Comparison of Deep Brain Stimulation of the Hippocampus to Thalamic Targets and Responsive Neurostimulation for Adult Intractable Epilepsy: A Systematic Review and Meta-Analysis

World Neurosurgery, Journal Year: 2025, Volume and Issue: 194, P. 123621 - 123621

Published: Jan. 23, 2025

Stereotactic neuromodulation, such as deep brain stimulation (DBS) and responsive neurostimulation (RNS), have emerged some of the more promising means for managing drug-resistant epilepsy. This study serves a comprehensive analysis DBS anterior nucleus thalamus (ANT), centromedian thalamic (CMT), hippocampus RNS seizure reduction in adult intractable Following PRISMA (Preferred Reporting Items Systematic Reviews Meta-Analyses) guidelines, systematic review was conducted PubMed, Cochrane Library, Embase databases from January 2000 to 2024 objectively assess effectiveness various neuromodulation modalities on reduction. Different software EndNote Rayyan utilized organize 1996 total reviewed studies run blinded multi-phase process. A 25 were included with 21 166 patients suitable meta-analysis. ANT, hippocampus, all found significant individual reductions 54.0%, 70.0%, 63.5%. CMT excluded since only 1 met inclusion criteria was, therefore, not Furthermore, 3 analyzed procedures be when compared one another. Focal versus general epilepsy ANT also had no difference. significantly higher rate mesial temporal sclerosis normal imaging findings. These results provide vast amount supporting data these while indicating difference between operations. Therefore, this target population, operative decisions can made based surgeon preference patient circumstance without affecting outcomes.

Language: Английский

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Kilohertz electrical stimulation evokes robust cellular responses like conventional frequencies but distinct population dynamics

Communications Biology, Journal Year: 2025, Volume and Issue: 8(1)

Published: Jan. 7, 2025

Intracranial electrical kilohertz stimulation has recently been shown to achieve similar therapeutic benefit as conventional frequencies around 140 Hz. However, it is unknown how influences neural activity in the mammalian brain. Using cellular calcium imaging awake mice, we demonstrate that intracranial at 1 kHz evokes robust responses many individual neurons, comparable those induced by 40 and Hz both hippocampus sensorimotor cortex. The evoked single-cell level are shaped prominent network inhibition critically depend on brain region. At level, all lead pronounced population suppression except cortex, which balanced excitatory inhibitory effects. Thus, robustly modulates single-neuron levels through mechanisms distinct from frequency stimulation, highlighting clinical potential of neuromodulation. Mechanistic study using reveals neuronal compared neuromodulation frequencies.

Language: Английский

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Intracranial closed-loop neuromodulation as an intervention for neuropsychiatric disorders: an overview

Frontiers in Psychiatry, Journal Year: 2025, Volume and Issue: 16

Published: Jan. 30, 2025

Recent technological advances in intracranial brain stimulation have enhanced the potential of neuromodulation for addressing neuropsychiatric disorders. We present a review methodology and preliminary outcomes pioneering studies exploring biomarker detection closed-loop to modulate high-symptom severity states searched PubMed, Scopus, Web Science, Embase, PsycINFO/PsycNet, followed by reference citation lists retrieved articles. This search strategy yielded total 583 articles, which 5 articles met inclusion criteria, focusing on depression, obsessive-compulsive disorder, post-traumatic stress binge eating disorder. discuss identification, biomarkers identified, treatment neuromodulation. Successful identification hinges investigating across various setting. Targeted neuromodulation, either directed at or within its associated neural network, offers promising approach. Future research should seek understand mechanisms underlying effects as well long-term viability these different conditions.

Language: Английский

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A Scoping Review of Responsive Neurostimulation in Focal Cortical Dysplasia-Related Epilepsy

Epilepsy & Behavior, Journal Year: 2025, Volume and Issue: 166, P. 110362 - 110362

Published: March 13, 2025

Language: Английский

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Neurostimulation in Childhood Epilepsy

Indian Pediatrics, Journal Year: 2025, Volume and Issue: unknown

Published: April 7, 2025

Abstract Epilepsy is a common and debilitating neurological disorder in children, approximately third of them have ongoing seizures despite adequate trial antiseizure medications. Neurostimulation approaches may be an option for those with drug resistant epilepsy. Several invasive non-invasive devices been trialled found to effective reducing seizure burden These techniques appear safe well tolerated. We review the available evidence use these devices, including vagus nerve stimulation, deep brain responsive neurostimulation, chronic subthreshold cortical transcranial magnetic stimulation direct current stimulation. The results trials are promising but there fewer studies children. Apart from none other neurostimulation currently approved children their off-label or clinical trials. Further well-designed needed, especially identify most options optimal parameters improvement quality life. also being treatment refractory status epilepticus, lack robust (mainly case series reports) makes it difficult predict therapeutic benefit at present.

