Emerging Trends in Neuromodulation for Treatment of Drug-Resistant Epilepsy

Abouelleil, Mohamed; Deshpande, Nachiket; Ali, Rushna

doi:10.3389/fpain.2022.839463

Cited by 11 publications

(7 citation statements)

References 84 publications

(93 reference statements)

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“…Neuromodulation and neurostimulation can also include the use of non-invasive techniques, such as transcranial magnetic stimulation or transcranial direct-current stimulation, that can modulate cortical excitability or plasticity [300,301]. For example, a study using precision medicine for the diagnosis and treatment of viral infections and epilepsy suggested that neuromodulation and neurostimulation may be useful for patients with refractory epilepsy who are not candidates for surgery or who have contraindications to antiviral drugs or anticonvulsant drugs [302].…”

Section: Future Directions and Precision Therapiesmentioning

confidence: 99%

Virus-Induced Epilepsy vs. Epilepsy Patients Acquiring Viral Infection: Unravelling the Complex Relationship for Precision Treatment

Costa,

Vale

2024

IJMS

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The intricate relationship between viruses and epilepsy involves a bidirectional interaction. Certain viruses can induce epilepsy by infecting the brain, leading to inflammation, damage, or abnormal electrical activity. Conversely, epilepsy patients may be more susceptible to viral infections due to factors, such as compromised immune systems, anticonvulsant drugs, or surgical interventions. Neuroinflammation, a common factor in both scenarios, exhibits onset, duration, intensity, and consequence variations. It can modulate epileptogenesis, increase seizure susceptibility, and impact anticonvulsant drug pharmacokinetics, immune system function, and brain physiology. Viral infections significantly impact the clinical management of epilepsy patients, necessitating a multidisciplinary approach encompassing diagnosis, prevention, and treatment of both conditions. We delved into the dual dynamics of viruses inducing epilepsy and epilepsy patients acquiring viruses, examining the unique features of each case. For virus-induced epilepsy, we specify virus types, elucidate mechanisms of epilepsy induction, emphasize neuroinflammation’s impact, and analyze its effects on anticonvulsant drug pharmacokinetics. Conversely, in epilepsy patients acquiring viruses, we detail the acquired virus, its interaction with existing epilepsy, neuroinflammation effects, and changes in anticonvulsant drug pharmacokinetics. Understanding this interplay advances precision therapies for epilepsy during viral infections, providing mechanistic insights, identifying biomarkers and therapeutic targets, and supporting optimized dosing regimens. However, further studies are crucial to validate tools, discover new biomarkers and therapeutic targets, and evaluate targeted therapy safety and efficacy in diverse epilepsy and viral infection scenarios.

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Section: Future Directions and Precision Therapiesmentioning

confidence: 99%

Virus-Induced Epilepsy vs. Epilepsy Patients Acquiring Viral Infection: Unravelling the Complex Relationship for Precision Treatment

Costa,

Vale

2024

IJMS

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“…Neuromodulation therapy acts as a non-pharmacological treatment for epilepsy; this type of therapy directly stimulates or prevents the conduction of electrical potential in the brain [139]. Neuromodulation acts directly on the electrical conduction system of the CNS, modulating or modifying brain excitability and impacting the intensity and frequency of seizures in cases of epilepsy [140,141].…”

Section: Neuromodulation Therapymentioning

confidence: 99%

“…This method is also a non-invasive technique that helps in epilepsy treatment by anticipating tonic-clonic and generalized seizures [139]. The mechanism of TNS is a similar to that of VNS, where the trigeminal nerve is part of the nucleus of the solitary tract (NTS) and locus coeruleus (LC), brain regions that are involved in seizure reduction [139,140,157,164].…”

Section: Trigeminal Nerve Stimulationmentioning

confidence: 99%

Pathophysiology to Risk Factor and Therapeutics to Treatment Strategies on Epilepsy

