gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Neurophysiological effects of DBS in anterior thalamus and nucleus accumbens in an patient with frontal lobe epilepsy

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  • F.C. Schmitt - Klinik für Neurologie, Otto-von-Guericke Universität, Magdeburg
  • C. Kluge - Klinik für Neurologie, Otto-von-Guericke Universität, Magdeburg
  • L. Büntjen - Klinik für Stereotaktische Neurochirurgie, Otto-von-Guericke Universität, Magdeburg
  • H. Stefan - Zentrum für Epilepsie Erlangen, Klinik für Neurologie, Universitätsklinikum Erlangen
  • T. Zähle - Institut für Psychologie, Otto-von-Guericke Universität, Magdeburg
  • J. Matzen - Klinik für Neurologie, Otto-von-Guericke Universität, Magdeburg
  • H.J. Heinze - Klinik für Neurologie, Otto-von-Guericke Universität, Magdeburg
  • I. Galazky - Klinik für Neurologie, Otto-von-Guericke Universität, Magdeburg
  • J. Voges - Klinik für Stereotaktische Neurochirurgie, Otto-von-Guericke Universität, Magdeburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.10.09

doi: 10.3205/12dgnc252, urn:nbn:de:0183-12dgnc2523

Published: June 4, 2012

© 2012 Schmitt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: This case study aims to characterize the neurophysiological effects of DBS in the anterior thalamus (ANT) and nucleus accumbens (NAcc). Several target point were used for DBS in the treatment of pharmacoresistant epilepsy. However, very little is known about the actual physiological effects of stimulation in this combination of target points.

Methods: In a 30-year-old patient with non-lesional, multiple pharmacoresistant frontal lobe epilepsy, DBS electrodes were implanted in the anterior thalamus (ANT) and ncl. accumbens (NAcc). Local field potentials and surface EEG were recorded during the immediate post-operative period (before implantation of the pulse generator) while individual target regions were stimulated with varying voltages. Spectal content was estimated and oscillatory interactions between individual regions were assessed via coherence analyses.

Results: Stimulation of the ANT reliably leads to an increase in coherence between the frontal and the central surface EEG electrodes. Stimulation of the NAcc, in turn, leads to a mix of spectral effects, some of which increase, and some of which decrease information transfer among the regions.

Conclusions: In this patient, DBS of ANT and NAcc led to clinical benefits both in terms of seizure outcome and behavioral effects. The data presented here aims to contribute to the understanding of the putative mechanism behind the clinical improvement seen with DBS of ANT and NAcc.