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Responsive stimulation of the thalamus for idiopathic generalized epilepsy: Results of the randomized controlled NAUTILUS trial through 18 months.

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Updated: Jan 13, 2026

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Clusters in Thalamic iEEG Spectral Features Reveal Sleep/Wake Differences Over Time.

David Burdette1, Sanjay Patra1, Martha Morrell2,3

  • 1Corewell Health; Grand Rapids, MI.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
|January 6, 2026
PubMed
Summary

Thalamic intracranial EEG data can identify sleep/wake states, enabling state-dependent neuromodulation for epilepsy. Changes in thalamocortical networks may be driven by neuromodulation, requiring further study.

Keywords:
CorticothalamicEpilepsyResponsive neurostimulation

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Area of Science:

  • Neuroscience
  • Epileptology
  • Biomedical Engineering

Background:

  • The thalamus is a key node in epilepsy networks due to its connections with the cortex.
  • Corticothalamic stimulation offers a potential strategy for focal neocortical epilepsy.
  • Sleep-wake cycles significantly interact with epilepsy, influencing treatment strategies.

Purpose of the Study:

  • To investigate the potential of thalamic intracranial EEG (iEEG) to differentiate sleep and wake states.
  • To explore state-dependent neuromodulation possibilities in epilepsy treatment.
  • To analyze neuromodulation-driven changes in thalamocortical networks.

Main Methods:

  • Retrospective analysis of 30 focal epilepsy patients undergoing cortical and thalamic responsive neurostimulation.
  • Thalamic leads implanted in specific nuclei (centromedian, pulvinar, mediodorsal, anterior) based on patient characteristics.
  • Evaluation of interictal thalamic iEEG power spectrum changes across frequency bands during ambulatory recordings.

Main Results:

  • Two distinct frequency clusters identified, correlating with daytime and nighttime recordings.
  • Time series evolution of clusters showed divergence, indicating state-specific patterns.
  • Cluster prominence varied across electrode contacts, suggesting anatomical specificity.

Conclusions:

  • Thalamic iEEG can potentially detect sleep/wake states electrographically, obviating traditional sleep studies.
  • This capability could facilitate state-dependent neuromodulation therapies for epilepsy.
  • Observed sleep/wake cluster changes may reflect neuromodulation effects on thalamocortical networks, meriting further research.