Progress in Neurobiology, Journal Year: 2025, Volume and Issue: 249, P. 102770 - 102770
Published: April 19, 2025
Language: Английский
Nature Communications, Journal Year: 2024, Volume and Issue: 15(1)
Published: Feb. 10, 2024
Abstract Lateral hypothalamic (LH) hypocretin/orexin neurons (HONs) control brain-wide electrical excitation. Abnormally high excitation produces epileptic seizures, which affect millions of people and need better treatments. HON population activity spikes from minute to minute, but the role this in seizures is unknown. Here, we describe correlative causal links between seizures. Applying temporally-targeted recordings optogenetic silencing a male mouse model acute epilepsy, found that pre-seizure predicts controls electrophysiology behavioral pathology subsequent No such were detected for during Having thus defined time window where HONs influence targeted it with LH deep brain stimulation (DBS), inhibited activity, produced seizure protection. Collectively, these results uncover feature linked demonstrate proof-of-concept treatment alleviates epilepsy.
Language: Английский
Citations
7
Neurological Sciences, Journal Year: 2024, Volume and Issue: 45(9), P. 4243 - 4268
Published: April 20, 2024
Language: Английский
Citations
6
Brain Sciences, Journal Year: 2023, Volume and Issue: 13(2), P. 349 - 349
Published: Feb. 18, 2023
Deep brain stimulation (DBS) has emerged as an invasive neuromodulation technique for the treatment of several neurological disorders, but mechanisms underlying its effects remain partially elusive. In this context, application Transcranial Magnetic Stimulation (TMS) in patients treated with DBS represents intriguing approach to investigate neurophysiology cortico-basal networks. Experimental studies combining TMS and that have been performed so far mainly aimed evaluate on cerebral cortex thus provide insights into DBS’s action. The modulation cortical excitability plasticity by is emerging a potential contributor therapeutic effects. Moreover, pairing stimuli could represent method induce synaptic plasticity, which still unexplored. Furthermore, advent new technologies novel targets will present research opportunities prospects However, combined TMS-DBS currently limited safety concerns. review, we sought overview well available evidence recommendations their combination. Additionally, outline perspectives future highlighting knowledge gaps possible applications approach.
Language: Английский
Citations
15
Therapeutic Advances in Neurological Disorders, Journal Year: 2023, Volume and Issue: 16
Published: Jan. 1, 2023
Background: Epilepsy is a widespread neurologic disorder and almost one-third of patients suffer from drug-resistant epilepsy (DRE). Neuromodulation targeting the centromediannucleus thalamus (CM) has been showing promising results for with generalized DRE who are not surgical candidates. Recently, effect CM- deep brain stimulation (DBS) in was investigated Electrical Stimulation Thalamus Lennox–Gastaut phenotype (ESTEL) trial, monocentric randomized-controlled study. The same authors described ‘cold-spot’ ‘sweet-spot’, which defined as volume yielding least best clinical response, respectively. However, it remains unclear structural connections may contribute to anti-seizure stimulation. Objective: We differences connectivity among CM, sweet-spot cold-spot. Furthermore, we tried validate our cohort underwent CM-DBS or CM-RNS (responsive neurostimulation). hypothesized that would share similar responder patients. Methods: By using software FMRIB Software Library (FSL), probabilistic tractography performed on 100 subjects Human Connectome Project calculate probability whole cold-spot 45 cortical subcortical areas. Results three seeds were compared multivariate analysis variance (MANOVA). Similarly, volumes tissue activated (VTAs) eight investigated. Patients divided into responders non-responders based degree reduction seizure frequency, mean probabilities similarly between two groups. Results: demonstrated significantly higher ( p < 0.001) precentral gyrus, superior frontal cerebellum than CM Responder displayed both ipsilateral = 0.011) contralateral 0.04) non-responders. Conclusion: Cerebellar seem beneficial effects CM-neuromodulation epilepsy.
