A Comprehensive Neurotechnology Platform for Brain Network Sensing and Stimulation: Optimizing Limbic Circuit Epilepsy Therapy with Quantitative Behavioral Tracking
Abstract number :
1.195
Submission category :
2. Translational Research / 2B. Devices, Technologies, Stem Cells
Year :
2024
Submission ID :
951
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Vaclav Kremen, PhD, MS, EMBA – Department of Neurology, Mayo Clinic, Rochester MN USA
Vlad Sladky, BS – Department of Neurology, Mayo Clinic, Rochester MN USA
Filip Mivalt, MS – Mayo Clinic
Irena Balzekas, Ph.D. – Mayo Clinic
Nicholas Gregg, MD – Mayo Clinic
Brian Lundstrom, MD, PhD – Mayo Clinic
Benjamin Brinkmann, PhD – Department of Neurology, Mayo Clinic, Rochester MN USA
Erik St. Louis, MD – Mayo Clinic
Jamie Van Gompel, MD – Mayo Clinic
Kai Miller, MD, PhD – Mayo Clinic
Timothy Denison, Ph.D. – University of Oxford
Gregory Worrell, MD, PhD – Mayo Clinic
Rationale: Temporal lobe epilepsy, a prevalent neurological disorder, is marked by recurrent seizures originating from limbic networks and accompanied by chronic comorbidities affecting memory, mood, and sleep (MMS). Deep brain stimulation targeting the anterior nucleus of the thalamus (ANT-DBS) has shown therapeutic promise, yet the optimal stimulation parameters remain elusive.
Methods: We developed a neurotechnology platform designed to track seizures and MMS, facilitating seamless data streaming between an investigational brain sensing-stimulation implant, mobile devices, and a cloud environment. Utilizing artificial intelligence algorithms, our system accurately catalogs seizures, interictal epileptiform spikes, and wake-sleep brain states. Remotely administered memory and mood assessments provides a dense sampling of cognitive and behavioral responses during ANT-DBS.
Results: The system has shown an excellent safety profile in preclinical trials with canines, leading to an FDA Investigational Device Exemption for an initial feasibility study with 20 individuals with Temporal Lobe Epilepsy. To date, the system has been successfully implanted in 10 participants, continuously monitoring seizures, sleep patterns, memory, and mood variations over several months. Evaluation of low-frequency versus high-frequency ANT-DBS revealed that while both approaches reduce seizure frequency and IES, low-frequency ANT-DBS improves sleep and memory outcomes.
Conclusions: These findings underscore the potential of integrated brain sensing and behavioral tracking for enhancing neuromodulation therapies in limbic circuit epilepsy.
Funding: NIH Brain Initiative UH2&3 NS095495 Neurophysiologically-Based Brain State Tracking & Modulation in Focal Epilepsy, R01-NS92882 Reliable Seizure Prediction Using Physiological Signals and Machine Learning, UG3/UH3 112826 Thalamic stimulation to prevent impaired consciousness in epilepsy, DARPA HR0011-20-2-0028 Manipulating and Optimizing Brain Rhythms for Enhancement of Sleep (Morpheus), Mayo Clinic, and Medtronic Inc. Medtronic provided the investigational Medtronic Summit RC+STM devices.
Translational Research