlighting the value of thalamic recordings in presurgical evaluation.

fundingStart-up funding of Duke University; National Natural Science Foundation of China (82471469, 82301636); Zhejiang Provincial Natural Science Foundation (LD24H090003); Canadian Institutes of Health Research funding (PJT-175056).

Indexed as

ElectroencephalographyEpilepsies, PartialThalamusAdolescentAdultChildFemaleHumansMaleMiddle AgedYoung AdultDrug-resistant epilepsyElectroencephalogramEpilepsy biomarkerNon-rapid eye movement sleepThalamus

Identifiers

PMID42119303
PMCPMC13193782

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