Adult epilepsy

The Lancet, Journal Year: 2023, Volume and Issue: 402(10399), P. 412 - 424

Published: July 1, 2023

Language: Английский

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Neurostimulation treatments for epilepsy: Deep brain stimulation, responsive neurostimulation and vagus nerve stimulation

Neurotherapeutics, Journal Year: 2024, Volume and Issue: 21(3), P. e00308 - e00308

Published: Jan. 4, 2024

Epilepsy is a common and debilitating neurological disorder, approximately one-third of affected individuals have ongoing seizures despite appropriate trials two anti-seizure medications. This population with drug-resistant epilepsy (DRE) may benefit from neurostimulation approaches, such as vagus nerve stimulation (VNS), deep brain (DBS) responsive (RNS). In some patient populations, these techniques are FDA-approved for treating DRE. VNS used adjuvant therapy children adults. Acting via the afferent network, modulates thalamocortical circuits, reducing in 50 ​% patients. RNS uses an adaptive (closed-loop) system that records intracranial EEG patterns to activate at time, being particularly well-suited treat arising within eloquent cortex. For DBS, most promising therapeutic targets anterior centromedian nuclei thalamus, nucleus DBS focal secondarily generalized forms DRE applied epilepsies Lennox-Gastaut syndrome. Here, we discuss indications, advantages limitations VNS, summarize spatial distribution neuroimaging observations related using NeuroQuery NeuroSynth.

Language: Английский

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Neuro-stimulation in focal epilepsy: A systematic review and meta-analysis

Epilepsy & Behavior, Journal Year: 2023, Volume and Issue: 142, P. 109182 - 109182

Published: March 25, 2023

Language: Английский

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Multimodal evaluation of network activity and optogenetic interventions in human hippocampal slices

Nature Neuroscience, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 15, 2024

Language: Английский

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Use of Recommended Neurodiagnostic Evaluation Among Patients With Drug-Resistant Epilepsy

JAMA Neurology, Journal Year: 2024, Volume and Issue: 81(5), P. 499 - 499

Published: April 1, 2024

Interdisciplinary practice parameters recommend that patients with drug-resistant epilepsy (DRE) undergo comprehensive neurodiagnostic evaluation, including presurgical assessment. Reporting from specialized centers suggests long delays to referral and underuse of surgery; however, longitudinal data are limited characterize evaluation among DRE in more diverse US settings populations.

Language: Английский

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An approach to detect and predict epileptic seizures with high accuracy using convolutional neural networks and single-lead-ECG signal

Biomedical Physics & Engineering Express, Journal Year: 2024, Volume and Issue: 10(2), P. 025041 - 025041

Published: Feb. 15, 2024

One of the epileptic patients' challenges is to detect time seizures and possibility predicting. This research aims provide an algorithm based on deep learning predict seizure from one two minutes before its occurrence. The proposed Convolutional Neural Network (CNN) can occurrence focal epilepsy through single-lead-ECG signal processing instead using EEG signals. structure CNN for detection prediction same. Considering requirements a wearable system, after few light pre-processing steps, ECG be used as input neural network without any manual feature extraction step. desired learns purposeful features according labelled signals then performs classification these Training 39-layer has been done separately. method with accuracy 98.84% them 94.29%. With this approach, promising indicator construction portable systems monitoring status patients.

Language: Английский

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Intraparenchymal delivery of adeno-associated virus vectors for the gene therapy of neurological diseases

Expert Opinion on Biological Therapy, Journal Year: 2024, Volume and Issue: 24(8), P. 773 - 785

Published: July 27, 2024

In gene therapy with adeno-associated virus (AAV) vectors for diseases of the central nervous system, can be administered into blood vessels, cerebrospinal fluid space, or brain parenchyma. When transfer to a large area is required, first two methods are used, but in which local expected effective, directly

Language: Английский

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Low‐Frequency Stimulation at the Ventromedial Hypothalamus Exhibits Broad‐Spectrum Efficacy Across Models of Epilepsy

CNS Neuroscience & Therapeutics, Journal Year: 2025, Volume and Issue: 31(2)

Published: Feb. 1, 2025

The limited efficacy and very restricted antiseizure range of current deep brain stimulation (DBS) targets highlight the need to find an optimal target for managing various seizure types. Here, we aimed investigate DBS on ventromedial hypothalamus (VMH) in different types experimental epileptic seizures. was examined models, potential mechanisms were investigated by using vivo calcium signal recording optogenetics. c-fos expression significantly increased glutamatergic neurons VMH (VMHglu) following Then, 1-Hz low-frequency (LFS) at successfully attenuated severities across models epilepsy, including maximal electroshock, pentylenetetrazol, absence seizure, cortical or hippocampal kainic acid-induced acute hippocampal-kindling models. imaging recordings revealed that LFS could inhibit activities VMHglu. Optogenetic inhibition VMHglu mirrored LFS's impact. Further anterograde viral tracing confirmed extensive distributed projections VMHglu, which may compose circuitry basis broad-spectral LFS. These findings demonstrate VMH-LFS is a broad-spectrum treatment approach decreasing activity.

Language: Английский

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Advances in the Treatment of Epilepsy by Electrostimulation of the Pulvinar

Journal of Integrative Neuroscience, Journal Year: 2025, Volume and Issue: 24(2)

Published: Feb. 20, 2025

Neuroregulatory therapy, encompassing deep brain stimulation and responsive neurostimulation, is increasingly gaining attention for the treatment of drug-resistant temporal occipital lobe epilepsy. Beyond approved anterior nucleus thalamus, pulvinar thalamus a potential target. Through confluence animal studies, electrophysiological research, imaging has been identified as having extensive connections with visual cortex, prefrontal limbic regions, multimodal sensory associative areas, playing pivotal role in multisensory integration serving propagation node both generalized focal This review synthesizes recent research on relation to cortical epileptic networks, well efficacy neuroregulatory therapy targeting Further warranted elucidate differential therapeutic effects stimulating various subregions specific mechanisms underlying epilepsy through stimulation.

Language: Английский

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Long-Term Efficacy and Quality-of-Life Changes After Vagus Nerve Stimulation in Adult Patients With Drug-Resistant Epilepsy

Journal of Clinical Neurology, Journal Year: 2025, Volume and Issue: 21(2), P. 113 - 113

Published: Jan. 1, 2025

There is a current need to understand the efficacy and quality of life (QoL) outcomes vagus nerve stimulation (VNS). Identifying patients most likely benefit from VNS could aid in their selection, reduce side effects, improve outcomes. Here we studied clinical QoL after with drug-resistant epilepsy attempted identify response predictors. This was retrospective study 55 treated surgically during 2004-2018, 40 whom were eligible for inclusion analysis. All surgeries performed using standard protocol by neurosurgeon experienced treatment referral an attending neurologist. Data collected medical records through 28-item questionnaire on seizure frequency, duration, strength before VNS, as number type postoperative complications significance patient, based 31-item Quality Life Epilepsy questionnaire. Improvements observed 65% VNS. The common complication hoarseness (70%), poorly tolerated 12% patients. Repeated surgery replace batteries or electrodes required 20% Health status only parameter significantly impacted No significant predictors identified. Efficacy across first month strong indicator long-term stimulator can be removed if it does not provide any benefit.

Language: Английский

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