EEC 2022 | What underlies the efficacy of thalamic DBS for drug-resistant epilepsy?

Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a novel and promising treatment strategy for patients with drug-resistant epilepsy. Data from the pivotal SANTE trial in 2015 showed that almost 70% of patients treated with ANT-DBS reported seizure-reduction rates greater than 50%. Jukka Peltola, MD, PhD, University Hospital of Tampere, Tampere University, Tampere, Finland, discusses the rationale behind targeting the ANT and what physiological changes underly its therapeutic efficacy. The location of the ANT makes it an attractive stimulation target: it is a major hub in the final common pathway of seizure spread and has strong connections to the hippocampus. Experimental studies have shown that stimulation on the ANT prevents impairment of consciousness and thus, interrupts the propagation of seizure activity. Given the complexity of the epilepsy network, it is conceivable that many more connections and network alterations are also at play here. More research is needed to further our understanding. This interview took place at the 14th European Epilepsy Congress (EEC) 2022 in Geneva, Switzerland.