Neurostimulation treatments for epilepsy: Deep brain stimulation, responsive neurostimulation and vagus nerve stimulation

Gouveia, Flavia Venetucci; Warsi, Nebras M.; Suresh, Hrishikesh; Matin, Rafi; Ibrahim, George M.

doi:10.1016/j.neurot.2023.e00308

Cited by 3 publications

(1 citation statement)

References 91 publications

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“…Vagus Nerve Stimulation (VNS) is a therapeutic method that employs electrical impulses to activate the vagus nerve, a component of the autonomic nervous system. Although widely recognized for its efficacy in treating epilepsy [ 88 ] and depression [ 89 ], VNS has also been investigated in chronic pain [ 90 ]. VNS involves the surgical placement of a stimulator device, delivering regular electrical impulses, connected to electrodes stimulating the vagus nerve.…”

Section: Introductionmentioning

confidence: 99%

Anatomo-physiological basis and applied techniques of electrical neuromodulation in chronic pain

Guzzi,

Della Torre,

Bruni

et al. 2024

J Anesth Analg Crit Care

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Chronic pain, a complex and debilitating condition, poses a significant challenge to both patients and healthcare providers worldwide. Conventional pharmacological interventions often prove inadequate in delivering satisfactory relief while carrying the risks of addiction and adverse reactions. In recent years, electric neuromodulation emerged as a promising alternative in chronic pain management. This method entails the precise administration of electrical stimulation to specific nerves or regions within the central nervous system to regulate pain signals. Through mechanisms that include the alteration of neural activity and the release of endogenous pain-relieving substances, electric neuromodulation can effectively alleviate pain and improve patients' quality of life. Several modalities of electric neuromodulation, with a different grade of invasiveness, provide tailored strategies to tackle various forms and origins of chronic pain. Through an exploration of the anatomical and physiological pathways of chronic pain, encompassing neurotransmitter involvement, this narrative review offers insights into electrical therapies’ mechanisms of action, clinical utility, and future perspectives in chronic pain management.

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Section: Introductionmentioning

confidence: 99%

Anatomo-physiological basis and applied techniques of electrical neuromodulation in chronic pain

Guzzi,

Della Torre,

Bruni

et al. 2024

J Anesth Analg Crit Care

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Deep brain stimulation: a promising approach to revolutionize the treatment of pediatric epilepsy

Ali,

Amer

2024

Neurosurg Rev

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Long-term effects of vagus nerve stimulation on EEG aperiodic components in patients with drug-resistant epilepsy

Yang,

Wang,

Wang

et al. 2024

Ther Adv Neurol Disord

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Background: Drug-resistant epilepsy (DRE) affects approximately one-third of epilepsy patients who do not achieve adequate seizure control with medication. Vagus nerve stimulation (VNS) is an adjunctive therapy for DRE, but its long-term effects on cortical excitability remain unclear. Objectives: This study aims to elucidate the long-term effects of VNS on electroencephalography (EEG) aperiodic components in patients with DRE. Our objective is to identify biomarkers that can serve as indicators of therapeutic efficacy and provide mechanistic insights into the underlying neural processes. Design: This longitudinal observational study focused on patients with DRE undergoing VNS therapy at Sanbo Brain Hospital. The reduction in seizure frequency rates was quantified over short-term (⩽1 year), medium-term (1–3 years), and long-term (⩾3 years) intervals to assess the therapeutic efficacy of VNS. Both the periodic and aperiodic components of EEG data were analyzed. Methods: Advanced signal processing techniques were utilized to parameterize the periodic and aperiodic components of EEG data, focusing particularly on “offset” and “exponent.” These measures were compared before and after VNS therapy. Correlation analyses were conducted to explore the relationship between these EEG parameters and clinical outcomes. Results: In all, 18 patients with DRE participated in this study. During the long-term follow-up period, the responder rate was 55.56%. Significant decreases were observed in aperiodic offset ( p = 0.022) and exponent ( p = 0.039) among responders. The impact of age on these results was not significant. Correlation analyses revealed a negative association between therapeutic efficacy and a decrease in offset ( R = −0.546, p = 0.019) and exponent ( R = −0.636, p = 0.019). Conclusion: EEG aperiodic parameters, including offset and exponent, have the potential to serve as promising biomarkers for evaluating the efficacy of VNS. An understanding of the regulatory influence of VNS on cortical excitability through these aperiodic parameters could provide a basis for the development of more effective stimulation parameters and therapeutic strategies.

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Neurostimulation treatments for epilepsy: Deep brain stimulation, responsive neurostimulation and vagus nerve stimulation

Cited by 3 publications

References 91 publications

Anatomo-physiological basis and applied techniques of electrical neuromodulation in chronic pain

Anatomo-physiological basis and applied techniques of electrical neuromodulation in chronic pain

Deep brain stimulation: a promising approach to revolutionize the treatment of pediatric epilepsy

Long-term effects of vagus nerve stimulation on EEG aperiodic components in patients with drug-resistant epilepsy

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