Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
Neuroelectrophysiological Laboratory, Xuanwu Hospital, Capital Medical University, Beijing, China.
Ann Clin Transl Neurol. 2020 Dec;7(12):2356-2369. doi: 10.1002/acn3.51214. Epub 2020 Oct 31.
Neuromodulatory anterior thalamic deep brain stimulation (DBS) is an effective therapy for intractable epilepsy, but few patients achieve complete seizure control with thalamic DBS. Other stimulation sites may be considered for anti-seizure DBS. We investigated bilateral low-frequency stimulation of the endopiriform nuclei (LFS-EPN) to control seizures induced by intracortically implanted cobalt wire in rats.
Chronic epilepsy was induced by cobalt wire implantation in the motor cortex unilaterally. Bipolar-stimulating electrodes were implanted into the EPN bilaterally. Continuous electroencephalography (EEG) was recorded using electrodes placed into bilateral motor cortex and hippocampus CA1 areas. Spontaneous seizures were monitored by long-term video-EEG, and behavioral seizures were classified based on the Racine scale. Continuous 1-Hz LFS-EPN began on the third day after electrode implantation and was controlled by a multi-channel stimulator. Stimulation continued until the rats had no seizures for three consecutive days.
Compared with the control and sham stimulation groups, the LFS-EPN group experienced significantly fewer seizures per day and the mean Racine score of seizures was lower due to fewer generalized seizures. Ictal discharges at the epileptogenic site had significantly reduced theta band power in the LFS-EPN group compared to the other groups.
Bilateral LFS-EPN attenuates cobalt wire-induced seizures in rats by modulating epileptic networks. Reduced ictal theta power of the EEG broadband spectrum at the lesion site may be associated with the anti-epileptogenic mechanism of LFS-EPN. Bilateral EPN DBS may have therapeutic applications in human partial epilepsies.
神经调节性丘脑深部电刺激（DBS）是治疗难治性癫痫的有效方法，但很少有患者通过丘脑 DBS 实现完全控制癫痫发作。可能需要考虑其他刺激部位来进行抗癫痫 DBS。我们研究了双侧内嗅核低频刺激（LFS-EPN）对大鼠皮质内植入钴丝诱导的癫痫发作的控制作用。
通过单侧皮质内植入钴丝诱导慢性癫痫。双侧植入双极刺激电极。使用放置在双侧运动皮层和海马 CA1 区的电极记录慢性脑电（EEG）。通过长期视频-EEG 监测自发性癫痫发作，并根据 Racine 量表对行为性癫痫发作进行分类。在电极植入后的第三天开始进行连续 1Hz 的 LFS-EPN，并由多通道刺激器进行控制。刺激持续到大鼠连续 3 天无癫痫发作为止。
与对照组和假刺激组相比，LFS-EPN 组每天发作的次数明显减少，发作的平均 Racine 评分也较低，因为发作次数减少且无全身性发作。与其他组相比，LFS-EPN 组在致痫部位的癫痫发作的θ波段功率显著降低。
双侧 EPN-DBS 通过调节癫痫网络来减轻大鼠钴丝诱导的癫痫发作。EEG 宽带频谱的癫痫发作时θ波功率降低可能与 LFS-EPN 的抗癫痫发生机制有关。双侧 EPN-DBS 可能在人类部分性癫痫中有治疗应用。
