Focal Cooling for Drug-Resistant Epilepsy: A Review

Overview

Journal JAMA Neurol

Publisher American Medical Association

Date 2022 Jul 25

PMID 35877102

Authors

Itamar Niesvizky-Kogan

Michelle Bass

Shira R Goldenholz

Daniel M Goldenholz

Affiliations

Soon will be listed here.

Abstract

Importance: Epilepsy affects at least 1.2% of the population, with one-third of cases considered to be drug-resistant epilepsy (DRE). For these cases, focal cooling therapy may be a potential avenue for treatment, offering hope to people with DRE for freedom from seizure. The therapy leverages neuroscience and engineering principles to deliver a reversible treatment unhindered by pharmacology.

Observations: Analogous to (but safer than) the use of global cooling in postcardiac arrest and neonatal ischemic injury, extensive research supports the premise that focal cooling as a long-term treatment for epilepsy could be effective. The potential advantages of focal cooling are trifold: stopping epileptiform discharges, seizures, and status epilepticus safely across species (including humans).

Conclusions And Relevance: This Review presents the most current evidence supporting focal cooling in epilepsy. Cooling has been demonstrated as a potentially safe and effective treatment modality for DRE, although it is not yet ready for use in humans outside of randomized clinical trials. The Review will also offer a brief overview of the technical challenges related to focal cooling in humans, including the optimal device design and cooling parameters.

Citing Articles

The efficacy and safety of third-generation antiseizure medications and non-invasive brain stimulation to treat refractory epilepsy: a systematic review and network meta-analysis study.

Yang Y, Shangguan Y, Wang X, Liu R, Shen Z, Tang M Front Neurol. 2024; 14:1307296.

PMID: 38264091 PMC: 10804851. DOI: 10.3389/fneur.2023.1307296.

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