颞叶癫痫的边缘回路调节:对癫痫发作、记忆、情绪和睡眠的影响。

IF 4.1 Q1 CLINICAL NEUROLOGY
Brain communications Pub Date : 2025-04-07 eCollection Date: 2025-01-01 DOI:10.1093/braincomms/fcaf106
Vaclav Kremen, Vladimir Sladky, Filip Mivalt, Nicholas M Gregg, Benjamin H Brinkmann, Irena Balzekas, Victoria Marks, Michal Kucewicz, Brian Nils Lundstrom, Jie Cui, Erik K St Louis, Paul Croarkin, Eva C Alden, Boney Joseph, Julie Fields, Karla Crockett, Jindrich Adolf, Jordan Bilderbeek, Dora Hermes, Steven Messina, Kai Joshua Miller, Jamie Van Gompel, Timothy Denison, Gregory A Worrell
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引用次数: 0

摘要

颞叶癫痫是一种常见的神经系统疾病,其特征是反复发作,通常起源于涉及杏仁核和海马的边缘网络。大脑边缘网络参与了包括记忆、情感和睡眠在内的重要生理功能。颞叶癫痫通常是耐药的,人们经常经历与记忆、情绪和睡眠相关的合并症。针对丘脑前核的深部脑刺激(ANT-DBS)是一种成熟的颞叶癫痫治疗方法。然而,最佳刺激参数及其对记忆、情绪和睡眠合并症的影响尚不清楚。我们使用了一种研究性的大脑感觉刺激植入装置来准确地追踪5名流动受试者的癫痫发作、癫痫发作间期峰(IES)以及记忆、情绪和睡眠合并症。在集成了云环境的移动设备上捕获了边缘网络局部场电位(LFPs)和受试者行为的无线流。应用于连续lfp的自动算法对癫痫发作、IES和睡眠-觉醒大脑状态进行准确分类。在ANT-DBS期间,对生活在自然家庭环境中的流动受试者进行远程记忆和情绪评估,以密集样本进行认知和行为反应。我们评估了持续低频和占空比高频抗脑起搏器对癫痫样活动、记忆、情绪和睡眠共病的影响。低频和高频抗- dbs疗法均能减少癫痫发作。然而,持续的低频抗脑起搏器显示出更大的IES减少,电痉挛和更好的睡眠和记忆结果。这些结果强调了同步脑传感和密集行为跟踪在ANT-DBS期间优化神经调节治疗的潜力。虽然需要更大患者数量的研究来验证低频抗- dbs的益处,但这些发现可能适用于目前植入抗- dbs系统的个体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modulating limbic circuits in temporal lobe epilepsy: impacts on seizures, memory, mood and sleep.

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.

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CiteScore
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