Epileptiform discharges in the anterior thalamus of epilepsy patients

Zsófia Jordán; Johanna-Petra Szabó; Anna Sákovics; Anna Kelemen; László Halász; Loránd Erőss; Dániel Fabó

doi:10.1016/j.isci.2024.109582

Epileptiform discharges in the anterior thalamus of epilepsy patients

iScience. 2024 Mar 27;27(5):109582. doi: 10.1016/j.isci.2024.109582. eCollection 2024 May 17.

Authors

Zsófia Jordán^{1

2}, Johanna-Petra Szabó^{1

2

3

4}, Anna Sákovics^{1

2

3}, Anna Kelemen^{1

2

5}, László Halász⁶, Loránd Erőss⁶, Dániel Fabó^{1

2

7}

Affiliations

¹ Epilepsy Unit, Department of Neurosurgery and Neurointervention, Faculty of Medicine, Semmelweis University, 1145 Budapest, Hungary.
² Member of the ERN EpiCARE, Budapest, Hungary.
³ János Szentágothai Neuroscience Program, School of PhD Studies, Semmelweis University, 1085 Budapest, Hungary.
⁴ Lendület Laboratory of Systems Neuroscience, Institute of Experimental Medicine, 1083 Budapest, Hungary.
⁵ András Pető Faculty, Semmelweis University, 1125 Budapest, Hungary.
⁶ Functional Neurosurgery Unit, Department of Neurosurgery and Neurointervention, Faculty of Medicine, Semmelweis University, 1145 Budapest, Hungary.
⁷ Department of Neurology, University of Szeged, 6720 Szeged, Hungary.

Abstract

Anterior thalamus (ANT) deep-brain stimulation (DBS) is an approved therapy for drug resistant epilepsy. We aimed to identify interictal epileptiform discharges (IED) in the ANT and to investigate their relationship with surface IEDs. Fifteen patients were monitored for two consecutive nights with externalized thalamic leads to analyze the intrathalamic epileptiform activities (TIED). Forty-six % of all contacts were located within the ANT. We found that all the responders had TIEDs within the ANT, while this held true only for 44% of the non-responders. The overall response rate (RR) at 1-year follow-up was 40%, while it was 44% in bilateral ANT hit patients and 45% in epileptic focus side hit. However, in case of TIEDs present in the focus side the RR reached as high as 71%. TIED activity may prove the pathophysiological connection to the seizure focus, and stimulation of this area might have a better suppressing effect on seizures.

Keywords: Clinical finding; Health sciences; Medical tests.