Responsive Brain Stimulation in Epilepsy

Overview

Journal Ther Adv Chronic Dis

Publisher Sage Publications

Date 2018 Jul 3

PMID 29963302

Citations 9

Authors

Alendia Hartshorn

Barbara Jobst

Affiliations

Soon will be listed here.

Abstract

Stimulation devices are considered in patients with drug-resistant epilepsy and who are not surgical candidates. Responsive neurostimulation (RNS) is a cortically based stimulator activated by electrocorticography (ECoG) patterns. Stimulation is applied directly to the seizure focus. The vagal nerve stimulator AspireSR 106 is also a responsive device which, in addition to basal stimulation, is activated by tachycardia. Deep brain stimulation of the anterior nucleus of the thalamus is used in Europe for intractable epilepsy and yields similar response rates to RNS using duty cycle stimulation. Chronic subthreshold cortical stimulation is an experimental form of constant, low-level stimulation applied to a seizure focus. These modalities are discussed and compared in this review.

Citing Articles

Focused ultrasound for treatment of epilepsy: a systematic review and meta-analysis of preclinical and clinical studies.

Khaboushan A, Zafari R, Sabahi M, Khorasanizadeh M, Dabbagh Ohadi M, Flouty O Neurosurg Rev. 2024; 47(1):839.

PMID: 39521750 DOI: 10.1007/s10143-024-03078-5.

The role of neuromodulation in the management of drug-resistant epilepsy.

Salama H, Salama A, Oscher L, Jallo G, Shimony N Neurol Sci. 2024; 45(9):4243-4268.

PMID: 38642321 DOI: 10.1007/s10072-024-07513-9.

Responsive deep brain stimulation guided by ventral striatal electrophysiology of obsession durably ameliorates compulsion.

Nho Y, Rolle C, Topalovic U, Shivacharan R, Cunningham T, Hiller S Neuron. 2023; 112(1):73-83.e4.

PMID: 37865084 PMC: 10841397. DOI: 10.1016/j.neuron.2023.09.034.

Delayed closed-loop neurostimulation for the treatment of pathological brain rhythms in mental disorders: a computational study.

Wahl T, Riedinger J, Duprez M, Hutt A Front Neurosci. 2023; 17:1183670.

PMID: 37476837 PMC: 10354341. DOI: 10.3389/fnins.2023.1183670.

Source-sink connectivity: a novel interictal EEG marker for seizure localization.

Gunnarsdottir K, Li A, Smith R, Kang J, Korzeniewska A, Crone N Brain. 2022; 145(11):3901-3915.

PMID: 36412516 PMC: 10200292. DOI: 10.1093/brain/awac300.

References

Morrell M . Responsive cortical stimulation for the treatment of medically intractable partial epilepsy. Neurology. 2011; 77(13):1295-304. DOI: 10.1212/WNL.0b013e3182302056. View

Lesser R, Luders H, Klem G, Dinner D, MORRIS H, Hahn J . Cortical afterdischarge and functional response thresholds: results of extraoperative testing. Epilepsia. 1984; 25(5):615-21. DOI: 10.1111/j.1528-1157.1984.tb03471.x. View

Scherrmann J, Hoppe C, Kral T, Schramm J, Elger C . Vagus nerve stimulation: clinical experience in a large patient series. J Clin Neurophysiol. 2001; 18(5):408-14. DOI: 10.1097/00004691-200109000-00004. View

Fisher R, Afra P, Macken M, Minecan D, Bagic A, Benbadis S . Automatic Vagus Nerve Stimulation Triggered by Ictal Tachycardia: Clinical Outcomes and Device Performance--The U.S. E-37 Trial. Neuromodulation. 2015; 19(2):188-95. PMC: 5064739. DOI: 10.1111/ner.12376. View

Jobst B, Cascino G . Resective epilepsy surgery for drug-resistant focal epilepsy: a review. JAMA. 2015; 313(3):285-93. DOI: 10.1001/jama.2014.17426. View

