Anterior Thalamic Deep Brain Stimulation: Functional Activation Patterns in a Large Animal Model

• ATN DBS (145 Hz, 90 µs, 5V) in a large animal model resulted in activation of ipsilateral temporal, prefrontal, and sensorimotor cortex.
• Amplitude- (2V, 5V, and 8V) and frequency- (60 Hz and 145 Hz) dependent effects on cortical activation were observed.
• Anterior thalamic DBS likely results in widespread, parameter-dependent effects on cortical activity.

BackgroundDeep brain stimulation (DBS) of the anterior thalamic nucleus (ATN) exerts its effects by modulating neural circuits involved in seizures. However, these networks remain incompletely characterized.ObjectiveInvestigate the effects of ATN DBS on network activity in a large animal model using 3-T fMRI.MethodsAnesthetized swine underwent ATN DBS using stimulation parameters applied in the Stimulation of the Anterior Thalamus for the Treatment of Epilepsy (SANTE) trial. Stimulation amplitude, frequency, and temporal paradigm were varied and the resulting blood oxygen level-dependent signal was measured.ResultsATN DBS resulted in activation within temporal, prefrontal, and sensorimotor cortex. An amplitude-dependent increase in cluster volume was observed at 60 Hz and 145 Hz stimulation.ConclusionATN DBS in swine induced parameter-dependent activation in cortical regions including but not limited to the Papez circuit. These findings may hold clinical implications for treatment of epilepsy in patients with temporal or extratemporal seizure foci.