Language: Английский
Citations
13
Epilepsia, Journal Year: 2024, Volume and Issue: 65(3), P. 542 - 555
Published: Jan. 24, 2024
Abstract We sought to perform a systematic review and individual participant data meta‐analysis identify predictors of treatment response following thalamic neuromodulation in pediatric patients with medically refractory epilepsy. Electronic databases (MEDLINE, Ovid, Embase, Cochrane) were searched, no language or restriction, studies reporting seizure outcomes populations deep brain stimulation (DBS) responsive neurostimulation (RNS) implantation nuclei. Studies featuring primary secondary generalized drug‐resistant epilepsy included. Response therapy was defined as >50% reduction frequency from baseline. Of 417 citations, 21 articles on 88 participants eligible. Mean age at 13.07 ± 3.49 years. Fifty (57%) underwent DBS, 38 (43%) RNS. Sixty (68%) implanted centromedian nucleus 23 (26%) anterior nucleus, five (6%) had both targets implanted. Seventy‐four (84%) bilaterally. The median time last follow‐up 12 months (interquartile range = 6.75–26.25). Sixty‐nine percent achieved treatment. Age, target, modality, laterality significant association univariate logistic regression. Until gains widespread approval for use patients, efficacy will continue be limited small retrospective cohorts case series. inherent bias these can overcome by using data. Thalamic appears safe effective Larger, prolonged prospective, multicenter are warranted further evaluate the DBS over RNS this patient population where resection curative intent is not option.
Language: Английский
Citations
5
Neurochemistry International, Journal Year: 2024, Volume and Issue: 174, P. 105699 - 105699
Published: Feb. 19, 2024
Language: Английский
Citations
5
Frontiers in Human Neuroscience, Journal Year: 2022, Volume and Issue: 16
Published: Aug. 3, 2022
Idiopathic generalized epilepsy (IGE) is a common type of and despite an increase in the number available anti-seizure medications, approximately 20–30% people with IGE continue to experience seizures adequate medication trials. Unlike focal epilepsy, resective surgery not viable treatment option for IGE; however, neuromodulation may be effective surgical IGE. Thalamic stimulation through deep brain (DBS) responsive neurostimulation (RNS) have been explored epilepsies. Although data regarding DBS RNS limited case reports series, results published studies promising. The current manuscript will review literature within centromedian nucleus thalamus IGE, as well highlight illustrative case.
Language: Английский
Citations
22
Epilepsy & Behavior, Journal Year: 2022, Volume and Issue: 137, P. 108951 - 108951
Published: Oct. 28, 2022
Language: Английский
Citations
22
Acta Neurologica Scandinavica, Journal Year: 2022, Volume and Issue: 146(6), P. 786 - 797
Published: Sept. 5, 2022
Nearly 1% of the global population suffers from epilepsy. Drug-resistant epilepsy (DRE) affects one-third epileptic patients who are unable to treat their condition with existing drugs. For treatment DRE, neuromodulation offers a lot potential. The background, mechanism, indication, application, efficacy, and safety each technique briefly described in this narrative review, an emphasis on three approved therapies: vagus nerve stimulation (VNS), deep brain anterior nucleus thalamus (ANT-DBS), closed-loop responsive neurostimulation (RNS). Neuromodulatory approaches involving direct or induced electrical currents have been developed lessen seizure frequency duration DRE since notion as therapy for neurologic diseases originated early nineteenth century. Although few people attained total independence more than 12 months using these treatments, half benefitted 50% drop over time. promising outcomes adults children achieved, challenges such heterogeneity among types etiologies, optimization parameters, lack biomarkers predict response therapies, high-level evidence aid decision-making, comparisons between neuromodulatory remain. To solve gaps, authorize new kinds neuromodulation, develop personalized further research is needed. Finally, both invasive non-invasive seems be safe. Implantation-related adverse events primarily include infection pain at implant site. Intracranial hemorrhage frequent event DBS RNS. Other stimulation-specific side-effects mild stimulation.
Language: Английский
Citations
19
World Neurosurgery, Journal Year: 2024, Volume and Issue: 185, P. e631 - e639
Published: Feb. 24, 2024
Language: Английский
Citations
4