Deep Brain Stimulation and Drug-Resistant Epilepsy: A Review of the Literature

Overview

Journal Front Neurol

Specialty Neurology

Date 2019 Jun 28

PMID 31244761

Citations 57

Authors

Nasser Zangiabadi

Lady Diana Ladino

Farzad Sina

Juan Pablo Orozco-Hernandez

Alexandra Carter

Jose Francisco Tellez-Zenteno

Affiliations

Soon will be listed here.

Abstract

Deep brain stimulation is a safe and effective neurointerventional technique for the treatment of movement disorders. Electrical stimulation of subcortical structures may exert a control on seizure generators initiating epileptic activities. The aim of this review is to present the targets of the deep brain stimulation for the treatment of drug-resistant epilepsy. We performed a structured review of the literature from 1980 to 2018 using Medline and PubMed. Articles assessing the impact of deep brain stimulation on seizure frequency in patients with DRE were selected. Meta-analyses, randomized controlled trials, and observational studies were included. To date, deep brain stimulation of various neural targets has been investigated in animal experiments and humans. This article presents the use of stimulation of the anterior and centromedian nucleus of the thalamus, hippocampus, basal ganglia, cerebellum and hypothalamus. Anterior thalamic stimulation has demonstrated efficacy and there is evidence to recommend it as the target of choice. Deep brain stimulation for seizures may be an option in patients with drug-resistant epilepsy. Anterior thalamic nucleus stimulation could be recommended over other targets.

Citing Articles

Effect of deep brain stimulation on the severity of seizures and the quality of life in patients with multifocal drug-resistant epilepsy in Iran: A pilot review of local experience.

Bahadori A, Javadnia P, Davari A, Shafiee S, Ranji S, Sheikhvatan M Epilepsy Behav Rep. 2025; 29:100742.

PMID: 39906530 PMC: 11791334. DOI: 10.1016/j.ebr.2025.100742.

Treatment options in autism with epilepsy.

Cano-Villagrasa A, Moya-Faz F, Porcar-Gozalbo N, Lopez-Zamora M Front Child Adolesc Psychiatry. 2025; 3():1265081.

PMID: 39816614 PMC: 11731780. DOI: 10.3389/frcha.2024.1265081.

A Comprehensive Overview of the Current Status and Advancements in Various Treatment Strategies against Epilepsy.

Waris A, Siraj M, Khan A, Lin J, Asim M, Alhumaydh F ACS Pharmacol Transl Sci. 2024; 7(12):3729-3757.

PMID: 39698272 PMC: 11650742. DOI: 10.1021/acsptsci.4c00494.

Assessment of the Efficacy of Deep Brain Stimulation (DBS) in Managing Drug-Resistant Epilepsy (DRE): A Systematic Review and Meta-Analysis of Randomized Controlled Trials (RCTs).

Raslan E, Al-Hawas S, Alghamdi M, Alblwan A, Alhomaidhi A, Alruwaili A Cureus. 2024; 16(10):e71348.

PMID: 39534832 PMC: 11555489. DOI: 10.7759/cureus.71348.

Noninvasive closed-loop acoustic brain-computer interface for seizure control.

Zou J, Chen H, Chen X, Lin Z, Yang Q, Tie C Theranostics. 2024; 14(15):5965-5981.

PMID: 39346532 PMC: 11426232. DOI: 10.7150/thno.99820.

References

Sun F, Morrell M . Closed-loop neurostimulation: the clinical experience. Neurotherapeutics. 2014; 11(3):553-63. PMC: 4121459. DOI: 10.1007/s13311-014-0280-3. View

Lim S, Lee C, Lee S, Tu P, Chang B, Lee C . Low and High Frequency Hippocampal Stimulation for Drug-Resistant Mesial Temporal Lobe Epilepsy. Neuromodulation. 2016; 19(4):365-72. PMC: 5074270. DOI: 10.1111/ner.12435. View

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

Albin R, Young A, Penney J . The functional anatomy of basal ganglia disorders. Trends Neurosci. 1989; 12(10):366-75. DOI: 10.1016/0166-2236(89)90074-x. View

Mirski M, Ferrendelli J . Interruption of the mammillothalamic tract prevents seizures in guinea pigs. Science. 1984; 226(4670):72-4. DOI: 10.1126/science.6433485. View

