Abstracts

Characterization of Sensory Side Effects Associated with Centromedian Nucleus Stimulation

Abstract number : 3.48
Submission category : 3. Neurophysiology / 3E. Brain Stimulation
Year : 2023
Submission ID : 1465
Source : www.aesnet.org
Presentation date : 12/4/2023 12:00:00 AM
Published date :

Authors :
Presenting Author: Gamaleldin Osman, MD – University of Texas in Houston

Hugh Simpson, MD, PhD – Department of Neurology, – Alfred Health, Melbourne, VIC, Australia; Bryan Klassen, MD – Department of Neurology – Mayo Clinic, Rochester, MN, USA; Brian Lundstrom, MD, PhD – Department of Neurology – Mayo Clinic, Rochester, MN, USA; Kai Miller, MD, PhD – Department of Neurosurgery – Mayo Clinic, Rochester, MN, USA; Jamie Van Gompel, MD – Department of Neurosurgery – Mayo Clinic, Rochester, MN, USA; Gregory Worrell, MD, PhD – Department of Neurology – Mayo Clinic, Rochester, MN, USA; Nicholas Gregg, MD – Department of Neurology – Mayo Clinic, Rochester, MN, USA

Rationale: CM-DBS and RNS are used to treat medication-resistant epilepsy. CM-DBS has also been used to treat movement disorders including Tourette syndrome. Sensory side effects are frequently noted and may limit therapy delivery, but have not been systematically investigated. 

Methods: Here we completed a retrospective chart review of clinical characteristics of patients undergoing testing for sensory side effects following CM-DBS or CM implantation as part of SEEG evaluation. Pre-operative MRI was co-registered to post-operative CT and electrodes were localized using Lead-DBS MATLAB toolbox. Linear regression analysis was utilized to assess effect of distance to relevant nearby anatomical structures (DISTAL thalamus atlas) on threshold to sensory side effects. ANOVA was used for P-value determination.  

Results: A total of 24 patients were identified including 23 patients with CM-DBS and one patient with CM implantation as part of SEEG evaluation. 22/24 (91.6%) patients had sensory side effects during clinical testing. Threshold to sensory side effects ranged from 0.2-5.3mA. Distance to rostral medial lemniscus (ML) predicted 24% of the variance in threshold to sensory side effects with stimulation of the two most distal contacts (pP= 4.4x10e-5). Distance of two most proximal stimulation contacts to VPL or VPM did not significantly predict sensory thresholds 

Conclusions: Sensory side effects are common with CM stimulation.  Close proximity to ML is associated with lower threshold to sensory side effects, which may impact therapy delivery. The location of the ML may be relevant for CM targeting.

Funding: None

Neurophysiology