Language: Английский

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Single-pulse electrical stimulations reduce the number of seizures during stereo-electroencephalography.

Brain stimulation, Journal Year: 2025, Volume and Issue: unknown

Published: April 1, 2025

Language: Английский

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Seizure and Cognitive Outcomes of Cortical Long Bursting Responsive Neurostimulation in Intractable Focal Epilepsy

Epilepsy Research, Journal Year: 2025, Volume and Issue: 214, P. 107555 - 107555

Published: April 11, 2025

Language: Английский

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On-demand low-frequency stimulation for seizure control: efficacy and behavioural implications

Brain, Journal Year: 2023, Volume and Issue: unknown

Published: Sept. 7, 2023

Abstract Mesial temporal lobe epilepsy (MTLE), the most common form of focal in adults, is often refractory to medication and associated with hippocampal sclerosis. Deep brain stimulation represents an alternative treatment option for drug-resistant patients who are ineligible resective surgery. In clinical practice, closed-loop at high frequencies applied interrupt ongoing seizures, yet has (i) a incidence false detections; (ii) drawback delayed seizure-suppressive intervention; (iii) limited success sclerotic tissue. As alternative, low-frequency (LFS) been explored recently epilepsies. preclinical models, LFS successfully prevented seizures when continuously. Since it would be advantageous reduce load, we developed protocol on-demand LFS. Given importance hippocampus navigation memory, investigated potential consequences on function. To this end, used intrahippocampal kainate mouse model, which recapitulates key features MTLE, including spontaneous seizure activity Specifically, our online detection algorithm monitored epileptiform local field recordings identified short bursts preceding clusters, triggering stabilize network state. probe behavioural performance, tested acute influence anxiety-like behaviour light-dark box test, spatial non-spatial memory object location novel recognition as well long-term Barnes maze. On-demand was almost effective continuous preventing clusters but significantly lower load. When compared performance chronically epileptic mice healthy controls, found that both groups were equally mobile, displayed increased anxiety level, altered learning strategy impaired performance. Most importantly, application before training test sessions, could rule out deleterious effects cognition even show alleviation deficits recall mice. Taken together, findings may provide promising current therapies, overcoming some their major limitations, inspire further investigation control syndromes.

Language: Английский

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High and low frequency anterior nucleus of thalamus deep brain stimulation: Impact on memory and mood in five patients with treatment resistant temporal lobe epilepsy

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Feb. 15, 2024

Abstract High frequency anterior nucleus of the thalamus deep brain stimulation (ANT DBS) is an established therapy for treatment resistant focal epilepsies. Although high frequency-ANT DBS well tolerated, patients are rarely seizure free and efficacy other parameters their impact on comorbidities epilepsy such as depression memory dysfunction remain unclear. The purpose this study was to assess low vs ANT verbal self-reported anxiety symptoms. Five with temporal lobe were implanted investigational sensing device capable ambulatory intracranial electroencephalographic (iEEG) monitoring, enabling long-term detection electrographic seizures. While received therapeutic (100 145 Hz continuous cycling) (2 7 continuous) stimulation, they completed weekly recall tasks thrice self-reports symptom severity. Mixed effects models then used evaluate associations between scores, self-reports, counts, frequency. Memory score significantly associated frequency, higher scores during DBS. Self-reported severity not These findings suggest choice parameter may patients’ cognitive function, independently its rates.

Language: Английский

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Brain-state modeling using electroencephalography: Application to adaptive closed-loop neuromodulation for epilepsy

bioRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: June 1, 2024

ABSTRACT The progress of developing an effective closed-loop neuromodulation system for many neurological pathologies is hindered by the difficulties in accurately capturing a useful representation brain’s instantaneous functional state. Existing approaches rely on expert labeling electroencephalography data to develop biomarkers neurophysiological pathology. These techniques do not capture highly complex states brain that are presumed exist between labeled or allow likely possibility variation among identically states. Thus, we propose BrainState, self-supervised technique model arbitrarily state using neural multivariate timeseries data. Application BrainState intracranial from patients with epilepsy was able diverse pre-seizure and quantify nuanced effects neuromodulation. We anticipate will enable development sophisticated systems array pathologies.

Language: Английский

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