Kros L, Eelkman Rooda O, Spanke J, Alva P, van Dongen M, Karapatis A . Cerebellar output controls generalized spike-and-wave discharge occurrence. Ann Neurol. 2015; 77(6):1027-49. PMC: 5008217. DOI: 10.1002/ana.24399. View

Mondragon S, LAMARCHE M . Suppression of motor seizures after specific thalamotomy in chronic epileptic monkeys. Epilepsy Res. 1990; 5(2):137-45. DOI: 10.1016/0920-1211(90)90030-y. View

Valentin A, Nguyen H, Skupenova A, Agirre-Arrizubieta Z, Jewell S, Mullatti N . Centromedian thalamic nuclei deep brain stimulation in refractory status epilepticus. Brain Stimul. 2011; 5(4):594-8. DOI: 10.1016/j.brs.2011.10.002. View

Lega B, Halpern C, Jaggi J, Baltuch G . Deep brain stimulation in the treatment of refractory epilepsy: update on current data and future directions. Neurobiol Dis. 2009; 38(3):354-60. DOI: 10.1016/j.nbd.2009.07.007. View

10.

Vesper J, Steinhoff B, Rona S, Wille C, Bilic S, Nikkhah G . Chronic high-frequency deep brain stimulation of the STN/SNr for progressive myoclonic epilepsy. Epilepsia. 2007; 48(10):1984-9. DOI: 10.1111/j.1528-1167.2007.01166.x. View

11.

Capecci M, Ricciuti R, Ortenzi A, Paggi A, Durazzi V, Rychlicki F . Chronic bilateral subthalamic stimulation after anterior callosotomy in drug-resistant epilepsy: long-term clinical and functional outcome of two cases. Epilepsy Res. 2011; 98(2-3):135-9. DOI: 10.1016/j.eplepsyres.2011.08.017. View

12.

Andrade D, Zumsteg D, Hamani C, Hodaie M, Sarkissian S, Lozano A . Long-term follow-up of patients with thalamic deep brain stimulation for epilepsy. Neurology. 2006; 66(10):1571-3. DOI: 10.1212/01.wnl.0000206364.19772.39. View

13.

Ladas T, Chiang C, Gonzalez-Reyes L, Nowak T, Durand D . Seizure reduction through interneuron-mediated entrainment using low frequency optical stimulation. Exp Neurol. 2015; 269:120-32. PMC: 4446206. DOI: 10.1016/j.expneurol.2015.04.001. View

14.

Reuber M, Rawlings G . Nonepileptic seizures - subjective phenomena. Handb Clin Neurol. 2016; 139:283-296. DOI: 10.1016/B978-0-12-801772-2.00025-4. View

15.

Tawfik V, Chang S, Hitti F, Roberts D, Leiter J, Jovanovic S . Deep brain stimulation results in local glutamate and adenosine release: investigation into the role of astrocytes. Neurosurgery. 2010; 67(2):367-75. PMC: 2919357. DOI: 10.1227/01.NEU.0000371988.73620.4C. View

16.

Upton A, Amin I, Garnett S, Springman M, Nahmias C, Cooper I . Evoked metabolic responses in the limbic-striate system produced by stimulation of anterior thalamic nucleus in man. Pacing Clin Electrophysiol. 1987; 10(1 Pt 2):217-25. DOI: 10.1111/j.1540-8159.1987.tb05952.x. View

17.

Lee K, Shon Y, Cho C . Long-term outcome of anterior thalamic nucleus stimulation for intractable epilepsy. Stereotact Funct Neurosurg. 2012; 90(6):379-85. DOI: 10.1159/000339991. View

18.

Hindle Fisher I, Pall H, Mitchell R, Kausar J, Cavanna A . Apathy in patients with Parkinson's disease following deep brain stimulation of the subthalamic nucleus. CNS Spectr. 2016; 21(3):258-64. DOI: 10.1017/S1092852916000171. View

19.

Valentin A, Selway R, Amarouche M, Mundil N, Ughratdar I, Ayoubian L . Intracranial stimulation for children with epilepsy. Eur J Paediatr Neurol. 2016; 21(1):223-231. DOI: 10.1016/j.ejpn.2016.10.011. View

20.

Pandey S, Sarma N . Deep brain stimulation: current status. Neurol India. 2015; 63(1):9-18. DOI: 10.4103/0028-3886.152623. View