• Nebras M Warsi, Han Yan, Simeon M Wong, Ivanna Yau, Sara Breitbart, Cristina Go, Carolina Gorodetsky, Alfonso Fasano, Suneil K Kalia, James T Rutka, Kerry Vaughan, and George M Ibrahim.
• Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.
• Neuromodulation. 2023 Apr 1; 26 (3): 601606601-606.

ObjectiveThe antiseizure effects of vagus nerve stimulation (VNS) are thought to be mediated by the modulation of afferent thalamocortical circuitry. Cross-frequency phase-amplitude coupling (PAC) is a mechanism of hierarchical network coordination across multiple spatiotemporal scales. In this study, we leverage local field potential (LFP) recordings from the centromedian (CM) (n = 3) and anterior (ATN) (n = 2) nuclei in five patients with tandem thalamic deep brain stimulation and VNS to study neurophysiological changes in the thalamus in response to VNS.Materials And MethodsBipolar LFP data were recorded from contact pairs spanning target nuclei in VNS "on" and "off" states.ResultsActive VNS was associated with increased PAC between theta, alpha, and beta phase and gamma amplitude in CM (q < 0.05). Within the ATN, PAC changes also were observed, although these were less robust. In both nuclei, active VNS also modulated interhemispheric bithalamic functional connectivity.ConclusionsWe report that VNS is associated with enhanced PAC and coordinated interhemispheric interactions within and between thalamic nuclei, respectively. These findings advance understanding of putative neurophysiological effects of acute VNS and contextualize previous animal and human studies showing distributed cortical synchronization after VNS.Copyright © 2022 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.

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