Anterior nucleus of the thalamus seizure detection in ambulatory humans
Anterior nucleus of the thalamus seizure detection in ambulatory humans
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DOI：
10.1111/epi.17047
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发表时间：
2021-08-21
期刊：
影响因子：
5.6
通讯作者：
Worrell, Gregory A.
中科院分区：
文献类型：
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作者：
Gregg, Nicholas M.;Marks, Victoria S.;Worrell, Gregory A.
缺乏指导丘脑前核（ANT）脑深部电刺激（DBS）的数据。临床Medtronic Percept DBS器械在频带内提供受限的大脑感知功率（带内功率[PIB]），以10分钟平均增量记录。在此，4例颞叶癫痫患者植入了一种研究器械，可从双侧ANT和海马（Hc）提供全带宽慢性颅内脑电图（cEEG）。评估了基于ANT PIB的癫痫发作检测。检测参数为cEEG PIB中心频率、带宽和历元持续时间。根据癫痫病学家证实的Hc癫痫发作评价性能，并通过精确-回忆曲线下面积（PR-AUC）进行评估。数据包括受试者1-4的99天cEEG和20、278、3和18 Hc癫痫发作。最佳检测器的中心频率为7 Hz，带宽为5 Hz，历元持续时间为10 s（组PR-AUC = 0.90），受试者1的灵敏度为75%，每天误报为0.38，受试者3和4的灵敏度为100%，每天误报为0.0。受试者2的HC癫痫发作未传播至ANT。对于所有检测到的癫痫发作，同侧ANT PIB的相对变化最大。慢性ANT和Hc记录为ANT DBS与大脑感应提供直接指导。
There is a paucity of data to guide anterior nucleus of the thalamus (ANT) deep brain stimulation (DBS) with brain sensing. The clinical Medtronic Percept DBS device provides constrained brain sensing power within a frequency band (power-in-band [PIB]), recorded in 10-min averaged increments. Here, four patients with temporal lobe epilepsy were implanted with an investigational device providing full bandwidth chronic intracranial electroencephalogram (cEEG) from bilateral ANT and hippocampus (Hc). ANT PIB-based seizure detection was assessed. Detection parameters were cEEG PIB center frequency, bandwidth, and epoch duration. Performance was evaluated against epileptologist-confirmed Hc seizures, and assessed by area under the precision-recall curve (PR-AUC). Data included 99 days of cEEG, and 20, 278, 3, and 18 Hc seizures for Subjects 1-4. The best detector had 7-Hz center frequency, 5-Hz band width, and 10-s epoch duration (group PR-AUC = .90), with 75% sensitivity and .38 false alarms per day for Subject 1, and 100% and .0 for Subjects 3 and 4. Hc seizures in Subject 2 did not propagate to ANT. The relative change of ANT PIB was maximal ipsilateral to seizure onset for all detected seizures. Chronic ANT and Hc recordings provide direct guidance for ANT DBS with brain sensing.