Journal article
Modulating limbic circuits in temporal lobe epilepsy: impacts on seizures, memory, mood and sleep
- Abstract:
- Temporal lobe epilepsy is a common neurological disease characterized by recurrent seizures that often originate within limbic networks involving amygdala and hippocampus. The limbic network is involved in crucial physiologic functions involving memory, emotion and sleep. Temporal lobe epilepsy is frequently drug-resistant, and people often experience comorbidities related to memory, mood and sleep. Deep brain stimulation targeting the anterior nucleus of the thalamus (ANT-DBS) is an established therapy for temporal lobe epilepsy. However, the optimal stimulation parameters and their impact on memory, mood and sleep comorbidities remain unclear. We used an investigational brain sensing-stimulation implanted device to accurately track seizures, interictal epileptiform spikes (IES), and memory, mood and sleep comorbidities in five ambulatory subjects. Wireless streaming of limbic network local field potentials (LFPs) and subject behaviour were captured on a mobile device integrated with a cloud environment. Automated algorithms applied to the continuous LFPs were used to accurately cataloged seizures, IES and sleep-wake brain state. Memory and mood assessments were remotely administered to densely sample cognitive and behavioural response during ANT-DBS in ambulatory subjects living in their natural home environment. We evaluated the effect of continuous low-frequency and duty cycle high-frequency ANT-DBS on epileptiform activity and memory, mood and sleep comorbidities. Both low-frequency and high-frequency ANT-DBS paradigms reduced seizures. However, continuous low-frequency ANT-DBS showed greater reductions in IES, electrographic seizures and better sleep and memory outcomes. These results highlight the potential of synchronized brain sensing and dense behavioural tracking during ANT-DBS for optimizing neuromodulation therapy. While studies with larger patient numbers are needed to validate the benefits of low-frequency ANT-DBS, these findings are potentially translatable to individuals currently implanted with ANT-DBS systems.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Supplementary materials, pdf, 3.3MB, Terms of use)
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(Preview, Version of record, pdf, 6.9MB, Terms of use)
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- Publisher copy:
- 10.1093/braincomms/fcaf106
Authors
+ European Union
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- Funder identifier:
- https://ror.org/019w4f821
- Grant:
- 101136607
+ Defense Advanced Research Projects Agency
More from this funder
- Funder identifier:
- https://ror.org/02caytj08
- Grant:
- HR0011-20-2-0028
+ National Institute of Neurological Disorders and Stroke
More from this funder
- Funder identifier:
- https://ror.org/01s5ya894
- Grant:
- UH2&3 NS095495
- R01-NS112144
- U24-NS113637
- Publisher:
- Oxford University Press
- Journal:
- Brain Communications More from this journal
- Volume:
- 7
- Issue:
- 2
- Article number:
- fcaf106
- Place of publication:
- England
- Publication date:
- 2025-04-07
- Acceptance date:
- 2025-03-07
- DOI:
- EISSN:
-
2632-1297
- Pmid:
-
40196395
- Language:
-
English
- Keywords:
- Pubs id:
-
2117203
- Local pid:
-
pubs:2117203
- Deposit date:
-
2025-05-15
- ARK identifier:
Terms of use
- Copyright holder:
- Kremen et al.
- Copyright date:
- 2025
- Rights statement:
- © The Author(s) 2025. Published by Oxford University Press on behalf of the Guarantors of Brain. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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