Non-invasive Temporal Interference Stimulation of the Hippocampus Suppresses Epileptic Biomarkers in Patients with Epilepsy: Biophysical Differences between Kilohertz and Amplitude Modulated Stimulation

作者：Florian Missey, Emma Acerbo, Adam S. Dickey, Jan Trajlínek, Ondřej Studnička, Claudia Lubrano, Mariane de Araújo e Silva, Evan Brady, Vít Všianský, Johanna Petra Szabó, Irena Doležalová, Dániel Fabó, Martin Pail, Claire‐Anne Gutekunst, Rosanna Migliore, Michele Migliore, Stanislas Lagarde, Romain Carron, Fariba Karimi, Raul Castillo Astorga, Antonino M. Cassarà, Niels Kuster, Esra Neufeld, Fabrice Bartolomei, Nigel P. Pedersen, Robert E. Gross, Viktor Jirsa, Daniel L. Drane, Milan Brázdil, Adam Williamson · 发表于：medRxiv · 年份：2024 · DOI：10.1101/2024.12.05.24303799 · 被引用次数：17 · 研究领域：Neurological disorders and treatments、Neuroscience and Neural Engineering、EEG and Brain-Computer Interfaces

Medication refractory focal epilepsy creates a significant challenge, with approximately 30% of patients ineligible for surgery due to the involvement of eloquent cortex in the epileptogenic network. For such patients with limited surgical options, electrical neuromodulation represents a promising alternative therapy. In this study, we investigate the potential of non-invasive temporal interference (TI) electrical stimulation to reduce epileptic biomarkers in patients with epilepsy by comparing intracerebral recordings obtained before, during, and after TI stimulation, to recordings during low and high kHz frequency (HF) sham stimulation. Thirteen patients with symptoms of mesiotemporal epilepsy (MTLE) and implanted with stereoelectroencephalography (sEEG) depth electrodes received TI stimulation with an amplitude modulation (AM) frequency of 130Hz (df), where the AM was delivered with lower frequency kHz carriers (1kHz + 1.13kHz), or higher frequency carriers (9kHz + 9.13kHz), targeting the hippocampus, a common epileptic focus and consequently stimulation target in MTLE. Our results show that TI stimulation yields a statistically significant decrease in interictal epileptiform discharges (IEDs) and pathological high-frequency oscillations (HFOs) specifically fast ripples (FR), where the suppression is apparent in the hippocampal focus and propagation from the focus is reduced brain-wide. HF sham stimulation at 1kHz frequency also impacted the IED rate in the cortex, but wit...