| Title |
Thalamo–cortical network underlying deep brain stimulation of centromedian thalamic nuclei in intractable epilepsy: a multimodal imaging analysis
|
|---|---|
| Published in |
Neuropsychiatric Disease and Treatment, October 2017
|
| DOI | 10.2147/ndt.s148617 |
| Pubmed ID | |
| Authors |
Seong Hoon Kim, Sung Chul Lim, Dong Won Yang, Jeong Hee Cho, Byung-Chul Son, Jiyeon Kim, Seung Bong Hong, Young-Min Shon |
| Abstract |
Deep brain stimulation (DBS) of the centromedian thalamic nucleus (CM) can be an alternative treatment option for intractable epilepsy patients. Since CM may be involved in widespread cortico-subcortical networks, identification of the cortical sub-networks specific to the target stimuli may provide further understanding on the underlying mechanisms of CM DBS. Several brain structures have distinguishing brain connections that may be related to the pivotal propagation and subsequent clinical effect of DBS. To explore core structures and their connections relevant to CM DBS, we applied electroencephalogram (EEG) and diffusion tensor imaging (DTI) to 10 medically intractable patients - three generalized epilepsy (GE) and seven multifocal epilepsy (MFE) patients unsuitable for resective surgery. Spatiotemporal activation pattern was mapped from scalp EEG by delivering low-frequency stimuli (5 Hz). Structural connections between the CM and the cortical activation spots were assessed using DTI. We confirmed an average 72% seizure reduction after CM DBS and its clinical efficiency remained consistent during the observation period (mean 21 months). EEG data revealed sequential source propagation from the anterior cingulate, followed by the frontotemporal regions bilaterally. In addition, maximal activation was found in the left cingulate gyrus and the right medial frontal cortex during the right and left CM stimulation, respectively. From DTI data, we confirmed concrete structural connections between CM and those maximal activation spots identified from EEG data. These results suggest that the anterior cingulate can be a core cortical structure for the bilateral propagation of CM stimulation. Our DTI findings also indicate that the propagation of CM stimulation may rely upon integrity of structural connections between CM and these key cortical regions. Structures and their connections found in this study may be relevant in the interpretation of the clinical outcomes of CM DBS. |
Mendeley readers
The data shown below were compiled from readership statistics for 69 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 69 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Doctoral Student | 10 | 14% |
| Researcher | 9 | 13% |
| Other | 7 | 10% |
| Student > Bachelor | 6 | 9% |
| Student > Ph. D. Student | 5 | 7% |
| Other | 9 | 13% |
| Unknown | 23 | 33% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 23% |
| Neuroscience | 12 | 17% |
| Engineering | 4 | 6% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Business, Management and Accounting | 2 | 3% |
| Other | 4 | 6% |
| Unknown | 29 | 42% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 October 2017.
All research outputs
#22,764,772
of 25,382,440 outputs
Outputs from Neuropsychiatric Disease and Treatment
#2,583
of 3,131 outputs
Outputs of similar age
#291,092
of 331,218 outputs
Outputs of similar age from Neuropsychiatric Disease and Treatment
#50
of 64 outputs
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