Introduction
Epilepsy is a prevalent chronic neurological disorder, with approximately one-third of patients experiencing intractable epilepsy, often necessitating surgical intervention. Deep brain stimulation (DBS) of the thalamus has been introduced as a palliative surgical option for seizure control; however, its precise mechanisms remain largely unclear. The thalamus plays a crucial role in coordinating neural networks, both in normal brain function and the propagation of epileptic activity. This study aims to investigate the involvement of the thalamus in epilepsy networks using stereoelectroencephalography (SEEG) to monitor thalamic activity during epileptic seizures in patients with drug-resistant epilepsy.
Methods and analysis
This single-arm, non-randomised, prospective, exploratory study will be conducted at Nagoya University Hospital, involving 10 patients undergoing SEEG for presurgical evaluation of drug-resistant epilepsy. Participants must be 18 years or older, have normal cognitive function and provide informed consent. Between 7 and 14 SEEG electrodes, including 2 in the bilateral thalamus, will be implanted in key thalamic nuclei (anterior, dorsomedial, centromedian and pulvinar) using a robotic system. The primary outcome focuses on electroencephalographic findings from the thalamus, emphasising waveform and frequency changes around seizures. Secondary outcomes include postoperative seizure frequency, changes in cognitive function and neuroimaging results. SEEG data will be recorded continuously for 1–2 weeks to capture both ictal and interictal activity. Data analysis will employ t-tests to compare ictal and interictal periods, with p values