Erik H Middlebrooks1, Chen Lin2, Lela Okromelidze2, Chun-Qiang Lu2, William O Tatum3, Robert E Wharen4, Sanjeet S Grewal4. 1. Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA. Electronic address: middlebrooks.erik@mayo.edu. 2. Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA. 3. Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA; Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA. 4. Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA.
Abstract
BACKGROUND: Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a recently approved therapy for patients with drug-resistant epilepsy. To date, there is a poor understanding of the mechanism of action and lack of in vivo biomarkers. We propose a method for investigating the in vivo stimulation effects using blood-oxygen-level-dependent (BOLD) magnetic resonance imaging (MRI) and present the brain activation pattern associated with ANT DBS. METHODS: Two patients undergoing ANT DBS for epilepsy underwent BOLD MRI using a block design after the DBS was programmed to alternate ON/OFF in 30-second blocks. The scanner was triggered using surface electrophysiologic recordings to detect the DBS cycle. Nine total runs were obtained and were analyzed using a general linear model. RESULTS: Active ANT stimulation produced activation within several areas of the brain, including the thalamus, bilateral anterior cingulate and posterior cingulate cortex, precuneus, medial prefrontal cortex, amygdala, ventral tegmental area, hippocampus, striatum, and right angular gyrus. CONCLUSIONS: Using block-design BOLD MRI, we were able to show widespread activation resulting from ANT DBS. Overlap with multiple areas of both the default mode and limbic networks was shown, suggesting that these nodes may modulate the effect of seizure control with ANT DBS.
BACKGROUND: Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a recently approved therapy for patients with drug-resistant epilepsy. To date, there is a poor understanding of the mechanism of action and lack of in vivo biomarkers. We propose a method for investigating the in vivo stimulation effects using blood-oxygen-level-dependent (BOLD) magnetic resonance imaging (MRI) and present the brain activation pattern associated with ANT DBS. METHODS: Two patients undergoing ANT DBS for epilepsy underwent BOLD MRI using a block design after the DBS was programmed to alternate ON/OFF in 30-second blocks. The scanner was triggered using surface electrophysiologic recordings to detect the DBS cycle. Nine total runs were obtained and were analyzed using a general linear model. RESULTS: Active ANT stimulation produced activation within several areas of the brain, including the thalamus, bilateral anterior cingulate and posterior cingulate cortex, precuneus, medial prefrontal cortex, amygdala, ventral tegmental area, hippocampus, striatum, and right angular gyrus. CONCLUSIONS: Using block-design BOLD MRI, we were able to show widespread activation resulting from ANT DBS. Overlap with multiple areas of both the default mode and limbic networks was shown, suggesting that these nodes may modulate the effect of seizure control with ANT DBS.
Authors: E H Middlebrooks; R A Domingo; T Vivas-Buitrago; L Okromelidze; T Tsuboi; J K Wong; R S Eisinger; L Almeida; M R Burns; A Horn; R J Uitti; R E Wharen; V M Holanda; S S Grewal Journal: AJNR Am J Neuroradiol Date: 2020-08-13 Impact factor: 3.825
Authors: Artur Vetkas; Jürgen Germann; Gavin Elias; Aaron Loh; Alexandre Boutet; Kazuaki Yamamoto; Can Sarica; Nardin Samuel; Vanessa Milano; Anton Fomenko; Brendan Santyr; Jordy Tasserie; Dave Gwun; Hyun Ho Jung; Taufik Valiante; George M Ibrahim; Richard Wennberg; Suneil K Kalia; Andres M Lozano Journal: Brain Commun Date: 2022-04-06
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