scholarly journals Brain Stimulation for Seizure Control: Considerations and Potential Mechanisms

10.5772/17638 ◽  
2011 ◽  
Author(s):  
Benedict Albensi
2018 ◽  
Vol 45 (2) ◽  
pp. E4 ◽  
Author(s):  
Neil Klinger ◽  
Sandeep Mittal

Antiepileptic drugs prevent morbidity and death in a large number of patients suffering from epilepsy. However, it is estimated that approximately 30% of epileptic patients will not have adequate seizure control with medication alone. Resection of epileptogenic cortex may be indicated in medically refractory cases with a discrete seizure focus in noneloquent cortex. For patients in whom resection is not an option, deep brain stimulation (DBS) may be an effective means of seizure control. Deep brain stimulation targets for treating seizures primarily include the thalamic nuclei, hippocampus, subthalamic nucleus, and cerebellum. A variety of stimulation parameters have been studied, and more recent advances in electrical stimulation to treat epilepsy include responsive neurostimulation. Data suggest that DBS is effective for treating drug-resistant epilepsy.


2019 ◽  
Vol 12 (2) ◽  
pp. 492-493
Author(s):  
F. Schaper ◽  
B. Plantinga ◽  
A. Colon ◽  
L. Wagner ◽  
P. Boon ◽  
...  

Epilepsia ◽  
2009 ◽  
Vol 51 (7) ◽  
pp. 1314-1316 ◽  
Author(s):  
Danielle M. Andrade ◽  
Clement Hamani ◽  
Andres M. Lozano ◽  
Richard A. Wennberg

2018 ◽  
Vol 39 (8) ◽  
pp. 1431-1435 ◽  
Author(s):  
Massimo Piacentino ◽  
Giacomo Beggio ◽  
Lara Zordan ◽  
Paolo Bonanni

2009 ◽  
Vol 19 (03) ◽  
pp. 173-196 ◽  
Author(s):  
LEVI B. GOOD ◽  
SHIVKUMAR SABESAN ◽  
STEVEN T. MARSH ◽  
KOSTAS TSAKALIS ◽  
DAVID TREIMAN ◽  
...  

We have designed and implemented an automated, just-in-time stimulation, seizure control method using a seizure prediction method from nonlinear dynamics coupled with deep brain stimulation in the centromedial thalamic nuclei in epileptic rats. A comparison to periodic stimulation, with identical stimulation parameters, was also performed. The two schemes were compared in terms of their efficacy in control of seizures, as well as their effect on synchronization of brain dynamics. The automated just-in-time (JIT) stimulation showed reduction of seizure frequency and duration in 5 of the 6 rats, with significant reduction of seizure frequency (>50%) in 33% of the rats. This constituted a significant improvement over the efficacy of the periodic control scheme in the same animals. Actually, periodic stimulation showed an increase of seizure frequency in 50% of the rats, reduction of seizure frequency in 3 rats and significant reduction in 1 rat. Importantly, successful seizure control was highly correlated with desynchronization of brain dynamics. This study provides initial evidence for the use of closed-loop feedback control systems in epileptic seizures combining methods from seizure prediction and deep brain stimulation.


Neurosurgery ◽  
2020 ◽  
Vol 87 (3) ◽  
pp. 602-610 ◽  
Author(s):  
Frédéric L W V J Schaper ◽  
Birgit R Plantinga ◽  
Albert J Colon ◽  
G Louis Wagner ◽  
Paul Boon ◽  
...  

Abstract BACKGROUND Deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) can improve seizure control for patients with drug-resistant epilepsy (DRE). Yet, one cannot overlook the high discrepancy in efficacy among patients, possibly resulting from differences in stimulation site. OBJECTIVE To test the hypothesis that stimulation at the junction of the ANT and mammillothalamic tract (ANT-MTT junction) increases seizure control. METHODS The relationship between seizure control and the location of the active contacts to the ANT-MTT junction was investigated in 20 patients treated with ANT-DBS for DRE. Coordinates and Euclidean distance of the active contacts relative to the ANT-MTT junction were calculated and related to seizure control. Stimulation sites were mapped by modelling the volume of tissue activation (VTA) and generating stimulation heat maps. RESULTS After 1 yr of stimulation, patients had a median 46% reduction in total seizure frequency, 50% were responders, and 20% of patients were seizure-free. The Euclidean distance of the active contacts to the ANT-MTT junction correlates to change in seizure frequency (r2 = 0.24, P = .01) and is ∼30% smaller (P = .015) in responders than in non-responders. VTA models and stimulation heat maps indicate a hot-spot at the ANT-MTT junction for responders, whereas non-responders had no evident hot-spot. CONCLUSION Stimulation at the ANT-MTT junction correlates to increased seizure control. Our findings suggest a relationship between the stimulation site and therapy response in ANT-DBS for epilepsy with a potential role for the MTT. DBS directed at white matter merits further exploration for the treatment of epilepsy.


2019 ◽  
Vol 76 (7) ◽  
pp. 800 ◽  
Author(s):  
Vasileios Kokkinos ◽  
Nathaniel D. Sisterson ◽  
Thomas A. Wozny ◽  
R. Mark Richardson

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