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Stimulation, surveillance et algorithme de détection du noyau antérieur du thalamus dans le cadre d'un modèle d'épilepsie focale motrice chez le primate

Abstract : It has been shown that the anterior nucleus of the thalamus (ANT) is involved in the mésio temporal lobe epilepsy (mTLE); but its role has not been described yet. This implication, in addition to its strategic position within the Papez circuit makes it a prime target for the deep brain stimulation (DBS). Many studies have then been led for twenty years in humans and animals, using many stimulation paradigms, and several conclusions, sometimes conflicting resulted. In order to stimulate the ANT in an adequate manner to obtain an effect on seizures, it is crucial to understand how the ANT is involved during mTLE. A reliable and representative animal model of the human pathology is needed to answer these questions. In the first part of this work, an on demand model of mTLE in the non-human primate (NHP) has been characterized. It has been shown in five NHPs that a penicillin (PNC) injection in the hippocampus (HPC) led to the occurrence of typical seizures during 4 to 5 hours. The onset and disappearance kinetic of ictal events doesn’t vary between animals and experiments; in addition, the seizure frequency presents a stable plateau which could be useful to test new drugs or therapies. A hippocampic sclerosis supported by cellular adjustments has also been observed in the injected HPC). In a second part, we used this model of mTLE in order to identify the involvement type of the ANT (common passive relay or node within the primary epileptic circuit). To do so, we evaluated the effects of chemical and electrical neuromodulation of the ANT on the HPC ictal activity. We observed variation of the HPC baseline electric activity at a specific stimulation frequency of the ANT. Then we found out that this stimulation frequency led to a significate improvement of the number of seizures and of the total time spent in seizure. Then, we tried to identify using coherence analysis between activities recorded in the ANT and the HPC some electrophysiological biomarkers to prevent a good efficacy of the DBS. This approach could then lead to solutions which could offer a smarter and better suited stimulation to the patients.
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Ariana Sherdil. Stimulation, surveillance et algorithme de détection du noyau antérieur du thalamus dans le cadre d'un modèle d'épilepsie focale motrice chez le primate. Neurosciences. Université Grenoble Alpes, 2017. Français. ⟨NNT : 2017GREAV046⟩. ⟨tel-01684772⟩

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