Cerebellar Stimulation in Alumina‐Gel Monkey Model: Inverse Relationship Between Clinical Seizures and EEG Interictal Bursts

Lockard, Joan S.; Ojemann, George A.; Congdon, William C.; DuCharme, Larry L.

doi:10.1111/j.1528-1157.1979.tb04799.x

Cited by 36 publications

(16 citation statements)

References 19 publications

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“…Numerous animal studies have demonstrated that electrical stimulation of the cerebellum may abort electrically or chemically induced seizures and drastically alter the electrophysiological profile of the neuronal tissue in vitro and in vivo. 1,2,5,8,[13][14][15]19,21,22,26,28,30,35,38,39,41,42,48,49,52,53 However, there are several issues that remain to be resolved and important questions that need to be answered.…”

Section: Discussionmentioning

confidence: 99%

“…The vast majority of the animal experimental studies but also the clinical trials have used the cerebellum cortical surface as stimulation target, with frequently contradictory results. 8,5,[14][15][16]22,23,38,48,52,53 However, the stimulation of the deep cerebellar nuclei appears to provide more solid data and better seizure control. 1,35 There are several mechanisms that may explain this discrepancy in the results of the cortical CS in animal and human studies.…”

Section: Discussionmentioning

confidence: 99%

“…15,22,38,48,52,53 Reimer et al 48 found that stimulation of the vermis produced prolongation of the seizures induced by cortical application of cobalt powder in their cats. Likewise, Hablitz 21 and Myers et al 43 found that CS had no effect on seizure activity in their penicillin-induced seizure models.…”

Section: Animal Experimental Studiesmentioning

confidence: 99%

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Cerebellar stimulation in the management of medically intractable epilepsy: a systematic and critical review

Fountas¹,

Kapsalaki²,

Hadjigeorgiou

2010

FOC

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Object The wide application of deep brain stimulation in the management of movement as well as other degenerative neurological and psychiatric disorders has renewed the interest in using deep brain stimulation in the management of medically intractable epilepsy. Various stimulation targets have been used with significantly varying results in aborting seizure activity. Electrical cerebellar stimulation (CS) has been used for more than 50 years in the management of epilepsy, with conflicting results. In the current study, the authors review the pertinent literature to outline the role of CS in the management of medically refractory epilepsy. Methods The PubMed medical database was systematically searched for the following terms: “cerebellar,” “epilepsy,” “stimulation,” and “treatment,” and all their combinations. Case reports were excluded from this study. Results The pertinent articles were categorized into 2 large groups: animal experimental and human clinical studies. Particular emphasis on the following aspects was given when reviewing the human clinical studies: their methodological characteristics, the number of participants, their seizure types, the implantation technique and its associated complications, the exact stimulation target, the stimulation technique, the seizure outcome, and the patients' psychological and social poststimulation status. Three clinical double-blind studies were found, with similar implantation surgical technique, stimulation target, and stimulation parameters, but quite contradictory results. Two of these studies failed to demonstrate any significant seizure reduction, whereas the third one showed a significant poststimulation decrease in seizure frequency. All possible factors responsible for these differences in the findings are analyzed in the present study. Conclusions Cerebellar stimulation seems to remain a stimulation target worth exploring for defining its potential in the treatment of medically intractable epilepsy, although the data from the double-blind clinical studies that were performed failed to establish a clear benefit in regard to seizure frequency. A large-scale, double-blind clinical study is required for accurately defining the efficacy of CS in epilepsy treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cerebellar stimulation in the management of medically intractable epilepsy: a systematic and critical review

Fountas¹,

Kapsalaki²,

Hadjigeorgiou

2010

FOC

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“…On the other hand, cerebellar stimulation increased seizure threshold in the rabbit following PTZ administration but not in the electrical stimulation induced seizure model (17). In a chronic epilepsy monkey model, anterior cerebellar vermis stimulation using parameters analogous to Cooper worsened seizure frequency (18). Reimer and colleagues described the effects of cerebellar stimulation on cobalt experimental epilepsy in the cat (19).…”

