Long-term follow-up of anterior thalamic deep brain stimulation in epilepsy: A 11-year, single center experience

Kim, Seong Hoon; Lim, Sung Chul; Kim, Jiyeon; Son, Byung-chul; Lee, Kyung Jin; Shon, Young-Min

doi:10.1016/j.seizure.2017.10.009

Cited by 59 publications

(83 citation statements)

References 29 publications

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“…Currently, U.S. Food and Drug Administration (FDA)‐approved chronically implanted intracranial neuromodulation systems include DBS and responsive neurostimulation (RNS). DBS has been used for decades to treat movement disorders and, more recently, to treat neuropsychiatric disorders and epilepsy . DBS systems are modular, consisting of a multicontact lead, an internal pulse generator (IPG), and an extension cable.…”

Section: Introductionmentioning

confidence: 99%

Estimating Risk for Future Intracranial, Fully Implanted, Modular Neuroprosthetic Systems: A Systematic Review of Hardware Complications in Clinical Deep Brain Stimulation and Experimental Human Intracortical Arrays

Bullard

Hutchison

Lee

et al. 2020

Neuromodulation: Technology at the Neural Interface

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Objective A new age of neuromodulation is emerging: one of restorative neuroengineering and neuroprosthetics. As novel device systems move toward regulatory evaluation and clinical trials, a critical need arises for evidence‐based identification of potential sources of hardware‐related complications to assist in clinical trial design and mitigation of potential risk. Materials and Methods The objective of this systematic review is to provide a detailed safety analysis for future intracranial, fully implanted, modular neuroprosthetic systems. To achieve this aim, we conducted an evidence‐based analysis of hardware complications for the most established clinical intracranial modular system, deep brain stimulation (DBS), as well as the most widely used intracranial human experimental system, the silicon‐based (Utah) array. Results Of 2328 publications identified, 240 articles met the inclusion criteria and were reviewed for DBS hardware complications. The most reported adverse events were infection (4.57%), internal pulse generator malfunction (3.25%), hemorrhage (2.86%), lead migration (2.58%), lead fracture (2.56%), skin erosion (2.22%), and extension cable malfunction (1.63%). Of 433 publications identified, 76 articles met the inclusion criteria and were reviewed for Utah array complications. Of 48 human subjects implanted with the Utah array, 18 have chronic implants. Few specific complications are described in the literature; hence, implant duration served as a lower bound for complication‐free operation. The longest reported duration of a person with a Utah array implant is 1975 days (~5.4 years). Conclusions Through systematic review of the clinical and human‐trial literature, our study provides the most comprehensive safety review to date of DBS hardware and human neuroprosthetic research using the Utah array. The evidence‐based analysis serves as an important reference for investigators seeking to identify hardware‐related safety data, a necessity to meet regulatory requirements and to design clinical trials for future intracranial, fully implanted, modular neuroprosthetic systems.

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Section: Introductionmentioning

confidence: 99%

Estimating Risk for Future Intracranial, Fully Implanted, Modular Neuroprosthetic Systems: A Systematic Review of Hardware Complications in Clinical Deep Brain Stimulation and Experimental Human Intracortical Arrays

Bullard

Hutchison

Lee

et al. 2020

Neuromodulation: Technology at the Neural Interface

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“…Thus, according to a randomized study, assessing the effectiveness of hippocampal stimulation in patients with temporal lobe DRE, positive effect in the form of complete disappearance of seizures was found in 50% of patients [60]. According to other studies, it was shown that after 11 years of deep brain stimulation, the attacks were not registered for at least 12 months in only 13.8% of the patients [61].…”

