Let there be light: Inhibitory effect of photic stimulation on spike frequency in patients with mesial temporal lobe epilepsy with hippocampal sclerosis

Elmalı, Ayşe Deniz; Özçeli̇k, Emel Ur; Bebek, Nerses; Baykan, Betül

doi:10.1016/j.eplepsyres.2021.106734

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…However, sensory stimulation can inhibit or interrupt some seizures and light flashes are a form of such stimulation. One study 174 recorded a mean reduction of interictal spiking from 1.17 per minute at baseline to 0.8 per minute during light flashes across the range of 5‐50 Hz. This raises the unexpected possibility that some types of light stimuli might be beneficial against seizures.…”

Section: Photic Eeg and Imagingmentioning

confidence: 99%

Visually sensitive seizures: An updated review by the Epilepsy Foundation

et al. 2022

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Light flashes, patterns, or color changes can provoke seizures in up to 1 in 4000 persons. Prevalence may be higher because of selection bias. The Epilepsy Foundation reviewed light-induced seizures in 2005. Since then, images on social media, virtual reality, three-dimensional (3D) movies, and the Internet have proliferated. Hundreds of studies have explored the mechanisms and presentations of photosensitive seizures, justifying an updated review. This literature summary derives from a nonsystematic literature review via PubMed using the terms "photosensitive" and "epilepsy." The photoparoxysmal response (PPR) is an electroencephalography (EEG) phenomenon, and photosensitive seizures (PS) are seizures provoked by visual stimulation. Photosensitivity is more common in the young and in specific forms of generalized epilepsy. PS can coexist with spontaneous seizures. PS are hereditable and linked to recently identified genes. Brain imaging usually is normal, but special studies imaging white matter tracts demonstrate abnormal connectivity. Occipital cortex and connected regions are hyperexcitable in subjects with light-provoked seizures. Mechanisms remain unclear. Video games, social media clips, occasional movies, and natural stimuli can provoke PS.

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Section: Photic Eeg and Imagingmentioning

confidence: 99%

Visually sensitive seizures: An updated review by the Epilepsy Foundation

et al. 2022

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“…; https://doi.org/10.1101/2023.03.14.23286691 doi: medRxiv preprint 40Hz sensory flicker was shown to modulate the medial temporal lobe (MTL) and prefrontal cortex (PFC), decrease the pathogenic peptide amyloid beta, and improve spatial memory deficits 51 . One study in humans suggested that visual flicker stimulation had an inhibitory effect on epileptic discharges in mesial temporal lobe epilepsy associated with hippocampal sclerosis 52 . Another small (4 subjects) pilot study 53 suggested that exposure to 40Hz monotone decreases IEDs in epileptic patients.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Multisensory Flicker Modulates Widespread Brain Networks and Reduces Interictal Epileptiform Discharges in Humans

Blanpain

Chen

Park

et al. 2023

Preprint

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Modulating brain oscillations has strong therapeutic potential. However, commonly used non-invasive interventions such as transcranial magnetic or direct current stimulation have limited effects on deeper cortical structures like the medial temporal lobe. Repetitive audio-visual stimulation, or sensory flicker, modulates such structures in mice but little is known about its effects in humans. Using high spatiotemporal resolution, we mapped and quantified the neurophysiological effects of sensory flicker in human subjects undergoing presurgical intracranial seizure monitoring. We found that flicker modulates both local field potential and single neurons in higher cognitive regions, including the medial temporal lobe and prefrontal cortex, and that local field potential modulation is likely mediated via resonance of involved circuits. We then assessed how flicker affects pathological neural activity, specifically interictal epileptiform discharges, a biomarker of epilepsy also implicated in Alzheimer's and other diseases. In our patient population with focal seizure onsets, sensory flicker decreased the rate interictal epileptiform discharges. Our findings support the use of sensory flicker to modulate deeper cortical structures and mitigate pathological activity in humans. Clinical Trial Registration ID: #NCT04188834

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Multisensory flicker modulates widespread brain networks and reduces interictal epileptiform discharges

Blanpain,

Cole,

Chen

et al. 2024

Nat Commun

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Modulating brain oscillations has strong therapeutic potential. Interventions that both non-invasively modulate deep brain structures and are practical for chronic daily home use are desirable for a variety of therapeutic applications. Repetitive audio-visual stimulation, or sensory flicker, is an accessible approach that modulates hippocampus in mice, but its effects in humans are poorly defined. We therefore quantified the neurophysiological effects of flicker with high spatiotemporal resolution in patients with focal epilepsy who underwent intracranial seizure monitoring. In this interventional trial (NCT04188834) with a cross-over design, subjects underwent different frequencies of flicker stimulation in the same recording session with the effect of sensory flicker exposure on local field potential (LFP) power and interictal epileptiform discharges (IEDs) as primary and secondary outcomes, respectively. Flicker focally modulated local field potentials in expected canonical sensory cortices but also in the medial temporal lobe and prefrontal cortex, likely via resonance of stimulated long-range circuits. Moreover, flicker decreased interictal epileptiform discharges, a pathological biomarker of epilepsy and degenerative diseases, most strongly in regions where potentials were flicker-modulated, especially the visual cortex and medial temporal lobe. This trial met the scientific goal and is now closed. Our findings reveal how multi-sensory stimulation may modulate cortical structures to mitigate pathological activity in humans.

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Let there be light: Inhibitory effect of photic stimulation on spike frequency in patients with mesial temporal lobe epilepsy with hippocampal sclerosis

Cited by 3 publications

References 24 publications

Visually sensitive seizures: An updated review by the Epilepsy Foundation

Visually sensitive seizures: An updated review by the Epilepsy Foundation

Multisensory Flicker Modulates Widespread Brain Networks and Reduces Interictal Epileptiform Discharges in Humans

Multisensory flicker modulates widespread brain networks and reduces interictal epileptiform discharges

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