Boleti,

Cardoso,

Frihling

et al. 2024

Brain Sciences

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Epilepsy represents a condition in which abnormal neuronal discharges or the hyperexcitability of neurons occur with synchronicity, presenting a significant public health challenge. Prognostic factors, such as etiology, electroencephalogram (EEG) abnormalities, the type and number of seizures before treatment, as well as the initial unsatisfactory effects of medications, are important considerations. Although there are several third-generation antiepileptic drugs currently available, their multiple side effects can negatively affect patient quality of life. The inheritance and etiology of epilepsy are complex, involving multiple underlying genetic and epigenetic mechanisms. Different neurotransmitters play crucial roles in maintaining the normal physiology of different neurons. Dysregulations in neurotransmission, due to abnormal transmitter levels or changes in their receptors, can result in seizures. In this review, we address the roles played by various neurotransmitters and their receptors in the pathophysiology of epilepsy. Furthermore, we extensively explore the neurological mechanisms involved in the development and progression of epilepsy, along with its risk factors. Furthermore, we highlight the new therapeutic targets, along with pharmacological and non-pharmacological strategies currently employed in the treatment of epileptic syndromes, including drug interventions employed in clinical trials related to epilepsy.

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“…Novel VNS approaches, such as non-invasive vagus nerve stimulation (nVNS), are being studied to explore their effectiveness as a less invasive alternative to traditional VNS therapy [ 90 , 91 ]. Some studies are investigating the potential synergistic effects of combining VNS with other neuromodulation techniques or with specific ASMs to enhance seizure control [ 92 , 93 , 94 ]. As VNS research continues to evolve, ongoing clinical trials hold the promise of further elucidating the therapeutic potential of VNS in various epilepsy syndromes and refining patient selection criteria for optimal outcomes.…”

Section: Vagus Nerve Stimulationmentioning

confidence: 99%

A Comprehensive Review of Emerging Trends and Innovative Therapies in Epilepsy Management

Ghosh,

Sinha,

Ghosh

et al. 2023

Brain Sciences

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Epilepsy is a complex neurological disorder affecting millions worldwide, with a substantial number of patients facing drug-resistant epilepsy. This comprehensive review explores innovative therapies for epilepsy management, focusing on their principles, clinical evidence, and potential applications. Traditional antiseizure medications (ASMs) form the cornerstone of epilepsy treatment, but their limitations necessitate alternative approaches. The review delves into cutting-edge therapies such as responsive neurostimulation (RNS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS), highlighting their mechanisms of action and promising clinical outcomes. Additionally, the potential of gene therapies and optogenetics in epilepsy research is discussed, revealing groundbreaking findings that shed light on seizure mechanisms. Insights into cannabidiol (CBD) and the ketogenic diet as adjunctive therapies further broaden the spectrum of epilepsy management. Challenges in achieving seizure control with traditional therapies, including treatment resistance and individual variability, are addressed. The importance of staying updated with emerging trends in epilepsy management is emphasized, along with the hope for improved therapeutic options. Future research directions, such as combining therapies, AI applications, and non-invasive optogenetics, hold promise for personalized and effective epilepsy treatment. As the field advances, collaboration among researchers of natural and synthetic biochemistry, clinicians from different streams and various forms of medicine, and patients will drive progress toward better seizure control and a higher quality of life for individuals living with epilepsy.

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Emerging Trends in Neuromodulation for Treatment of Drug-Resistant Epilepsy

Cited by 11 publications

References 84 publications

Virus-Induced Epilepsy vs. Epilepsy Patients Acquiring Viral Infection: Unravelling the Complex Relationship for Precision Treatment

Virus-Induced Epilepsy vs. Epilepsy Patients Acquiring Viral Infection: Unravelling the Complex Relationship for Precision Treatment

Pathophysiology to Risk Factor and Therapeutics to Treatment Strategies on Epilepsy

A Comprehensive Review of Emerging Trends and Innovative Therapies in Epilepsy Management

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