BACKGROUND Although the mechanisms by which deep brain stimulation (DBS) modifies the activity of the ictal network are mostly undefined, recent studies have suggested that DBS of the anterior nucleus of the thalamus (ANT) can be an effective treatment for mesial temporal lobe epilepsy (MTLE) when resective surgery cannot be performed. In a nonhuman primate (NHP) model of MTL seizures, we showed that the ANT was actively involved during interictal and ictal periods through different patterns and that the hippocampus (HPC) and ANT synchronously oscillate in the high beta-band during seizures. OBJECTIVE Based on those findings, we evaluated whether the frequency of stimulation is an important parameter that interferes with seizures and how to adapt stimulation protocols to it. METHODS We investigated the effects of low-frequency (40Hz - determined as the ictal frequency of correlation between structures) and high-frequency (130Hz - as commonly used in clinic) ANT stimulation in three monkeys in which MTLE seizures were initiated. RESULTS Low-frequency stimulation had a strong effect on the number of seizures and the total time spent in seizure, whereas high-frequency stimulation had no effect. The coherence of oscillations between the HPC and the ANT was significantly correlated with the success of low-frequency stimulation: the greater the coherence was, the greater the antiepileptic effect of ANT-DBS. CONCLUSION Our results suggest that low-frequency stimulation is efficient in treating seizures in a nonhuman primate model. More importantly, the study of the coherence between the ANT and HPC during seizures can help to predict the anti-epileptic effects of ANT stimulation. Furthermore, the DBS paradigm could be customized in frequency for each patient on the basis of the coherence spectral pattern.

中文翻译：

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海马体和丘脑前核之间的一致性作为改善颞叶癫痫神经刺激效果的工具：一项实验研究

背景虽然深部脑刺激 (DBS) 改变发作网络活动的机制尚不明确，但最近的研究表明，丘脑前核 (ANT) 的 DBS 可以有效治疗内侧颞叶癫痫。 MTLE）无法进行切除手术时。在 MTL 癫痫发作的非人类灵长类动物 (NHP) 模型中，我们表明 ANT 在发作间期和发作期通过不同模式积极参与，并且海马 (HPC) 和 ANT 在癫痫发作期间在高β-波段同步振荡。目标 基于这些发现，我们评估了刺激频率是否是干扰癫痫发作的重要参数，以及如何使刺激方案适应它。方法我们研究了低频（40Hz - 确定为结构之间相关性的发作频率）和高频（130Hz - 如临床常用）ANT 刺激对三只开始 MTLE 癫痫发作的猴子的影响。结果低频刺激对癫痫发作次数和癫痫发作总时间有很强的影响，而高频刺激没有影响。HPC 和 ANT 之间振荡的相干性与低频刺激的成功显着相关：相干性越大，ANT-DBS 的抗癫痫作用越大。结论 我们的结果表明，低频刺激可有效治疗非人类灵长类动物模型的癫痫发作。更重要的是，对癫痫发作期间 ANT 和 HPC 之间一致性的研究有助于预测 ANT 刺激的抗癫痫作用。此外，DBS 范式可以根据相干谱模式为每个患者定制频率。