Characteristics of ictal thalamic EEG in pediatric-onset neocortical focal epilepsy

Benjamin Edmonds; Makoto Miyakoshi; Luigi Gianmaria Remore; Samuel Ahn; H Westley Phillips; Atsuro Daida; Noriko Salamon; Ausaf Bari; Raman Sankar; Joyce H Matsumoto; Aria Fallah; Hiroki Nariai

doi:10.1016/j.clinph.2023.07.007

Characteristics of ictal thalamic EEG in pediatric-onset neocortical focal epilepsy

Clin Neurophysiol. 2023 Oct:154:116-125. doi: 10.1016/j.clinph.2023.07.007. Epub 2023 Aug 6.

Authors

Affiliations

¹ Division of Pediatric Neurology, Department of Pediatrics, UCLA Mattel Children's Hospital, David Geffen School of Medicine, Los Angeles, CA, USA. Electronic address: benjamin.edmonds@seattlechildrens.org.
² Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Swartz Center for Computational Neuroscience, Institute for Neural Computation, University of California San Diego, UCSD Medical Center, San Diego, CA, USA. Electronic address: Makoto.Miyakoshi@cchmc.org.
³ Department of Neurosurgery, UCLA Medical Center, David Geffen School of Medicine, Los Angeles, CA, USA.
⁴ Division of Pediatric Neurology, Department of Pediatrics, UCLA Mattel Children's Hospital, David Geffen School of Medicine, Los Angeles, CA, USA.
⁵ Department of Radiological Sciences, University of California, Los Angeles, CA, USA.
⁶ Division of Pediatric Neurology, Department of Pediatrics, UCLA Mattel Children's Hospital, David Geffen School of Medicine, Los Angeles, CA, USA; The UCLA Children's Discovery and Innovation Institute, Los Angeles, CA, USA.
⁷ Division of Pediatric Neurology, Department of Pediatrics, UCLA Mattel Children's Hospital, David Geffen School of Medicine, Los Angeles, CA, USA; The UCLA Children's Discovery and Innovation Institute, Los Angeles, CA, USA. Electronic address: hnariai@mednet.ucla.edu.

PMID: 37595481
PMCID: PMC10529874 (available on 2024-10-01)
DOI: 10.1016/j.clinph.2023.07.007

Abstract

Objective: To characterize ictal EEG change in the centromedian (CM) and anterior nucleus (AN) of the thalamus, using stereoelectroencephalography (SEEG) recordings.

Methods: Forty habitual seizures were analyzed in nine patients with pediatric-onset neocortical drug-resistant epilepsy who underwent SEEG (age 2-25 y) with thalamic coverage. Both visual and quantitative analysis was used to evaluate ictal EEG signal in the cortex and thalamus. The amplitude and cortico-thalamic latencies of broadband frequencies at ictal onset were measured.

Results: Visual analysis demonstrated consistent detection of ictal EEG changes in both the CM nucleus and AN nucleus with latency to thalamic ictal EEG changes of less than 400 ms in 95% of seizures, with low-voltage fast activity being the most common ictal pattern. Quantitative broadband amplitude analysis showed consistent power changes across the frequency bands, corresponding to ictal EEG onset, while while ictal EEG latency was variable from -18.0 seconds to 13.2 seconds. There was no significant difference between detection of CM and AN ictal activity on visual or amplitude analysis. Four patients with subsequent thalamic responsive neurostimulation (RNS) demonstrated ictal EEG changes consistent with SEEG findings.

Conclusions: Ictal EEG changes were consistently seen at the CM and AN of the thalamus during neocortical seizures.

Significance: It may be feasible to use a closed-loop system in the thalamus to detect and modulate seizure activity for neocortical epilepsy.

Keywords: Drug-resistant epilepsy; Epilepsy surgery; Neurostimulation; RNS; Thalamus.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adolescent
Adult
Child
Child, Preschool
Electroencephalography
Epilepsies, Partial* / diagnosis
Epilepsy* / diagnosis
Humans
Neocortex*
Seizures
Thalamus
Young Adult

Abstract

Publication types

MeSH terms

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