Section: Deep Brain Stimulation Of the Epilepsy Control Systemsmentioning

confidence: 99%

Deep Brain Stimulation for Epilepsy

Nagel¹,

Najm²

2009

Neuromodulation: Technology at the Neural Interface

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Introduction. There is renewed interest in the use of electrical stimulation to control seizures in patients with medically refractory epilepsy. The evidence indicates that multiple nuclei are involved in the onset, spread, or termination of seizures. Establishing electrical stimulation parameters tailored to these nuclei that best control seizures is ongoing. Methods. The aim of this article is to review the published literature on electrical stimulation of the brain for epilepsy in animals and humans. Results. Animal and human research efforts have focused primarily on the study of the cerebellum, anterior thalamus, centromedian thalamus, substania nigra, caudate nucleus, subthalamic nucleus, and amygdalo-hippocampal complex. Electrical stimulation of deep brain nuclei has in some instances controlled seizures and epilepsy. The advent of seizure detection devices used in closed-loop studies has in part redefined the strategy to prevent seizure occurrence and limit spread. Discussion. A number of studies in animals and humans indicate that electrical stimulation may be an alternative treatment for some patients with medically intractable epilepsy who are not candidates for conventional surgical options. Conclusion. The reduction in the number and/or severity of seizures found in some studies supports further investigation into the effects of electrical stimulation on the brain and the continuation of testing in animals and humans.

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“…Moruzzi und Magoun fanden eine Verminderung der Dezerebrationsstarre bei Ratten durch Hochfrequenzstimulation des Kleinhirns [76]. Daraufhin wurden in verschiedenen Institutionen Tierversuche zur Anfallskontrolle durch Kleinhirnstimulation durchgeführt, die sowohl positive [5,42,51] als auch negative [47,62,79] Ergebnisse brachten. Cooper et alversuchten schließ-lich 1970, menschliche Anfälle mit Kleinhirnstimulation zu behandeln und berichteten über Anfallsfreiheit bei 27% der Probanden in unkontrollierten Fallserien [27,28,29].Diese Resultate konnten jedoch in doppelblind kontrollierten Studien [110,127] nicht bestätigt werden.…”

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Elektrische Hirnstimulation in der Epilepsietherapie

et al. 2003

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Attempts to control epileptic seizures by electrical brain stimulation have been performed for 50 years. Many different stimulation targets and methods have been investigated. Vagal nerve stimulation (VNS) is now approved for the treatment of refractory epilepsies by several governmental authorities in Europe and North America. However, it is mainly used as a palliative method when patients do not respond to medical treatment and epilepsy surgery is not possible. Numerous studies of the effect of deep brain stimulation (DBS) on epileptic seizures have been performed and almost invariably report remarkable success. However, a limited number of controlled studies failed to show a significant effect. Repetitive transcranial magnetic stimulation (rTMS) also was effective in open studies, and controlled studies are now being carried out. In addition, several uncontrolled reports describe successful treatment of refractory status epilepticus with electroconvulsive therapy (ECT). In summary, with the targets and stimulation parameters investigated so far, the effects of electrical brain stimulation on seizure frequency have been moderate at best. In the animal laboratory, we are now testing high-intensity, low-frequency stimulation of white matter tracts directly connected to the epileptogenic zone (e.g., fornix, corpus callosum) as a new methodology to increase the efficacy of DBS ("overdrive method").

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Cerebellar Stimulation in Alumina‐Gel Monkey Model: Inverse Relationship Between Clinical Seizures and EEG Interictal Bursts

Cited by 36 publications

References 19 publications

Cerebellar stimulation in the management of medically intractable epilepsy: a systematic and critical review

Cerebellar stimulation in the management of medically intractable epilepsy: a systematic and critical review

Deep Brain Stimulation for Epilepsy

Elektrische Hirnstimulation in der Epilepsietherapie

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