# Network based neuro-modulation for mesial temporal lobe epilepsy

> **NIH NIH UH3** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2024 · $987,971

## Abstract

Pharmacologically refractory epilepsy afflicts more than a million Americans. In a substantial proportion
(25%) of these cases, epilepsy originates in the mesial temporal lobes (mesial temporal lobe epilepsy;
MTLE), engaging and perturbing the neural mechanisms underlying episodic memory. While many patients
with MTLE are candidates for resective surgery, no reasonable resective or ablative options are feasible in
locations where viable memory and epilepsy co-exist – a condition we term Epilepsy in a Precious
Hippocampus (EPH). Current neuromodulation techniques and devices, inspired by stimulation parameters
for movement disorders, deliver unifocal high frequency stimulation. They have limited impact on seizure
burden and rarely result in durable seizure freedom. For the EPH conundrum, there is an urgent
requirement for more efficacious neuromodulatory solutions, since the threat of major morbidity and
mortality is otherwise substantial. We propose a novel network-based neuromodulation approach to disrupt
seizures at levels above what has previously been accomplished. Eight patients with EPH who have been
scheduled for stereo-electroencephalography (SEEG) will be recruited at two busy epilepsy centers -
UTHealth Houston and the Mayo Clinic. They will undergo recordings from the anterior nucleus of the
thalamus (ANT) in addition to traditional SEEG targets in MTLE, while seizure foci are localized. Patients
will then undergo chronic depth electrode implants targeting pyriform cortex (area tempestus), ento-rhinal
cortex, fornix and ANT, and implantation of the Medtronic Percept PC Neurostimulator DBS System with
BrainSense Technology. Intracranial data from both implants will be used to build a comprehensive
individual and generalizable network model. We will demonstrate safety and efficacy of the Percept PC
device for detecting seizures. We will then utilize low frequency stimulation at each of these targets and
patterned network stimulation to determine their impact on seizures. The most effective approach will be
implemented for longer durations, and comparisons on seizure control will be made relative to baseline and
to traditional duty cycle high frequency ANT stimulation, that will be used as the control, wash-out
stimulation parameter between the trials of each stimulation type. This work promises to dramatically
improve our understanding of the MTLE network and develop a new approach to network based
neuromodulation.

## Key facts

- **NIH application ID:** 10608930
- **Project number:** 5UH3NS119834-02
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** Behnaam Aazhang
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $987,971
- **Award type:** 5
- **Project period:** 2022-04-15 → 2029-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10608930

## Citation

> US National Institutes of Health, RePORTER application 10608930, Network based neuro-modulation for mesial temporal lobe epilepsy (5UH3NS119834-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10608930. Licensed CC0.

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