Section: Deep Brain Stimulationmentioning

confidence: 94%

The Role of Nondrug Treatment Methods in the Management of Epilepsy

Shnayder¹,

Narodova²,

Народова³

et al. 2019

Epilepsy - Advances in Diagnosis and Therapy

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The review is devoted to the issue of nondrug epilepsy treatment in the adult population in Russia and abroad. The conducted literature review allowed us to reveal the basic nondrug epilepsy treatment options. However, not all of these options have a sufficient evidence base, and some of them are not always safe. Particularly, methods with low level of evidence include acupuncture and aromatherapy. Further studies are needed to explore the methods aimed to eliminate the epileptic system dominant through the development of a new, more powerful dominant. One of the methods, which can influence the pathogenesis of epilepsy, is physical activity for patients with epilepsy, since epileptiform activity on the EEG is reported to disappear during exercises. The positive results of the application of art therapy (music therapy) are also described in the modern literature. Tеmporhythm correction methods hold a specific place in neurorehabilitation. There are considerable amount of studies concerning the application of tempo-rhythmic methods in neurology and psychiatry. It can be concluded that these methods are relevant worldwide and can be used in diagnostics and correction of neurological and psychiatric diseases (such as schizophrenia, Parkinson's disease, epilepsy).

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“…59 In a separate study of 29 patients followed for 11 years, DBS of the ANT resulted in a median 70% reduction in total seizures. 96 Similarly to RNS, the DBS trial reported implant site infections in 10% of patients; however, the authors also reported incorrect lead position in 8.2% of the cases (possibly due to variability between frame and frameless implantation procedures). 97 In addition, a 7-year mood and memory outcome study in the DBS trial revealed that 14.8% and 13% of the active stimulation group reported an adverse event related to depression and memory, respectively.…”

Section: Deep Brain Stimulationmentioning

confidence: 97%

“…It is important to note that after 5 years, 16% of patients had demonstrated seizure freedom in the previous 6 months (Table ) . In a separate study of 29 patients followed for 11 years, DBS of the ANT resulted in a median 70% reduction in total seizures …”

Section: Neurostimulation To Treat Epilepsymentioning

confidence: 99%

Clinically indicated electrical stimulation strategies to treat patients with medically refractory epilepsy

et al. 2018

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SummaryFocal epilepsies represent approximately half of all diagnoses, and more than one‐third of these patients are refractory to pharmacologic treatment. Although resection can result in seizure freedom, many patients do not meet surgical criteria, as seizures may be multifocal in origin or have a focus in an eloquent region of the brain. For these individuals, several U.S. Food and Drug Administration (FDA)–approved electrical stimulation paradigms serve as alternative options, including vagus nerve stimulation, responsive neurostimulation, and stimulation of the anterior nucleus of the thalamus. All of these are safe, flexible, and lead to progressive seizure control over time when used as an adjunctive therapy to antiepileptic drugs. Focal epilepsies frequently involve significant comorbidities such as cognitive decline. Similar to antiepilepsy medications and surgical resection, current stimulation targets and parameters have yet to address cognitive impairments directly, with patients reporting persistent comorbidities associated with focal epilepsy despite a significant reduction in the number of their seizures. Although low‐frequency theta oscillations of the septohippocampal network are critical for modulating cellular activity and, in turn, cognitive processing, the coordination of neural excitability is also imperative for preventing seizures. In this review, we summarize current FDA‐approved electrical stimulation paradigms and propose that theta oscillations of the medial septal nucleus represent a novel neuromodulation target for concurrent seizure reduction and cognitive improvement in epilepsy. Ultimately, further advancements in clinical neurostimulation strategies will allow for the efficient treatment of both seizures and comorbidities, thereby improving overall quality of life for patients with epilepsy.

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Long-term follow-up of anterior thalamic deep brain stimulation in epilepsy: A 11-year, single center experience

Cited by 59 publications

References 29 publications

Estimating Risk for Future Intracranial, Fully Implanted, Modular Neuroprosthetic Systems: A Systematic Review of Hardware Complications in Clinical Deep Brain Stimulation and Experimental Human Intracortical Arrays

Estimating Risk for Future Intracranial, Fully Implanted, Modular Neuroprosthetic Systems: A Systematic Review of Hardware Complications in Clinical Deep Brain Stimulation and Experimental Human Intracortical Arrays

The Role of Nondrug Treatment Methods in the Management of Epilepsy

Clinically indicated electrical stimulation strategies to treat patients with medically refractory epilepsy

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