Chen W, Meng F . Ictal heart rate changes and the effects of vagus nerve stimulation for patients with refractory epilepsy. Neuropsychiatr Dis Treat. 2017; 13:2351-2356. PMC: 5592906. DOI: 10.2147/NDT.S142714. View

Sprengers M, Vonck K, Carrette E, Marson A, Boon P . Deep brain and cortical stimulation for epilepsy. Cochrane Database Syst Rev. 2017; 7:CD008497. PMC: 6483316. DOI: 10.1002/14651858.CD008497.pub3. View

Heck C, King-Stephens D, Massey A, Nair D, Jobst B, Barkley G . Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: final results of the RNS System Pivotal trial. Epilepsia. 2014; 55(3):432-41. PMC: 4233950. DOI: 10.1111/epi.12534. View

Troster A, Meador K, Irwin C, Fisher R . Memory and mood outcomes after anterior thalamic stimulation for refractory partial epilepsy. Seizure. 2017; 45:133-141. DOI: 10.1016/j.seizure.2016.12.014. View

10.

Helmstaedter C, Witt J . Epilepsy and cognition - A bidirectional relationship?. Seizure. 2017; 49:83-89. DOI: 10.1016/j.seizure.2017.02.017. View

11.

Geller E, Skarpaas T, Gross R, Goodman R, Barkley G, Bazil C . Brain-responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy. Epilepsia. 2017; 58(6):994-1004. DOI: 10.1111/epi.13740. View

12.

Handforth A, DeGiorgio C, Schachter S, Uthman B, Naritoku D, Tecoma E . Vagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial. Neurology. 1998; 51(1):48-55. DOI: 10.1212/wnl.51.1.48. View

13.

Jitkritsadakul O, Bhidayasiri R, Kalia S, Hodaie M, Lozano A, Fasano A . Systematic review of hardware-related complications of Deep Brain Stimulation: Do new indications pose an increased risk?. Brain Stimul. 2017; 10(5):967-976. DOI: 10.1016/j.brs.2017.07.003. View

14.

Eggleston K, Olin B, Fisher R . Ictal tachycardia: the head-heart connection. Seizure. 2014; 23(7):496-505. DOI: 10.1016/j.seizure.2014.02.012. View

15.

Loring D, Kapur R, Meador K, Morrell M . Differential neuropsychological outcomes following targeted responsive neurostimulation for partial-onset epilepsy. Epilepsia. 2015; 56(11):1836-44. DOI: 10.1111/epi.13191. View

16.

Salanova V, Witt T, Worth R, Henry T, Gross R, Nazzaro J . Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy. Neurology. 2015; 84(10):1017-25. PMC: 4352097. DOI: 10.1212/WNL.0000000000001334. View

17.

King-Stephens D, Mirro E, Weber P, Laxer K, Van Ness P, Salanova V . Lateralization of mesial temporal lobe epilepsy with chronic ambulatory electrocorticography. Epilepsia. 2015; 56(6):959-67. PMC: 4676303. DOI: 10.1111/epi.13010. View

18.

Bergey G, Morrell M, Mizrahi E, Goldman A, King-Stephens D, Nair D . Long-term treatment with responsive brain stimulation in adults with refractory partial seizures. Neurology. 2015; 84(8):810-7. PMC: 4339127. DOI: 10.1212/WNL.0000000000001280. View

19.

Child N, Stead M, Wirrell E, Nickels K, Wetjen N, Lee K . Chronic subthreshold subdural cortical stimulation for the treatment of focal epilepsy originating from eloquent cortex. Epilepsia. 2014; 55(3):e18-21. DOI: 10.1111/epi.12525. View

20.

Englot D, Chang E, Auguste K . Efficacy of vagus nerve stimulation for epilepsy by patient age, epilepsy duration, and seizure type. Neurosurg Clin N Am. 2011; 22(4):443-8, v. DOI: 10.1016/j.nec.2011.07.002. View