Effects of Therapeutic Stimulation of Nucleus caudatus on Epileptic Electrical Activity of Brain in Patients with Intractable Epilepsy

Chkhenkeli, S. A.; Chkhenkeli, Irina S

doi:10.1159/000099878

Cited by 136 publications

(70 citation statements)

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“…With the rationale of modulating the cortico-striato-thalamic network and inducing cortical hyperpolarization, Chkhenkeli and colleagues [91][92][93] tested DBS of the ventral caudate in a l a r g e n u m b e r o f p a t i e n t s u n d e r g o i n g s t e r e oelectroencephalography for seizure disorders. Lowfrequency (4-8 Hz) stimulation decreased cortical and hippocampal interictal spiking and epileptiform activity in a subset of these patients, several dozen of whom subsequently underwent placement of internalized DBS systems.…”

Section: Caudate Nucleusmentioning

confidence: 99%

Deep Brain Stimulation for the Treatment of Epilepsy: Circuits, Targets, and Trials

2014

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Deep brain stimulation (DBS) has proven remarkably safe and effective in the treatment of movement disorders. As a result, it is being increasingly applied to a range of neurologic and psychiatric disorders, including medically refractory epilepsy. This review will examine the use of DBS in epilepsy, including known targets, mechanisms of neuromodulation and seizure control, published clinical evidence, and novel technologies. Cortical and deep neuromodulation for epilepsy has a long experimental history, but only recently have better understanding of epileptogenic networks, precise stereotactic techniques, and rigorous trial design combined to improve the quality of available evidence and make DBS a viable treatment option. Nonetheless, underlying mechanisms, anatomical targets, and stimulation parameters remain areas of active investigation.

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Section: Caudate Nucleusmentioning

confidence: 99%

Deep Brain Stimulation for the Treatment of Epilepsy: Circuits, Targets, and Trials

2014

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“…Indeed, low-frequency stimulation (4 -8 Hz) of the ventral part of the HCN has been shown to suppress interictal activity, focal amygdalohippocampal discharges, and generalization of seizures. 61,62 Controlled clinical studies are necessary to further evaluate the HCN as a target for DBS in epilepsy.…”

Section: Caudate Nucleusmentioning

confidence: 99%

Deep Brain Stimulation for Epilepsy

et al. 2008

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Summary:Many patients who suffer from medically refractory epilepsy are not candidates for resective brain surgery. Success of deep brain stimulation (DBS) in relieving a significant number of symptoms of various movement disorders paved the way for investigations into this modality for epilepsy. Open-label and small blinded trials have provided promising evidence for the use of DBS in refractory seizures, and the first randomized control trial of DBS of the anterior thalamic nucleus is currently underway.There are multiple potential targets, because many neural regions have been implicated in seizure propagation. Thus, it is difficult as yet to make any definitive judgments about the efficacy of DBS for seizure control. Future study is necessary to identify a patient population for whom this technique would be indicated, the most efficacious target, and optimal stimulation parameters.

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“…A few epilepsy centers around the world have recently reinitiated trials with DBS in the thalamus, the subthalamic nucleus, and the caudate nucleus. [11][12][13][14][15] The present review focuses on VNS and hippocampal DBS as a treatment for epilepsy. The precise mechanism of action by which VNS exerts its antiepileptic effect is unknown.…”

Section: Introductionmentioning

confidence: 99%

“…18 For DBS, little information on efficacious stimulation parameters is available from limited human or animal epilepsy experiments. A range of potentially efficacious and safe stimulation parameters have been identified from previous DBS studies in other intracerebral targets [7][8][9][10][11][12][13][14][15] and from studies in patients with movement disorders.…”

Section: Introductionmentioning

confidence: 99%

Electrical Stimulation for the Treatment of Epilepsy

et al. 2009

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Summary: Despite the advent of new pharmacological treatments and the high success rate of many surgical treatments for epilepsy, a substantial number of patients either do not become seizure-free or they experience major adverse events (or both). Neurostimulation-based treatments have gained considerable interest in the last decade. Vagus nerve stimulation (VNS) is an alternative treatment for patients with medically refractory epilepsy, who are unsuitable candidates for conventional epilepsy surgery, or who have had such surgery without optimal outcome. Although responder identification studies are lacking, long-term VNS studies show response rates between 40% and 50% and long-term seizure freedom in 5% to 10% of patients. Surgical complications and perioperative morbidity are low. Research into the mechanism of action of VNS has revealed a crucial role for the thalamus and cortical areas that are important in the epileptogenic process. Acute deep brain stimulation (DBS) in various thalamic nuclei and medial temporal lobe structures has recently been shown to be efficacious in small pilot studies. There is little evidence-based information on rational targets and stimulation parameters. Amygdalohippocampal DBS has yielded a significant decrease of seizure counts and interictal EEG abnormalities during long-term follow-up. Data from pilot studies suggest that chronic DBS for epilepsy may be a feasible, effective, and safe procedure. Further trials with larger patient populations and with controlled, randomized, and closed-loop designs should now be initiated. Further progress in understanding the mechanism of action of DBS for epilepsy is a necessary step to making this therapy more efficacious and established.

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Effects of Therapeutic Stimulation of Nucleus caudatus on Epileptic Electrical Activity of Brain in Patients with Intractable Epilepsy

Cited by 136 publications

References 0 publications

Deep Brain Stimulation for the Treatment of Epilepsy: Circuits, Targets, and Trials

Deep Brain Stimulation for the Treatment of Epilepsy: Circuits, Targets, and Trials

Deep Brain Stimulation for Epilepsy

Electrical Stimulation for the Treatment of Epilepsy

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