Thalamic Stimulation Induced Changes in Network Connectivity and Excitability in Epilepsy.

Area of Science:

• Neuroscience
• Neurology
• Biomarkers

Background:

• Deep brain stimulation (DBS) effects occur over various timescales, complicating epilepsy treatment optimization.
• Brain stimulation evoked potentials (BSEPs) offer insights into network excitability and connectivity.

Purpose of the Study:

• To integrate BSEPs and DBS trials during sEEG to map seizure networks.
• To modulate network dynamics and monitor excitability for biomarker-informed neuromodulation in epilepsy.

Main Methods:

• Retrospective analysis of 10 epilepsy patients undergoing clinical sEEG.
• High-frequency thalamic DBS trials with pre- and post-stimulation BSEP acquisition.
• Automated tracking of interictal epileptiform discharges.

Main Results:

• Baseline BSEPs identified distinct thalamic subfield network engagement patterns.
• DBS >1.5 hours reduced BSEP amplitudes, correlating with connectivity strength.
• Shorter DBS trials suppressed interictal epileptiform discharge rates in connected networks.

Conclusions:

• BSEPs and DBS trials during sEEG provide novel network biomarkers.
• This approach enables evaluation of large-scale network modulation across timescales.
• Advances biomarker-informed neuromodulation strategies for epilepsy treatment.