Po st ro te ct e y yr ig C op 0 ht 4000 ms s. er .C 00 rs F1 te te c control 10 0 er s pr o familiar speech 0 ct te pr o ht 10 s. er Hz Example: Coherence of left contact 0/3 with Cz/Fz. Black curve: familiar speech, red curve: control, black line: p=0.05 level of significant coherence d. F ig Po st Conclusions te ec ot pr s. rig ht er te rs ht pr o .C op y st rig Po s 1.Schiff ND, Giacino JT, Kalmar K et al. Behavioural improvements with thalamic stimulation after severe traumatic brain injury. Nature 2007;448:600-3. 2.Eickhoff SB, Dafotakis M, Grefkes C et al. fMRI reveals cognitive and emotional processing in a long-term comatose patient. Exp Neurol 2008;214:240-6. 00 Po 10 00 ed .F The study provides electrophysiological evidence by means of increased oscillatory activity in the theta band for the responsiveness of the central thalamus to emotionally relevant and directly addressing speech. The finding that oscillatory power changes could also be recorded with bipolar reference indicates that this activity is generated in the thalamus rather than being far field potentials from the amygdala or STS. This local thalamic activation reflects involvement of the central thalamus in emotional and cognitive processing in a comatose patient. C op yr 00 0 •Time frequency analysis for stimulus-specific induced power changes from baseline ro te ct 0.01 0 F1 ed . ct te ed .F ht C op yr ig Po st 00 0 0.02 op y .C Po s te op y d. Mean (SD) of LFP-sEEG coherence (3-9 Hz) across all channels for familiar versus control stimuli, *** p<0.001 00 pr ht rig op 0 ot ec Po te st d. ig 0.01 •Stimulus specific LFP-sEEG coherence analysis ec t ot pr ht ig yr op 3000 C 2000 0.02 0 pr o rig ht F1 00 te d. st 0 00 1000 F1 0 1 cm F1 ed . +40µV Induced power changes from baseline (-500 to 0 msec). Difference between familiar addressing speech and neutral speech stimuli, contact 0/1 bipolar Po te ot ec 5 •Auditory control stimuli (4sec, 137 trials): non familiar speaker pronouncing neutral words without addressing the patient op y ot ec ig ht er d. 10 •Auditory stimuli (4sec, 137 trials) that evoked strongest activity in the previous fMRI experiment: recordings of the patient’s children addressing the patient .C 0 s. F1 15 0.03 ct te ro ht p ig -40 µv C 00 0 20 •Postoperative intracranial LFP and surface EEG (sEEG) recordings yr op yr Hz •LFP-sEEG coherence (3-9 Hz) was significant higher during familiar speech yr op C s. st er Po 00 0 F1 ed . ct te pr te rs Po s •Significant differences could be recorded both from monopolar and bipolar electrode references -500 •DBS electrodes were bilaterally implanted in the internal medullary lamina and the nucleus reticularis thalami ro 00 yr ig .C op •This effect was found bilaterally pr Methods Po op y C te rs . 0 F1 00 te d. te c pr o ht ig yr op C s. •Power significantly increased (t=5, p< 0.001) about 200 ms after speech onset and during stimulus presentation in the 5-7 Hz band during familiar speech compared to control stimuli Po s There is evidence for possible arousal effects in patients with minimal conscious state by deep brain stimulation (DBS) of the central thalamus.[1] Functional magnetic resonance tomography imaging (fMRI) revealed emotional and cognitive processing by activity increase in the superior temporal sulcus (STS) and the amygdala in response to familiar speech in a long-term comatose patient that was later on selected for central-thalamic DBS.[2] The objective of this study was to determine by means of postoperative local field potential (LFP) recordings from implanted DBS electrodes if the central thalamus is also activated by these emotionally relevant stimuli. Thus, activation could reflect involvement of the central thalamus in emotional and cognitive processing. er st ht pr ot ec te d. F1 0 rig ht st er s. C 0 10 0 pr ot ec te d. F ig ht Po 3) Eickhoff , Results Planned trajectory (drawing from: J.K. Mai, Atlas of the Human Brain, coronar slice, 10.7 mm behind AC) for stimulation of the internal medullary lamina (iml) and the Ncl. reticluaris thalami (Rt), red line: AC-PC line C op te rs . S. D. S. J. Vesper4), A. Schnitzler1)2) Po ct ed .F 10 op yr 00 1) Petri , Po s 1)2) Elben , 1) Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf 2) Department of Neurology / Centre for Movement Disorders and Neuromodulation, Heinrich-Heine-University Düsseldorf 3) Translational Brain Medicine in Psychiatry und Neurology, Department of Psychiatry and Psychotherapy, RWTH Aachen 4) Department of Stereotactic and Functional Neurosurgery / Centre for Movement Disorders and Neuromodulation, Heinrich-HeineUniversity Düsseldorf all in Germany Objectives Introduction s. 10 00 pr ot ec te d. F 1)2) Wojtecki , op y 00 Po s L. rig h tp te rs . C op Increase of central thalamic theta oscillations in response to familiar speech in a long term comatose patient