Deep brain stimulation of the anterior nucleus of the thalamus increases slow wave activity in non-rapid eye movement sleep. 2023

Jana C Buenzli, and Esther Werth, and Christian R Baumann, and Anina Belvedere, and Roland Renzel, and Lennart H Stieglitz, and Lukas L Imbach
Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.

Previous studies suggest that intermittent deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) affects physiological sleep architecture. Here, we investigated the impact of continuous ANT DBS on sleep in epilepsy patients in a multicenter crossover study in 10 patients. We assessed sleep stage distribution, delta power, delta energy, and total sleep time in standardized 10/20 polysomnographic investigations before and 12 months after DBS lead implantation. In contrast to previous studies, we found no disruption of sleep architecture or alterations of sleep stage distribution under active ANT DBS (p = .76). On the contrary, we observed more consolidated and deeper slow wave sleep (SWS) under continuous high-frequency DBS as compared to baseline sleep prior to DBS lead implantation. In particular, biomarkers of deep sleep (delta power and delta energy) showed a significant increase post-DBS as compared to baseline (36.67 ± 13.68 μV2 /Hz and 799.86 ± 407.56 μV2 *s, p < .001). Furthermore, the observed increase in delta power was related to the location of the active stimulation contact within the ANT; we found higher delta power and higher delta energy in patients with active stimulation in more superior contacts as compared to inferior ANT stimulation. We also observed significantly fewer nocturnal electroencephalographic discharges in DBS ON condition. In conclusion, our findings suggest that continuous ANT DBS in the most cranial part of the target region leads to more consolidated SWS. From a clinical perspective, these findings suggest that patients with sleep disruption under cyclic ANT DBS could benefit from an adaptation of stimulation parameters to more superior contacts and continuous mode stimulation.

UI MeSH Term Description Entries
D005133 Eye Movements Voluntary or reflex-controlled movements of the eye. Eye Movement,Movement, Eye,Movements, Eye
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069279 Drug Resistant Epilepsy Epileptic condition in which adequate trials of two tolerated and appropriately chosen and used ANTIEPILEPTIC DRUGS schedules to achieve sustained seizure freedom failed. Drug Refractory Epilepsy,Epilepsy, Drug Refractory,Epilepsy, Drug Resistant,Epilepsy, Intractable,Intractable Epilepsy,Medication Resistant Epilepsy,Refractory Epilepsy,Drug Refractory Epilepsies,Drug Resistant Epilepsies,Epilepsies, Drug Refractory,Epilepsies, Drug Resistant,Epilepsies, Intractable,Epilepsies, Medication Resistant,Epilepsies, Refractory,Epilepsy, Medication Resistant,Epilepsy, Refractory,Intractable Epilepsies,Medication Resistant Epilepsies,Refractory Epilepsies,Refractory Epilepsies, Drug,Refractory Epilepsy, Drug,Resistant Epilepsies, Drug,Resistant Epilepsies, Medication,Resistant Epilepsy, Drug,Resistant Epilepsy, Medication
D012890 Sleep A readily reversible suspension of sensorimotor interaction with the environment, usually associated with recumbency and immobility. Sleep Habits,Sleeping Habit,Sleeping Habits,Habit, Sleep,Habit, Sleeping,Habits, Sleep,Habits, Sleeping,Sleep Habit
D046690 Deep Brain Stimulation Therapy for MOVEMENT DISORDERS, especially PARKINSON DISEASE, that applies electricity via stereotactic implantation of ELECTRODES in specific areas of the BRAIN such as the THALAMUS. The electrodes are attached to a neurostimulator placed subcutaneously. Brain Stimulation, Deep,Electrical Stimulation of the Brain,Brain Stimulations, Deep,Deep Brain Stimulations,Stimulation, Deep Brain,Stimulations, Deep Brain
D018592 Cross-Over Studies Studies comparing two or more treatments or interventions in which the subjects or patients, upon completion of the course of one treatment, are switched to another. In the case of two treatments, A and B, half the subjects are randomly allocated to receive these in the order A, B and half to receive them in the order B, A. A criticism of this design is that effects of the first treatment may carry over into the period when the second is given. (Last, A Dictionary of Epidemiology, 2d ed) Cross-Over Design,Cross-Over Trials,Crossover Design,Crossover Studies,Crossover Trials,Cross Over Design,Cross Over Studies,Cross Over Trials,Cross-Over Designs,Cross-Over Study,Crossover Designs,Crossover Study,Design, Cross-Over,Design, Crossover,Designs, Cross-Over,Designs, Crossover,Studies, Cross-Over,Studies, Crossover,Study, Cross-Over,Study, Crossover,Trial, Cross-Over,Trial, Crossover,Trials, Cross-Over,Trials, Crossover
D020643 Anterior Thalamic Nuclei Three nuclei located beneath the dorsal surface of the most rostral part of the thalamus. The group includes the anterodorsal nucleus, anteromedial nucleus, and anteroventral nucleus. All receive connections from the MAMILLARY BODY and BRAIN FORNIX, and project fibers to the CINGULATE BODY. Anterior Nuclear Group,Anterodorsal Thalamic Nucleus,Anteromedial Thalamic Nucleus,Anteroventral Thalamic Nucleus,Anterior Nucleus of Thalamus,Anterior Thalamic Nucleus,Anterior Thalamus,Anterodorsal Nucleus,Anteromedial Nucleus,Anteroventral Nucleus,Nuclei, Anterior Thalamic,Nucleus, Anterodorsal,Nucleus, Anterodorsal Thalamic,Nucleus, Anteromedial,Nucleus, Anteromedial Thalamic,Nucleus, Anteroventral,Nucleus, Anteroventral Thalamic,Thalamic Nuclei, Anterior,Thalamic Nucleus, Anterodorsal,Thalamic Nucleus, Anteromedial,Thalamic Nucleus, Anteroventral,Thalamus Anterior Nucleus,Thalamus, Anterior

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