Bilateral Centromedian Thalamic Nucleus Deep Brain Stimulation for Epilepsy in Children and Adults. 32 Cases and One Spectral Analysis Local Field Potentials During Emotional Stimuli
Bibliographic record
Abstract
Introduction: This study evaluates the clinical efficacy and safety of bilateral deep brain stimulation (DBS) of the centromedian (CM) nucleus of the thalamus in 32 cases in a heterogeneous population of children and adults with drug-resistant epilepsy (DRE) performed in a single center in Hospital San Vicente Fundacion Rionegro Colombia. We also analized the last patient who was implanted with Percept PC battery that allow record local field potential from the centromedianos nucleos In this patient, LFPs were analyzed during both emotional discrimination and motor tasks, providing novel insights into thalamocortical network dynamics in epilepsy. These recordings revealed task-specific oscillatory patterns that may serve as potential biomarkers for future closed-loop neuromodulation strategies.Method: A retrospective analysis was conducted on 32 patients treated between 2017 and 2024. The primary outcomes included seizure frequency, seizure-free days, and quality of life, while surgical complications and mortality were also assessed. We also analyzes local field potentials (LFPs) in one of the patient who underwent percept PC battery. The recordings were obtained during a task involving the presentation of emotional images (five happy and five sad), with the DBS stimulator turned ON. Signals were segmented according to image presentation times and analyzed using Welch’s method. A 1/f correction was applied to the power spectra to compensate for the natural decline in power at higher frequencies.Results: The general results of DBS demonstrated a significant reduction in seizure frequency, from an average of 331.97 to 21.63 seizures per month (p = 0.001), representing a 93.45% median reduction. Seizure-free days increased from 9.1 to 60.77 days per month (p = 0.012), and 83% of patients reported improved life satisfaction. Device-related infections occurred in 9.3% of patients, and three deaths unrelated to DBS were recorded. In the patient implanted with percept PC, LFPs were analyzed during both emotional discrimination and motor tasks, providing novel insights into thalamocortical network dynamics in epilepsy. These recordings revealed task-specific oscillatory patterns that may serve as potential biomarkers for future closed-loop neuromodulation strategies.Discussion: In both hemispheres, DBS ON is associated with increased low-frequency power (especially in theta and alpha bands), suggesting enhanced thalamic responsiveness to positive emotional stimuli under stimulation.The DBS ON condition reveals increased power in both hemispheres, particularly in the low-frequency range (1–5 Hz) and mid-frequency range (15–25 Hz), suggesting that stimulation enhances thalamic responsiveness to emotionally salient stimuli. In contrast, the DBS OFF condition shows reduced spectral power, indicating diminished thalamocortical engagement during passive emotional processing. These findings suggest that DBS in the centromedian thalamus does more than suppress seizures—it may also restore or enhance physiological oscillations that are otherwise dormant or disrupted in epilepsy. The reactivation of low-frequency and mid-frequency bands could reflect a normalization of thalamocortical communication, which is critical for both conscious awareness and emotional processing.Conclusions: The findings support CM-DBS as a safe and effective therapeutic option for DRE, with significant improvements in seizure control and quality of life. The integration of Percept RC technology opens new avenues for personalized, biomarker-guided DBS programming. Further prospective studies are warranted to validate these results and explore the long-term benefits of adaptive neuromodulation in epilepsy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".