Authors :
Presenting Author: Taruna Yadav, PhD – Yale School of Medicine
Zheng Zhang, PhD – Yale University
Vaclav Kremen, PhD – Mayo Clinic
Jordan Burchfield, Undergraduate – University of Texas San Antonio
Kristine Dacosta, Project Manager – Yale University
Maxime Oriol, Project Manager – Yale University
Christopher Benjamin, PhD – Yale University
Kate Christison-Lagay, PhD – Yale University
Eyiyemisi Damisah, MD – Yale University
Devon Cormier, MA – Yale University
Allyson Derry, BS – Yale University
Abhijeet Gummadavelli, MD PhD – Yale University
Tyler Hamilton, - – Yale University
Lawrence Hirsch, MD – Yale University School of Medicine
Patrice Lauture, - – Yale University
Bogdan Patedakis Litvinov, MD – Yale University
Dennis Spencer, MD – Yale University
Kim Bailey, - – Mayo Clinic
Karla Crockett, - – Mayo Clinic
Starr Guzman, - – Mayo Clinic
Vladimir Sladky, MSc – Mayo Clinic
Delana Weis, CCRP – Mayo Clinic
Jennifer Hong, MD – Dartmouth-Hitchcock Medical Center
Krzysztof Bujarski, MD – DHMC/Geisel School of Medicine
Charlotte Jeffreys, CCRC – Dartmouth-Hitchcock medical center
Anastasia Kanishcheva, MPH, CCRC – Dartmouth-Hitchcock Medical Centre
Grant Moncrief, NeuroPsy – Dartmouth-Hitchcock medical center
Robert Roth, NeuroPsy – Dartmouth-Hitchcock medical center
George Thomas, MD – Dartmouth-Hitchcock medical center
Jonathan Baker, PhD – Weill Cornel Medical School
Eun Young Choi, PhD – Stanford University
Jamie Hendorson, MD – Stanford University
Matthew Hook, MS – University of Florida
Irina Korytov, - – University of Florida
Kyle O'Sullivan, MS – University of Utah
Brian Rutt, PhD – Stanford University
Joseph Giacino, PhD – Harvard Medical School
Benjamin Brinkmann, PhD – Mayo Clinic
George W Culler, MD – Dartmouth-Hitchcock medical center
Nicholas Gregg, MD – Mayo clinic, Rochester, Minnesota
Brian Lundstrom, MD PhD – Mayo clinic, Rochester, Minnesota
Imran Quraishi, MD, PhD – Yale School of Medicine
Joshua P Aronson, MD – Dartmouth-Hitchcock medical center
Jason Gerrard, MD – Yale University
Jamie J Van Gompel, MD – Mayo Clinic, Rochester MN, USA.
Christopher Butson, PhD – University of Florida
Nicholas Schiff, MD – Weill Cornel Medical School
Barbara Jobst, MD, Dr. MED, FAES, FAAN – Dartmouth Health
Gregory Worrel, MD,PhD – Mayo Clinics
Hal Blumenfeld, MD, PhD – Yale University
Rationale:
Impaired consciousness is a well-known phenomenon that negatively impacts the quality of life for people with temporal lobe epilepsy (TLE). While the mechanisms of such impairment have been studied in the limbic and neocortical regions, the involvement of intralaminar centrolateral thalamus (CL) during focal temporal lobe seizures is studied less and poorly understood. Here, we quantified intracranial EEG (icEEG) power changes in simultaneously recorded hippocampal (HC) and thalamic activity during seizures while they received bilateral thalamic stimulation.
Methods:
For our ongoing clinical trial (Stimulation of the Thalamus for Arousal Restoral in TLE), five patients with medically refractory mesial TLE were implanted with the investigational neurostimulator with close loop capabilities. During the open label CL stimulation phase, all seizures received up to 5 sec of responsive HC stimulation (125 Hz, 90 or 120 µs) followed by 5 minutes of therapeutic CL stimulation (40 or 125 Hz, 90 or 120µs) at individual’s tolerated current levels. Along with simultaneous recording from HC and CL channels, patient’s behavior during seizures was continuously assessed for ~7minutes using the Automatic Response Testing in Epilepsy (ARTiE) Watch. Tests were scored (0-3) per patient’s responses. Seizures with mean score > 2.1 and < =2.1 on the first three test items were considered Focal Preserved Consciousness (FPC) and Focal Impaired Consciousness (FIC) seizures respectively. Seizure icEEG analysis pipeline included identification and removal of HC and CL stimulation related artifacts followed by computation of fast Fourier transform based intracranial EEG power in 1-sec bins during baseline (30 sec), ictal (up to 370 sec) and postictal (60 sec) periods.